A nurse is caring for a client who is receiving continuous bladder irrigation following a transurethral resection of the prostate (TURP). The client reports sharp lower abdominal pain. Which of the following actions should the nurse take first?
A.
Increase the client’s fluid intake.
B.
Check the client’s urine output.
C.
Reposition the client in bed.
D.
Administer PRN pain medication.
The Correct Answer and Explanation is:
The correct answer is B. Check the client’s urine output.
Explanation:
A transurethral resection of the prostate (TURP) is a common surgical procedure to remove portions of the prostate gland in men with benign prostatic hyperplasia (BPH). Following this procedure, continuous bladder irrigation (CBI) is used to prevent clot formation, maintain catheter patency, and flush out blood and other debris from the bladder. Continuous bladder irrigation involves the use of a three-way Foley catheter, with one port for inflating the balloon, one port for irrigation fluid inflow, and another port for urine outflow.
When a client reports sharp lower abdominal pain after TURP surgery, it may be a sign of bladder distension, which can occur due to a blockage in the urinary catheter. Bladder distension can cause significant discomfort and can lead to complications such as bladder rupture or damage if not addressed promptly. The most common cause of this blockage is the formation of blood clots or debris, which can obstruct the flow of urine.
Checking the client’s urine output (Option B) should be the first action. This assessment will help determine if the urinary catheter is patent or if there is an obstruction preventing urine from draining properly. If little to no urine is draining despite continuous irrigation, it indicates that there may be a blockage, and the nurse will need to intervene by irrigating the catheter manually to dislodge any clots.
Other options should not be prioritized over assessing urine output:
- Increasing the client’s fluid intake (Option A) could exacerbate bladder distension if there is a blockage, causing more discomfort.
- Repositioning the client (Option C) might provide temporary comfort but does not address the root cause of the pain.
- Administering PRN pain medication (Option D) may mask the symptoms and delay identifying the underlying problem.
Thus, assessing urine output is the most critical first step in identifying and addressing the cause of the client’s pain.