Page 1867 - Saunders Comprehensive Review For NCLEX-RN

C. Interventions
1. Encourage fluid intake of up to 2000 to 3000 mL/day
unless contraindicated.
2. Prepare for urinary catheterization to drain the
bladder and prevent distention.

3. Avoid administering medications that cause

urinary retention, such as anticholinergics,
antihistamines, decongestants, and antidepressants.
4. Administer medications as prescribed to shrink the
prostate gland and improve urine flow.
5. Administer medications as prescribed to relax
prostatic smooth muscle and improve urine flow.
6. Instruct the client to decrease intake of caffeine and
artificial sweeteners and limit spicy or acidic foods.
7. Instruct the client to follow a timed voiding schedule.
8. Prepare the client for surgery or invasive procedures
as prescribed (Figs. 54-7 and 54-8).
D. Surgical interventions and postoperative care (see Chapter 44)
XXVI. Bladder Cancer: Refer to Chapter 44
XXVII. Bladder Trauma
A. Description
1. Occurs following a blunt or penetrating injury to the
lower abdomen
2. Blunt trauma causes compression of the abdominal
wall and bladder.
3. Penetrating wounds occur as a result of a stabbing,
gunshot wound, or other objects piercing the
abdominal wall.
4. A fractured pelvis that causes bone fragments to
puncture the bladder is a common cause of bladder
trauma.
B. Assessment
1. Anuria
2. Hematuria
3. Pain below the level of the umbilicus; can radiate to
the shoulders
4. Nausea and vomiting
C. Interventions
1. Monitor vital signs.

2. Monitor for hematuria, bleeding, and signs of

shock.
3. Maintain bed rest.
4. If blood is seen at the meatus, avoid urinary
catheterization until a retrograde ureterogram can be
obtained.

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