Podcast
Questions and Answers
A patient recovering from surgery is experiencing urinary retention. Which intervention should the nurse prioritize to promote spontaneous voiding?
A patient recovering from surgery is experiencing urinary retention. Which intervention should the nurse prioritize to promote spontaneous voiding?
- Administer an anticholinergic medication to stimulate bladder contractions.
- Encourage the patient to drink large amounts of caffeine to increase urine production.
- Provide privacy and run water in the sink to promote relaxation and urination. (correct)
- Restrict oral fluid intake to reduce bladder filling and discomfort.
An elderly male patient with a history of benign prostatic hyperplasia (BPH) presents with urinary retention. What is the primary pathophysiological mechanism contributing to his condition?
An elderly male patient with a history of benign prostatic hyperplasia (BPH) presents with urinary retention. What is the primary pathophysiological mechanism contributing to his condition?
- Bladder paresis due to neurological damage.
- Decreased bladder sensitivity due to aging.
- Overactive bladder contractions leading to incomplete emptying.
- Urethral obstruction due to prostate enlargement. (correct)
A patient with urinary retention is experiencing overflow incontinence. Which statement best describes the underlying mechanism?
A patient with urinary retention is experiencing overflow incontinence. Which statement best describes the underlying mechanism?
- The bladder is overfilled, causing urine to leak out due to increased pressure. (correct)
- The bladder is contracting involuntarily, leading to leakage.
- The patient is unaware of the need to void due to nerve damage.
- The patient is unable to reach the toilet in time due to mobility issues.
A patient with chronic urinary retention is at risk for developing hydronephrosis. What is the mechanism by which urinary retention leads to hydronephrosis?
A patient with chronic urinary retention is at risk for developing hydronephrosis. What is the mechanism by which urinary retention leads to hydronephrosis?
Which of the following medications is most likely to contribute to urinary retention?
Which of the following medications is most likely to contribute to urinary retention?
A nurse assesses a patient with urinary retention and notes a firm, distended bladder displaced from the midline. What does this finding indicate?
A nurse assesses a patient with urinary retention and notes a firm, distended bladder displaced from the midline. What does this finding indicate?
Prolonged urinary retention increases the risk of urinary tract infections (UTIs) due to which primary factor?
Prolonged urinary retention increases the risk of urinary tract infections (UTIs) due to which primary factor?
A patient with urinary retention develops skin breakdown due to urine leakage. Which component of urine contributes most directly to this skin breakdown?
A patient with urinary retention develops skin breakdown due to urine leakage. Which component of urine contributes most directly to this skin breakdown?
Flashcards
Urinary Retention
Urinary Retention
Inability to completely empty the bladder.
Postvoid Residual Volume
Postvoid Residual Volume
The amount of urine remaining in the bladder after urination.
BPH (Benign Prostatic Hyperplasia)
BPH (Benign Prostatic Hyperplasia)
An enlarged prostate that can obstruct the urethra.
Overflow Incontinence
Overflow Incontinence
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Hydronephrosis
Hydronephrosis
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Bladder Distension
Bladder Distension
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Urinary Tract Infection (UTI)
Urinary Tract Infection (UTI)
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Running Water
Running Water
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Study Notes
- Urinary retention is the inability to completely empty the bladder
- It leads to high postvoid residual volume
- It is caused by urethral obstruction or bladder paresis
- Postvoid residual volume is the amount of urine remaining in the bladder after urination
Associated Conditions
- Prostate enlargement (BPH)
- Urethral trauma (e.g., strictures)
- Anesthesia leading to bladder paresis
- Neurologic conditions (e.g., stroke, spinal injury)
- Certain medications like anticholinergics and opioids can prevent chemicals from binding to receptor sites
- This prevents the bladder from contracting and releasing urine
Clinical Features
- It can be acute (e.g., anesthesia, surgery) or chronic (such as with BPH)
- It causes lower abdominal pain, pressure, and discomfort due to urine buildup
- Obstruction leads to straining to void
- It causes decreased urine output
- Overflow incontinence occurs when the bladder overfills with urine
- There is a feeling of incomplete bladder emptying, leading to the need to go to the bathroom despite urine buildup
- The bladder is firm on palpation and may be displaced from the midline when overfilled
Complications
- Bladder distension is a displaced bladder from the midline that indicates an overfilled and swollen bladder
- Tissues are at risk of injury
- Urinary tract infection can occur due to injured tissue and urine pooling in the bladder
- Prolonged urine buildup in the bladder is a breeding ground for bacteria
- The bacteria may travel up the ureters into the kidneys, causing pyelonephritis
- Untreated infections may travel to the bloodstream, resulting in sepsis
- Hydronephrosis is when blockage inhibits urine from leaving the body
- Pooling of urine and bacterial growth may stretch the bladder, causing hypertrophy
- Retrograde urine flow may inflame the ureters, leading to kidney inflammation and infection
- Skin breakdown occurs due to urine leakage
- Alkaline urine converts uric acid to urea by bacteria on the skin, causing quick skin breakdown
Nursing Interventions
- Promote spontaneous voiding by helping the client use the bathroom, bedside commode, or urinal
- Provide privacy to encourage muscle relaxation
- Run water in the sink or pour water over the perineum to promote urination
- Encourage oral fluid intake to stimulate the body's natural reflexes for urination
- Monitor intake and output
- Bladder scan before and after urination to assess urine volume in the bladder
- Normal PVR is 50-75 mL
- Perform intermittent urinary catheterization if there is no urine output
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