Health guidance after bladder irrigation

Answer: c

Postoperative care: (1) rest diet: after lying flat for 2 days, change to semi-lying position. If there is no nausea and vomiting, you can enter a liquid diet, drink more water, increase urine volume and flush the urinary tract 6 hours after operation. (2) Observe the condition: closely observe the state of consciousness and vital signs, and pay attention to whether there is bleeding. (3) Nursing care of the balloon catheter: it should be properly pulled and fixed on the inner thigh of the patient's side for 8 ~ 10h, and the patient should be told not to loosen or curl the leg by himself, so that it can play the role of compression and hemostasis. The catheter can be removed 3 ~ 5 days after transurethral prostatectomy. (4) Bladder irrigation: After operation, the bladder was continuously irrigated with normal saline for 3-5 days. The flushing speed should be determined according to the color of urine, with fast color depth and slow color light. If the drainage is not smooth, high-pressure irrigation and blood coagulation should be carried out in time to avoid bladder filling and bladder spasm and aggravate bleeding. Record urine volume and urine volume, urine volume = urine volume-urine volume. (5) Pain nursing: Postoperative bladder spasm can cause paroxysmal abdominal pain and also induce bleeding. The causes of bladder spasm include bladder filling caused by hematocele, stimulation of catheter in bladder, instability of bladder detrusor, low temperature of irrigation solution (below 20℃) and so on. When abdominal pain occurs, patients should be instructed to use analgesic pump to relieve pain, or nifedipine, propylamine, diazepam or verapamil should be given according to the doctor's advice, and bladder irrigation should be added to normal saline to relieve pain. (6) Take good care of all drainage tubes: besides balloon catheter, there may also be retropubic drainage tubes and cystostomy tubes. And take good care of them as usual. (7) Prevention of infection: use antibacterial drugs according to the doctor's advice and do a good job in urethral orifice nursing; Observe signs of infection such as fearless cold, fever, epididymal swelling and pain. (8) Nursing care of complications: ① Postoperative bleeding: If hematuria is dark red or gradually deepened, it indicates that there is active bleeding, and timely assistance should be given. After operation, you can get out of bed gradually 1 week to avoid exertion and constipation, and it is forbidden to enema or anal exhaust to prevent delayed bleeding of prostate fossa. ②TUR syndrome: It refers to a clinical syndrome in which a large amount of flushing fluid is absorbed during transurethral resection of prostate, which makes the blood volume increase sharply and forms diluted hyponatremia. Patients may experience irritability, nausea, vomiting, convulsions and coma within a few hours, and in severe cases, pulmonary edema, cerebral edema and heart failure. Once it happens, you should immediately slow down the infusion speed, take oxygen, and give diuretics, dehydrating agents and cardiotonic agents. (3) Urinary incontinence: Frequent urination and urinary incontinence may occur after the catheter is removed. Therefore, the patient is instructed to exercise the contraction of abdominal muscles, gluteal muscles and anal sphincter 2-3 days after operation to restore the function as soon as possible; It can also be supplemented by acupuncture or physical therapy. Generally, symptoms can be relieved after 1-2 weeks. (9) Rehabilitation guidance: Avoid strenuous activities (running, cycling, sexual life, etc. After 1 ~ 3 months, continue to exercise levator ani and restore the function of urethral sphincter as soon as possible.