After undergoing transurethral resection of the prostate to treat benign prostatic hyperplasia, a male client returns to the room with continuous bladder irrigation. On the first day after surgery, the client reports bladder pain. What should Nurse Anthony do first?
A. Increase the I.V. flow rate.
B. Notify the physician immediately.
C. Assess the irrigation catheter for patency and drainage.
D. Administer meperidine (Demerol), 50 mg I.M., as prescribed.
Correct Answer: C. Assess the irrigation catheter for patency and drainage.
Although postoperative pain is expected, the nurse should make sure that other factors, such as an obstructed irrigation catheter, aren’t the cause of the pain. Palpate bladder to determine presence of distention. Check drainage tubing for kinks. Observe drainage for an adequate amount, presence of clots that might be blocking drainage tubes. Evaluate I & O. Avoid cold irrigation solution as it may cause bladder spasm.
Option A: Increasing the I.V. flow rate may worsen the pain. If there is increased bloody drainage or presence of clots, the nurse may increase the rate of irrigation infusion as per physician’s orders. If a large amount of blood or clots persists, notify the physician.
Option B: Notifying the physician isn’t necessary unless the pain is severe or unrelieved by the prescribed medication. Complete pain assessment using the 0-10 or visual analogue scale.
Option D: After assessing catheter patency, the nurse should administer an analgesic, such as meperidine, as prescribed. To help prevent urinary tract obstruction by flushing out small blood clots that form after prostate or bladder surgery. Check the inflow and outflow lines periodically for kinks, to make sure the solution is running freely.
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