一位接受經尿道前列腺切除術(TURP)的病人正進行連續膀胱沖洗(CBI)。下列何種徵象需要立即通知醫師?(選所有適合的)
A nurse is caring for a client with a continuous bladder irrigation (CBI) following a transurethral resection of the prostate (TURP). Which findings require immediate notification of the provider? (Select all that apply.)
- ABright red drainage with clots✓ 正解帶有血塊的鮮紅色引流液
- BDrainage output less than irrigation input✓ 正解引流量少於沖洗液輸入量
- CClient reports bladder spasms案主表示有膀胱痙攣
- DPinkish-tinged urine output尿液呈現淡粉紅色
- EAbsence of output despite high-pressure irrigation✓ 正解儘管高壓沖洗卻無引流液排出
TURP 術後 CBI 的目標是保持引流管暢通且尿液顏色轉為淺粉紅。鮮紅色出血伴隨血塊表示動脈出血;引流量小於沖洗量或完全無尿,顯示引流管阻塞,若不立即處理會導致膀胱破裂風險。膀胱痙攣(C)雖不適但屬術後常見現象,粉紅色尿液(D)則是期待的臨床結果。
The goals of CBI after TURP are to keep the drainage tube patent and to clear urine to a light pink color. Bright red drainage with clots indicates arterial bleeding; drainage less than irrigation input or no output indicates a blocked catheter, which can rupture the bladder if not addressed immediately. Bladder spasms (C) are uncomfortable but expected after surgery, and pink-tinged urine (D) is the desired clinical progression.
CBI 護理在兩地泌尿科病房皆為常規,但台灣護理師常需負擔較多術後衛教與導管維護成本。