After TURP, a male client has a three-way catheter with continuous bladder irrigation. Which finding suggests the catheter is occluded?

• A. The client reports bladder spasms and the urge to void.
• B. The urine is bright red and non-clotting.
• C. The catheter drainage is clear and continuous without effort.
• D. The patient reports no pain or discomfort.

Answer: (A)

The key idea is that continuous bladder irrigation relies on unobstructed drainage through the three-way catheter. If the catheter becomes occluded, urine cannot leave the bladder, leading to bladder distention. The bladder becomes irritated and responds with spasms and a strong urge to void. That combination—spasms plus an urge to void—indicates the outlet is blocked and needs assessment for blockage and irrigation.

In contrast, clear, continuous drainage without effort means the catheter is patent; bright red blood that is non-clotting can occur after TURP and doesn’t by itself signal an occlusion; and lack of pain or discomfort doesn’t point to a blockage. If occlusion is suspected, check for kinks or misplacement, ensure the irrigation system is functioning and not clogged, and perform appropriate catheter irrigation as ordered.