After transurethral resection of the prostate with continuous bladder irrigation, a patient reports bladder pain on the first postoperative day. What should the nurse do first?

• A. Increase the IV flow rate
• B. Notify the physician
• C. Assess the irrigation catheter for patency and drainage
• D. Administer meperidine

Answer: (C)

A key concept here is that bladder pain after TURP with continuous bladder irrigation is often caused by obstruction of the irrigation system, leading to bladder distention. The first step is to check the irrigation catheter for patency and drainage. If the catheter or tubing is kinked, clogged with clots, or not draining properly, the bladder cannot empty and pain increases. By assessing and clearing any blockage or restoring patency, you directly address the most common and reversible cause of the symptom.

So, begin by inspecting the catheter and tubing: ensure there are no kinks, verify that irrigation solution is flowing, confirm there’s adequate drainage into the collection bag, and look for clots in or around the catheter. If patency is compromised, clear the blockage or irrigate as prescribed and reassess the patient. If the catheter is patent and drainage is adequate but pain persists, then evaluate for bladder spasms or other issues and escalate care accordingly.