Which observation by the nurse best indicates that a continuous bladder irrigation for a patient following genitourinary surgery is effective?

Choice A reason: Opioids slow gastrointestinal motility by binding to mu-opioid receptors in the gut, reducing peristalsis and increasing water absorption, leading to constipation. This is a common, predictable side effect requiring proactive monitoring to prevent discomfort or complications like impaction.

Choice B reason: Diarrhea is less likely with opioids, which typically cause constipation. While diarrhea could indicate an unrelated issue, it is not a primary concern associated with opioid use, making it a lower priority for assessment.

Choice C reason: Hemorrhoids may result from straining due to constipation but are a secondary concern. Opioids do not directly cause hemorrhoids, so assessing for constipation takes precedence to address the root cause of potential straining.

Choice D reason: Clostridium difficile infection is a risk with antibiotic use, not opioids. While opioid-induced constipation could alter gut flora indirectly, C. difficile is not a primary concern, making constipation the more immediate assessment priority.

Choice A reason: Preventing bathroom interruptions is not the primary rationale. While convenient, indwelling catheters are used for clinical reasons like monitoring or preventing complications. This rationale overlooks the physiological effects of surgery and anesthesia, which are more critical for catheter use in abdominal procedures.

Choice B reason: Checking patency post-surgery is not the primary reason for intraoperative catheter placement. While catheters monitor urine output, the main goal is to manage bladder function during and immediately after surgery, when anesthesia and surgical manipulation increase retention risks, not just patency.

Choice C reason: Anesthetics, especially general or spinal, reduce detrusor muscle contractility, impairing bladder emptying. This increases urinary retention risk during and post-surgery. An indwelling catheter ensures continuous drainage, preventing bladder overdistention, discomfort, or complications like urinary tract infections or bladder injury.

Choice D reason: Uncontrolled voiding during surgery is unlikely under anesthesia, which suppresses bladder reflexes. While catheters prevent intraoperative bladder filling, the primary concern is retention from anesthetic effects, not involuntary voiding, making this rationale less accurate for catheter use.