A 34-year-old diabetic female client had a spontaneous vaginal birth of a 37-week 6.2 kg infant. The nurse caring for the client post-partum understands that due to the traumatic birth the client is at increased risk for:
1. Acute urinary retention
2. Hematuria
3. Kidney failure
4. Enuresis
ANS: 1
In acute retention key signs are bladder distention and absence of urine output over several hours. The client under the influence of anesthetics or analgesics often feels only pressure, but the alert client has severe pain as the bladder distends beyond its normal capacity. In severe urinary retention the bladder holds as much as 2000 to 3000 mL of urine. Retention occurs as a result of urethral obstruction, surgical or childbirth trauma, alterations in motor and sensory innervation of the bladder, medication side effects, or anxiety.
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