What is the most appropriate initial nursing action when a patient with TURP reports bladder spasms?

• A. Administer antispasmodics
• B. Irrigate the catheter manually
• C. Apply heat to the abdomen
• D. Stop continuous bladder irrigation

Answer: (A)

Bladder spasms after TURP come from irritation of the bladder and catheter. The most appropriate initial action is to give an antispasmodic to relax the detrusor muscle and relieve the contractions, which reduces the urge to void and the uncomfortable spasms. This helps improve comfort and urinary flow through the catheter. After giving the medication, reassess the patient’s relief, check catheter patency if spasms continue, and monitor for anticholinergic side effects like dry mouth or urinary retention. If spasms persist, evaluate for obstruction or clot formation and follow the ordered plan.

Manual irrigation would address possible obstruction but isn’t the first action for spasms themselves. Applying heat to the abdomen and stopping continuous bladder irrigation don’t target the spasm and could cause other issues, so they’re not the initial steps.