The body compensates for obstructed urine outflow up to a certain point. Which of the following signs/symptoms lead the nurse to suspect decompensatory changes are occurring? Select all that apply

Question

A) Reports of renal colic
B) Urinary frequency noted
C) High residual volume up to 1000 mL
D) Postvoid residual volume less than 50 mL
E) Must strain to initiate the stream of urine

Answer 1

Ans: B, C, E
Feedback:
Compensatory changes to chronic obstruction include increased urge to urinate (urinary frequency). When compensatory mechanism no longer is effective, signs of decompensation begin to appear. The period of detrusor muscle contraction becomes too short to expel the urine completely, and residual urine remains in the bladder. A PVR value of less than 50 mL is considered adequate bladder emptying, and more than 200 mL indicates inadequate bladder emptying. At this point, the symptoms of obstruction—frequency of urination (during day and night), hesitancy, need to strain to initiate urination, a weak and small stream, and termination of the stream before the bladder is completely emptied—become pronounced. Bladder spasms are a symptom of outlet obstruction and do not increase urine output/decrease obstruction.