A client undergoes transurethral resection of the prostate for benign prostatic hyperplasia. The client has a 3-way Foley catheter with continuous bladder irrigation. Which assessment is the best indication that the bladder irrigation flow rate is productive?

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11ecbb05_ca7b_bc62_b433_fd011b35ca02_MD0009_00 Transurethral resection of the prostate (TURP) involves the insertion of a scope to remove obstructing prostate tissue. Continuous bladder irrigation (CBI) with a 3-way Foley catheter is initiated after the procedure. The catheter balloon applies direct pressure to the bleeding tissue while the tubing allows the urine to drain. During the first 24 hours, the urine color changes from reddish-pink to pink. Small clots are also expected for up to 36 hours after surgery. However, the nurse should adjust the irrigation rate with these normal findings so that the urine remains light pink without clots (Option D). (Option A) Vital signs within normal limits indicate hemodynamic stability but will not reflect the patency of the draining catheter. (Option B) Painful bladder spasms are expected after TURP and catheter placement. Spasms are typically treated with antispasmodics (eg, belladonna-opium suppositories, oxybutynin [Ditropan]). (Option C) The total Foley output should be more than the CBI input, as the Foley output includes CBI fluid (not processed through the kidneys) plus the normal renal output of urine. An obstruction is indicated if the CBI input is equal to or greater than the Foley output. Educational objective: A 3-way Foley catheter with continuous bladder irrigation allows urine to drain after a transurethral resection of the prostate. During the first 24 hours, the urine color changes from reddish-pink to pink. Small clots may occur for up to 36 hours. However, the nurse adjusts the irrigation flow to keep the urine light pink without clots.

A Client Undergoes Transurethral Resection of the Prostate for Benign