The nurse is caring for a patient in the postanesthesia care unit. The patient asks for a bedpan and states to the nurse, "I feel like I need to go to the bathroom, but I can't." Which nursing intervention will be most appropriate initially?
a. Assess the patient for bladder distention.
b. Encourage the patient to wait a minute and try again.
c. Inform the patient that everyone feels this way after surgery.
d. Call the health care provider to obtain an order for catheterization.
ANS: A
Depending on the surgery, some patients do not regain voluntary control over urinary function for 6 to 8 hours after anesthesia. Palpate the lower abdomen just above the symphysis pubis for bladder distention. Another option is to use a bladder scan or
ultrasound to assess bladder volume. The nurse must assess before deciding if the patient can try again. Not everyone feels as if they need to go but can't after surgery. Calling the health care provider is not the initial best action. The nurse needs to have data before calling the provider.
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