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Chapter 22: Problem 38

Intravesical instillations of \(\mathrm{BCG}\) vaccine have been ordered for a client with bladder cancer. Prior to the procedure the nurse should: A. Offer the client additional fluids B. Administer pain medication C. Assist the client to the bathroom D. Request an \(x\)-ray of the bladder

Short Answer

Expert verified
Answer: Assist the client to the bathroom.

Step by step solution

01

Analyze Option A - Offer the client additional fluids

Offering additional fluids to the client before the procedure might increase the need for voiding, leading to the bladder not holding the BCG vaccine for the desired time. This option is therefore not suitable.
02

Analyze Option B - Administer pain medication

Administering pain medication before the procedure might be helpful but it is not the first priority or crucial step for the nurse to take. Pain medication can be given when necessary during or after the instillation procedure.
03

Analyze Option C - Assist the client to the bathroom

Assisting the client to the bathroom before the procedure ensures that the client has an empty bladder to accommodate the BCG solution, minimizing the risk for premature voiding of the solution. Hence, this option is a necessary step that the nurse should take before instillation.
04

Analyze Option D - Request an x-ray of the bladder

Requesting an x-ray of the bladder is not a necessary step in preparing a client with bladder cancer for an intravesical BCG instillation. The x-ray results are not required to proceed with the treatment and are not relevant for the nurse's immediate preparation actions.
05

Determine the correct answer

Based on the analysis of the four options, option C - "Assist the client to the bathroom" is the most suitable action for the nurse to take before the intravesical instillation of the BCG vaccine.

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