a. Trauma to the bladder includes contusions, rupture, or urethral injuries.

b. Causes include blunt trauma and penetrating injuries to the lower abdomen, fractures of the pelvis or symphysis pubis, and “seatbelt” rupture. (A full bladder can be ruptured by the force of impact in a collision when the seatbelt is worn snugly.)

c. Signs and symptoms of an injured or ruptured bladder include:

(1) Hematuria.

(2) Blood at the urinary meatus.

(3) Failure to void.

(4) Rigid abdomen.

(5) Shock.

(6) Hemorrhage.

d. Nursing implications.

(1) Treat shock and hemorrhage.

(2) Maintain strict I & O.

(3) Catheterize as ordered.

(4) Prepare for surgical repair of the bladder if indicated.