Final answer:
The nurse should monitor the client's fluid intake and output, facilitate safe bathroom access, treat pain during urination, and possibly use a urinary catheter to manage urinary retention in a client with stage IV prostate cancer.
Step-by-step explanation:
The nurse has identified a problem of urinary retention in a client diagnosed with stage IV cancer of the prostate. The presence of symptoms such as difficulty initiating urination or emptying the bladder completely, frequent urination, painful urination, and potential blood in the urine are common with advanced prostate cancer affecting the urethra passing through the prostate gland.
Considering Robert's history and symptoms, a clear intervention would be to ensure that he is adequately hydrated, monitor his fluid intake and output, support him in safely navigating to the bathroom, and manage any pain associated with urination. A urinary catheter may also be necessary to relieve retention.
The nurse should collaborate with healthcare providers to further assess and potentially treat any underlying urinary tract infections (UTIs), which could be exacerbating his symptoms, as indicated by a fever and dysuria. Advanced prostate cancer and prostate conditions, alongside a weakened immune system in the elderly, can significantly increase the risk for UTIs, which can further impact cognitive functions as seen in Robert's episodes of confusion and delirium.