Simple Nursing

• Benign Prostatic Hyperplasia - TURP


  Transurethral resection of the prostate - less invasive as an instrument inserted directly through the urethra to remove the prostate.

  -3 way foley catheter is used for Continuous bladder irrigation. This gives pressure to bleeding tissue & allows urine drainage.
• Benign Prostatic Hyperplasia - Prostatectomy


  MORE invasive as a surgical incision is made.

  3 way foley catheter is used for Continuous bladder irrigation. This gives pressure to bleeding tissue & allows urine drainage.
• Prostatectomy 5 days ago... small blood clots. First action?


  Advise client to follow up with HCP immediately
• Benign Prostatic Hyperplasia TEST TIP


  • Assess amount & urine output; Light pink color - BEST
  • Output = MORE than input NOT "equal to" or "less than"
• CROHN'S DISEASE & ULCERATIVE COLITIS NURSING CARE FLUID & E+


  • Strict I & O monitoring
  • 2 Liters of water daily + more with with diarrhea
  • Hypokalemia low potassium 3.5 or less
  • Daily multivitamins containing Calcium
• CROHN'S DISEASE & ULCERATIVE COLITIS DIET


  • High: Protein & Calories
  • Low: Fiber
  • Keep food journal NCLEX TIP
  • Small frequent meals
• CROHN'S DISEASE & ULCERATIVE COLITIS Nursing Care


  • Pain - administer analgesics
  • AVOID Alcohol
  • Reduce Caffeine (coffee, tea)
  • PsychoSocial
  • Stress reduction
  • Encourage clients to discuss feelings
• Client with ulcerative colitis interventions


  1. Discuss plans to decrease client's stress
  2. Give analgesics as prescribed
  3. Increase protein foods with meals
  4. Monitor I & O closely
• CROHN'S DISEASE & ULCERATIVE COLITIS Complication - PERITONITIS


  • Fever (over 100.3F)
  • Rebound tenderness
  • "Rigid" or "board-like abdomen"
  • Increasing Pain, tenderness
  • Restless
  • Fast HR & RR (tachycardia/tachypnea)
• CROHN'S DISEASE & ULCERATIVE COLITIS Complication


  Bowel Rupture from a toxic megacolon, which can lead to peritonitis (Deadly infection in the peritoneal cavity)
• Sulfasalazine


  "STOPS body attacking itself"

  
  

  (CROHN'S DISEASE & ULCERATIVE COLITIS)
• PredniSONE


  Steroids "Sooth the Swelling"

  (CROHN'S DISEASE & ULCERATIVE COLITIS)
• Loperamide


  "Low bowel movements"

  • Antidiarrheal

  (CROHN'S DISEASE & ULCERATIVE COLITIS)
• Dicyclomine


  "Dry Cycle"

  • Antidiarrheal

  (CROHN'S DISEASE & ULCERATIVE COLITIS)
• ISOTONIC


  think "I-SO-perfect"

  these solutions have perfect balance (equilibrium) of solutes both inside & outside of the cell, therefore no fluid shifts are made. Human blood is isotonic thus very little osmosis occurs, since isotonic solutions have the same osmolality as body fluids
• ISOTONIC Caution


  • too much isotonic
  • Fluid volume overload!
  • Monitor: Blood Pressure
  • Key Manifestations: Hypertension
  • BP over 180/systolic
  • Risk for CVA stroke
• ISOTONIC fluids


  • 0.9% Sodium Chloride (normal saline)
  • Lactated Ringer's (LR)
• ISOTONIC fluids - NS / LR - Uses


  • Hypotension (low blood pressure)
  • Blood transfusion
  • Hemorrhaging (blood loss)
  • DKA (type 1 diabetic disorder)
  • HHNS (type 2 diabetic disorder)
• HYPOTONIC


  HYPO-tonic think LOW

  (cells swell with fluid)

  MEMORY TRICK

  • A lot of numbers
  • A lot of fluid in the cell!

  these solutions have a LOWer osmolarity & LOWer concentration of solutes than body fluids. they cause the movement of water into cells by osmosis, swelling the cells like a BIG fat hippo, & therefore should be administered slowly to prevent cellular edema
• HYPOTONIC caution


  • Give slowly to prevent
  • cellular edema & cerebral swelling
  • NOT for:
  • ICP (intracranial pressure)
• HYPOTONIC Manifestations to monitor


  • Cerebral Edema
  • Headache
  • Mental Status Changes
  • "Altered level of consciousness"
  • New confusion, restless, agitated
  • Seizures & Coma
• HYPOTONIC fluids


  • 0.45% Sodium Chloride (1/2 NS)
  • 0.225% Sodium Chloride (1/4 NS)
  • 0.33% Sodium Chloride (1/3 NS)
  • 5% Dextrose in 0.225% Saline (D51/4NS)
  • 5% Dextrose in Water (D5W)
  • SIDE NOTE:
  • D5W
  • Isotonic in bag
  • HYPO tonic in body
• HYPOTONIC - Used for Cellular Dehydration


  • Hypernatremia (Sodium over 145 mEq/L)
• HYPERTONIC


  HYPER-tonic think HIGH & dry

  HIGHER Osmolarity than body fluids

  MEMORY TRICK

  • HYPER - tonic
  • HYPER person (very skinny cells)
  • very little numbers
  • very little fluid in the cell

  these solutions have a HIGHER osmolarity & HIGHER concentration solutes than body fluids. they are very thick salty solutions having more solutes & less water, causing water to be moved outside the cells & making the cells skinny like a hyper person
• HYPERTONIC caution


  Give slowly to prevent:

  • Cellular dehydration
  • Fluid volume overload!
  • Monitor: Blood Pressure
  • Key Manifestation:
  • BP over 180/systolic
  • Risk for CVA stroke
• HYPERTONIC fluids


  • 3% Sodium Chloride (3% NS)
  • 5% Sodium Chloride (5% NS)
  • 10% Dextrose in Water (D10W)
  • 5% Dextrose in 0.45% Sodium Chloride (D51/2NS)
  • 5% dextrose in Lactated Ringer's (D5LR)
• HYPERTONIC used for clients


  • Hypovolemia
  • Heat related (heat exhaustion)
  • Peritonitis
  • Peritoneal Dialysis
• Creatinine


  (over 1.3) BAD KIDNEY
• GLUCOSE


  (70-110)

  
  

  Hypogly = Brain Die
• White Blood Cell (WBC)

  
  

  (5,000-10,000) HIGH = Infection
• Red Blood Cell (RBC)

  M (4.7-6.1)

  F (4.22-5.4)

  
  

  Low = anemia
• Normal hemoglobin range

  • M (14-18)
  • F (12-16)
• Below 7 = Blood Transfusion
• Antiplatelet drugs

  • AsaParin
  • CloPidogrel