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학습 자료 둘러보기 →In a patient with bladder cancer, painless gross hematuria with clots is an oncologic emergency. The primary danger is not just blood loss but clot retention, which mechanically obstructs urine outflow.
Immediate nursing actions include inserting a large-bore 3-way Foley catheter (typically 22-24 Fr) to begin continuous bladder irrigation (CBI) with normal saline. The goal is to evacuate clots and maintain clear, pink-tinged outflow.
Monitor closely for signs of bladder perforation or severe distension. If irrigation fails to clear the obstruction, the patient may require emergent cystoscopy for clot evacuation and fulguration. Strictly monitor intake and output and watch for rising creatinine indicating post-renal kidney injury.
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