I am a new charge in LTC. We have a male post TURP that suffers from severe bladder spasms. No Ditropan order: MD made aware. Ordered see urologist if continues or worsens. Vicodan one given q 4 hours prn. The second vicodan was somewhat effective.
My questions are as follows: If the foley is patent and draining, is there a need to irrigate the foley? Can an irrigation of 30 cc be expected to return, or can it pool in the bladder of a resident in a supine position?
Do I remember correctly from nursing school
that bladder spasms used to be treated with belladonna and opium suppositories? Is this outdated now?
Thanks for being there for me guys!
May 17, '02
There may be some history of drug seeking. I will look into it on Monday. I'm off for the weekend. Here comes the sun?
I asked around today, but nobody heard of B&O for bladder spasms! Wish me luck. Thanks allnurse.com! Nice to have a world wide sounding board-LOL!
Last edit by cargal on May 17, '02
May 17, '02
Not to jump up on my soapbox but...
Drug seeking is no reason not to medicate someone. Does this patient have a history of drug abuse or other similar history? People in pain are going to "seek" medication to help alleviate pain... period.
In any case... a TURP is painful and the bladder does spasm. He deserves something other than vicodin, as that does not address the spasms... which are very real... and for which B&O supps ARE the appropriate medication. http://www.sykart.com/keenie/turp/Meds.html
I agree with the suggestion of checking the inflation of the balloon, as well. Just don't let it slip out or you'll have a heck of a time getting it back in...LOL
Last edit by Fgr8Out on May 17, '02
May 18, '02
Just to clarify things, I am still finding my way around this facility. I would not let a patient suffer if I could help it! Sometimes it takes more than one day! I called the doctor and deferred to at least four seasoned nurses that knew that resident and the doctor. I am trying to figure it out, but rest assured, I would not let a patient suffer if I could help it. I probably should have consulted a drug manual and let my instints be my guide, but instead, called the MD and talked to at least four other nurses. I am still learning. I believe he had spasms before his TURP, maybe he has more than TURP The day was like a hurricane hit. If I am guilty of anything, it is not consulting the drug manual and his chart. I was too busy checking his foley, palpating his bladder and trying to figure out what was wrong, and finding our what they for him before and what worked. I have no problem with B& O supppositories, that is why I was asking. I am always a patient advocate and I want to help him! I am not here to judge if the man was drug seeking. I am trying to find out why the MD would not order B&O suppositories. I am here to learn from you guys!
Lilgirl, what is uro-spaz and isn't pyridium rifampin?
You see, I don't see alot of post TURPs in LTC or personal care. But I would NEVER let a man suffer. I am trying!
Last edit by cargal on May 18, '02