A nurse is assessing a client who is postoperative following a transurethral resection of the prostate and is receiving continuous bladder irrigation. The client reports bladder spasms, and the nurse notes a scant amount of fluid in the urinary drainage bag. Which of the following actions should the nurse take?
A. Apply a cold compress to the suprapubic area.
B. Secure the urinary catheter to the upper left quadrant of the client’s abdomen.
C. Use 0.9% sodium chloride to perform an intermittent bladder irrigation.
D. Encourage the client to urinate every 2 hr.
The Correct answer and Explanation is:
The correct answer is C. Use 0.9% sodium chloride to perform an intermittent bladder irrigation.
Explanation:
In a postoperative setting following a transurethral resection of the prostate (TURP), continuous bladder irrigation (CBI) is often utilized to prevent blood clots and maintain urine patency. The client’s report of bladder spasms and the observation of scant fluid in the urinary drainage bag suggest a potential obstruction in the catheter or bladder spasm caused by irritation from the surgery or a clot formation.
- Understanding Bladder Irrigation: Continuous bladder irrigation is crucial after TURP to keep the catheter patent and prevent clots. If there’s inadequate drainage (indicated by scant urine output), it could mean the catheter is blocked or the bladder is not being adequately irrigated.
- Intermittent Irrigation: Performing intermittent bladder irrigation with 0.9% sodium chloride is an appropriate intervention to ensure the catheter is clear of any obstructions, such as blood clots. This solution is isotonic, ensuring that the bladder is not irritated further while flushing out any potential blockages. This step can alleviate bladder spasms by reducing irritation caused by clots.
- Inappropriate Options:
- A. Apply a cold compress to the suprapubic area: This may provide temporary relief for bladder spasms but does not address the underlying issue of possible obstruction or inadequate irrigation.
- B. Secure the urinary catheter to the upper left quadrant of the client’s abdomen: While securing the catheter is important, it will not relieve the bladder spasms or address the scant urine output.
- D. Encourage the client to urinate every 2 hr: After TURP, the client may not be able to urinate independently due to the catheter, and encouraging urination may cause more discomfort and does not resolve the issue of irrigation.
In summary, using 0.9% sodium chloride for intermittent bladder irrigation directly addresses the issue of potential obstruction while helping alleviate bladder spasms, making it the most appropriate nursing intervention in this scenario.