Urinary Disorders Q 139 - Gyan Darpan : Learning Portal
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Monday 4 April 2022

Urinary Disorders Q 139

A client had a transurethral prostatectomy for benign prostatic hypertrophy. He’s currently being treated with a continuous bladder irrigation and is complaining of an increase in severity of bladder spasms. Which of the interventions should be done first?
    A. Administer an oral analgesic.
    B. Stop the irrigation and call the physician.
    C. Administer a belladonna and opium suppository as ordered by the physician.
    D. Check for the presence of clots and make sure the catheter is draining properly.

Correct Answer: D. Check for the presence of clots, and make sure the catheter is draining properly.

Blood clots and blocked outflow of urine can increase spasms. Bladder irrigation helps remove and prevent blood clots in the bladder. The blood clots stop urine from flowing through the catheter. The urine collects in the bladder and causes pain that gets worse as the bladder fills.

Option A: Oral analgesics should be given if the spasms are unrelieved by the belladonna and opium suppository. Pain is a common symptom after endoscopic urologic surgery, and the need for effective pain management is obvious. Pain after TURP is due to bladder spasms and the catheter thus differs from open operations. The ideal postoperative analgesic treatment should provide rapid and effective pain relief, have a low incidence of adverse effects, and a minimal impact on organ systems or no significant interaction with other pharmacologic agents.
Option B: The irrigation shouldn’t be stopped as long as the catheter is draining because clots will form. The client can expect some discomfort with the catheter in place. At the start of the irrigation, the urine will be bloody and may have blood clots in it. As the irrigation continues, the urine should become pink and clear. The healthcare providers will empty the drainage bag frequently. The bladder irrigation will be stopped when the client has had clear or slightly pink urine for 1 to 2 days.
Option C: A belladonna and opium suppository should be given to relieve spasms but only after assessment of the drainage. Belladonna and Opium Suppositories (B & O Suppositories) relax the muscles in the rectum, vagina, or bladder. They may also help with relieving pain by decreasing spasms.

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