A client undergoes a transurethral resection, prostate (TURP). He returns from surgery with a three- way continuous Foley irrigation of normal saline…

Following a transurethral resection of the prostate (TURP), the prostatic fossa has a raw, bleeding surface. Continuous bladder irrigation (CBI) is a standard postoperative intervention used to flush the bladder with a sterile irrigant, typically normal saline. The primary purpose of this continuous flow is to prevent blood from stagnating and forming clots within the bladder. These clots can obstruct the Foley catheter, leading to acute urinary retention, bladder distention, and significant pain. The irrigation rate is titrated to keep the urinary drainage light pink or clear, ensuring catheter patency.

A. Bladder spasms: While CBI can help reduce spasms by preventing the formation of irritating clots, its primary purpose is clot prevention, not the direct prevention of spasms.

C. Scrotal edema: This is a potential complication related to inflammation or lymphatic drainage issues post-surgery and is not influenced by bladder irrigation.

D. Prostatic infection: The primary goal of CBI is mechanical flushing to prevent obstruction, not antimicrobial action. Aseptic technique is the main strategy to prevent infection.

1. Lewis, S. L., Dirksen, S. R., Heitkemper, M. M., & Bucher, L. (2017). Medical-Surgical Nursing: Assessment and Management of Clinical Problems (10th ed.). Elsevier. In the chapter on Nursing Management: Male Reproductive Problems, the text states, "The bladder is irrigated, either continuously or intermittently... to remove blood clots and ensure drainage of urine" (p. 1263).

2. University of Virginia School of Nursing. (n.d.). GNUR 5140: Adult Health Nursing II Course Materials. In the module covering Benign Prostatic Hyperplasia and surgical management, the rationale for post-TURP continuous bladder irrigation is explicitly identified as the prevention of blood clot formation and maintenance of catheter patency.

3. Rassweiler, J., Teber, D., Kuntz, R., & Hofmann, R. (2006). Complications of transurethral resection of the prostate (TURP)—incidence, management, and prevention. European Urology, 50(5), 969-980. https://doi.org/10.1016/j.eururo.2005.12.047. This article discusses postoperative management, noting that irrigation is essential to "prevent clot retention" (Section 5.1, Postoperative complications).