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1. Continuous bladder irrigation: A three-way (lumen) irrigation is used to de-
crease bleeding and to keep the bladder free from clots—one lumen is for inflating
the balloon (30 mL); one lumen is for instillation (inflow); one lumen is for outflow.
Continuous irrigation may be used with TURP.
The amount of fluid recovered in the drainage bag must equal the amount of fluid
instilled -- secondary hemorrhage may occur from overdistension
2. Urethritis: Common in postmenopausal women
Low estrogen levels decrease moisture and secretions in the perineal area, predis-
posing it to the development of infection
Testing: STI, multiple dipstick, leukocyte esterase, nitrite testing, x-ray, CT, ultra-
sonography, kidney scans
3. Renal Calculi Risk Factors: 1. Kidney diseases: Polycystic kidney disease,
horseshoe kidneys, chronic strictures, and medullary sponge disease
2. IBD, ileostomy, bowel resection
3. Medications: Antacids, acetazolamide (Diamox), vitamin D, laxatives, and high
doses of aspirin
4. Calculi pain: Requires immediate attention
IV or IM opioids
IV NSAIDs
If pain increases, notify HCP
5. Imitrex contraindications: Ischemic heart disease
St. John's wort
6. Seizures: Assessment
· History, factors/precipitating events, alcohol, aura
Planning and Goals
· Prevention of injury, control seizures, psychosocial adjustment, understanding,
absence of complications
Nursing Interventions
· Prevent injury, seizure precautions
Reducing Fear of Seizures
· Adhere to prescribed treatment, take on a regular basis, monitor for drug resistance
Precipitating factors:
, Milestone 2 retake
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· Emotional disturbances, new environmental stressors, onset of menstruation, fever,
change in lifestyle routine, bright flickering lights, stress, alcohol
Monitoring and Managing Potential Complications
· Status epilepticus
· Toxicity of meds
7. Hyperthyroidism signs/symptoms: Ophthalmopathy - exophthalmos (abnor-
mal protrusion of one or both eyeballs), (not always reversible)
Nervousness: Hyperexcitable, irritable, apprehensive, · cannot sit quietly, fine hand
tremor
Cardiac: palpitations, rapid pulse, A-fib (new onset in adults), fatigability, weakness
Skin: tolerate heat poorly, perspire, flushed skin, dry skin, diffuse pruritus
GI: · amenorrhea, changes in bowel function, increased appetite, weight loss
8. Exophthalmos-POC: Assessment:
- Vision changes, trauma, visual acuity
Treatments:
- Antibiotic eyedrops if infection is the underlying cause
- Antithyroid therapy (propylthiouracil, methimazole), if Graves' disease is the under-
lying cause
- Corticosteroids for optic neuropathy
- Eye lubricants (artificial tears)
- Surgery if vision is threatened
General:
- Cold/warm compresses (trauma)
- Eye protection (sunglasses)
Testing:
- CT, MRI, ultrasonography
9. Sensory perception peripheral neuropathy: The heels are particularly suscep-
tible to breakdown because of loss of sensation of pain and pressure associated
with sensory neuropathy.
The skin is assessed for dryness, cracks, breakdown, and redness, especially at