— 降低風險 · HARD · SATA —
病人行經尿道攝護腺切除術後進行連續膀胱沖洗，哪些情況須立即通知醫師？（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 warrant immediate notification of the provider? (Select all that apply.)
- ABright red, thick, clot-filled drainage✓ 正解鮮紅色、濃稠且充滿血塊的引流液
- BClient reports bladder spasms病人主訴膀胱痙攣
- CDrainage output is less than irrigation input✓ 正解引流輸出量少於灌洗輸入量
- DClear, light pink-tinged drainage清澈、淡粉紅色的引流液
- EClient reports urge to void病人主訴有排尿急迫感
— Explanation · 中文詳解 —
TURP 術後 CBI 的目標是維持引流液呈淡粉紅色。若引流液轉為鮮紅且帶有大量血塊（A），代表活動性出血，可能阻塞管路；若引流輸出量少於輸入量（C），暗示管路阻塞或膀胱過度充盈，皆為急症。膀胱痙攣（B）與尿急感（E）則是術後常見反應，可透過止痙攣藥物處理。
Bright red drainage with clots indicates active hemorrhage, and output less than input suggests catheter obstruction, both of which require immediate provider notification. Bladder spasms and an urge to void are expected postoperative findings managed with medication or reassurance.
✦ 台美臨床差異
台灣常規由護理師評估引流色澤，但對於 CBI 的流速調整權限，台灣相較美國較需遵循醫師明確指令。