Which action should the nurse take first? A client hasn't voided - ProProfs Discuss
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Which action should the nurse take first? A client hasn't voided since before surgery, which took place 8 hours ago.



A. Call the physician to report the client s condition.
B. Catheterize the client with a straight catheter.
C. Assess the client for bladder fullness.
D. Tell the client to bear down and try to void.
Asked by Ellsworth, Last updated: Jan 16, 2020

This question is part of

Basic Physical care (Part 2)

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2 Answers

T. Moore

Have keen interest in writing, traveller by heart.

T. Moore, Writer, MA, Washington

Answered Jan 28, 2019

One thing that the nurse will do when he or she has a patient who just had surgery is to monitor their functions. This includes urinating. The nurse would determine when the patient urinated before and after the surgery. However, a patient may have only urinated before surgery. That may cause a problem and the nurse needs to do something about it.

Another word for urinated is the term voided which is often used in medical areas to represent urination. If the surgery for the patient took place eight hours ago, it would be expected that the patient would have urinated during that time. If not, then the nurse should assess the client for bladder fullness. If the bladder is full, then it is time for the patient to urinate.

 

John Smith

John Smith

Answered Sep 09, 2016

Assess the client for bladder fullness.-rationale: before taking any action, the nurse must assess the clients bladder area for fullness. urine retention is a common adverse effect of anesthesia. after confirming retention, the nurse should call the physician and expect an order to catheterize the client. telling the client to bear down and try to void is inappropriate.client needs category: physiological integrityclient needs subcategory: basic care and comfortcognitive level: applicationreference: craven, r.f., and hirnle, c.j. fundamentals of nursing: human health and function, 5th ed. philadelphia: lippincott williams & wilkins, 2007, p. 1084.
 

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