The client underwent transurethral resection of the prostate gland 24 hours ago and is on continuous bladder irrigation. Nurse Yonny is aware that the following nursing interventions are appropriate?
A. Tell the client to try to urinate around the catheter to remove blood clots.
B. Restrict fluids to prevent the client’s bladder from becoming distended.
C. Prepare to remove the catheter.
D. Use aseptic technique when irrigating the catheter.
Correct Answer: D. Use aseptic technique when irrigating the catheter.
If the catheter is blocked by blood clots, it may be irrigated according to physician’s orders or facility protocol. The nurse should use sterile technique to reduce the risk of infection. Maintain a sterile catheter system. Provide regular catheter and meatal care with soap and water. Apply antibiotic ointment around the catheter site. Measures to prevent introduction of bacteria that may cause infection or sepsis.
Option A: Urinating around the catheter can cause painful bladder spasms. Ambulate with a drainage bag dependent. Avoids backward reflux of urine, which may introduce bacteria into the bladder. Encourage the patient to void when urge is noted but not more than every 2–4 hr per protocol.
Option B: Encourage the client to drink fluids to dilute the urine and maintain urine output. Encourage fluid intake to 3000 mL as tolerated. Limit fluids in the evening, once the catheter is removed. Maintains adequate hydration and renal perfusion for urinary flow. Reducing fluid intake at the right schedule decreases the need to void and interrupt sleep during the night.
Option C: The catheter remains in place for 2 to 4 days after surgery and is only removed with a physician’s order. Maintain continuous bladder irrigation (CBI), as indicated, in early postoperative period. Flushes bladder of blood clots and debris to maintain patency of the catheter and urine flow.
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