Six hours after a transurethral resection of the prostate, a patient reports abdominal pain and bladder distension. What action should the practical nurse take?

Six hours after a transurethral resection of the prostate, a patient reports abdominal pain and bladder distension. What action should the practical nurse take?

• A. Pain assessment
• B. Flushing of the continuous bladder irrigation catheter
• C. Decreasing the flow rate in the bladder irrigation
• D. Notifying the physician

Answer: (B)

When a patient starts having abdominal pain and bladder distension after a transurethral resection of the prostate, the priority is to restore bladder drainage by clearing the catheter obstruction. Continuous bladder irrigation is used to prevent clot formation, but clots can still block the catheter, causing the bladder to back up and distend. Flushing the irrigation catheter with sterile saline directly addresses the blockage, clears any clots, and re-establishes drainage, which relieves the distension and associated pain. After the flush, you’d recheck patency, monitor urine flow, and ensure the irrigation rate remains appropriate. If the distension or drainage obstruction recurs despite flushing, you would escalate by notifying the physician. The other options don’t relieve the immediate blockage: assessing pain alone doesn’t fix the drainage issue, decreasing the flow could worsen retention, and waiting for a physician without attempting to clear the obstruction misses the most direct, corrective action.

When a patient starts having abdominal pain and bladder distension after a transurethral resection of the prostate, the priority is to restore bladder drainage by clearing the catheter obstruction. Continuous bladder irrigation is used to prevent clot formation, but clots can still block the catheter, causing the bladder to back up and distend. Flushing the irrigation catheter with sterile saline directly addresses the blockage, clears any clots, and re-establishes drainage, which relieves the distension and associated pain. After the flush, you’d recheck patency, monitor urine flow, and ensure the irrigation rate remains appropriate. If the distension or drainage obstruction recurs despite flushing, you would escalate by notifying the physician. The other options don’t relieve the immediate blockage: assessing pain alone doesn’t fix the drainage issue, decreasing the flow could worsen retention, and waiting for a physician without attempting to clear the obstruction misses the most direct, corrective action.