About
Trans Urethral Radical Prostatectomy; Surgery to remove the prostate gland through the urethra.
Assess
Urinary drainage, irrigation, color of urine, presence of clots; assess incision if present, pain, vitals
Complications
Post-operative complications- infection, pneumonia, pain, paralytic ileus, constipation, blood clots
Hemorrhage, clots, urinary retention
Diagnosis
- Knowledge deficit related to post-operative care
- Acute pain related to surgical procedure
- Risk for urinary retention related to obstruction of urethra or clots in catheter
- Risk for infection related to invasive procedure and portal of entry from catheter
Goals
- The client will have slightly pink to clear urine output without clots.
- The client will state positive pain relief.
- The client will state understanding of pre-, intra-, and post-operative instructions.
Interventions
- Teach client what to expect prior to, during, and after procedure.
- Assess understanding of surgical procedure.
- Monitor VS post-operatively every 15 minutes X 2, every 30 minutes X 2, every hour X 2, than every four hours ( may have different guidelines for each clinical agency).
- Monitor urine output, color, clarity.
- Monitor for s/s of infection, urinary retention, excessive bleeding.
- Administer medicines ( analgesics, etc.) as ordered.
- Maintain a patent urinary catheter with continuous bladder irrigation as ordered.
- Perform intermittent manual irrigation of urinary catheter as indicated.
- Teach client methods to reduce post-operative complications ( incentive spirometry, early ambulation, etc).
- If going home with catheter, teach proper catheter care and application of a leg-bag.
- If catheter is ordered to be removed, monitor for urinary output and residuals as indicated.
- Monitor for signs/ symptoms of complications.
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