What action should the nurse take for a client with pressure, pain, and 500 mL of urine in the bladder?

The most appropriate action for the nurse to take in this scenario is to perform intermittent catheter insertion. When a client is experiencing pressure and pain along with a significant volume of urine in the bladder, it indicates that the bladder may be overdistended and unable to effectively void. This situation can lead to discomfort, pain, and potentially further complications, such as bladder infections or even damage to the bladder itself if not addressed.

Performing intermittent catheterization is a direct method to relieve the bladder of its contents, thereby alleviating the pressure and pain the client is experiencing. This procedure allows the nurse to remove urine from the bladder without the need for a permanent catheter, thereby protecting the client against infection while providing immediate relief.

In contrast, encouraging the client to drink more fluids would not be appropriate, as it could exacerbate the overdistension of the bladder and lead to increased discomfort. Assessing for bladder infection symptoms could be useful, but it would not address the immediate concern of bladder distension and pain. Positioning the client comfortably is also beneficial for the client’s overall comfort but does not specifically address the underlying issue of urinary retention and would not alleviate the pain or pressure caused by the full bladder.