Medical Surgical Urinary retention vs Incontinence #1

Question

A client is recovering from orthopedic surgery and having difficulty emptying the bladder despite multiple attempts to void. The client had spinal anesthesia and is on a patient-controlled analgesia (PCA) pump. Which condition does the nurse suspect based on the current data?

Answers

  1. A precursor to renal failure.
    • Rationale:

      This answer is not correct because difficulty emptying the bladder in the postoperative period is not a precursor to renal failure; therefore, the nurse does not suspect that the client is experiencing this condition.

  2. Postoperative opioid reaction.
    • Rationale:

      This answer is not correct because difficulty emptying the bladder in the postoperative period when the client is prescribed and receiving opioid analgesic via a PCA for pain control is not a reaction to the prescribed medication; however, urinary retention is a side effect to opioid analgesics.

  3. Postoperative urinary retention.
    • Rationale:

      This answer is correct because this client is experiencing PUR due to the type of surgery, the method of anesthesia, and the continued use of opioid analgesics all of which can cause urinary retention.

  4. Failure of spinal anesthesia induction.
    • Rationale:

      This answer is not correct because the client’s clinical manifestations are not caused by failure of spinal anesthesia. Clients who undergo surgery for pelvic or orthopedic procedures are at risk for postoperative urinary retention (PUR).

Overview

There are several conditions or circumstances that may increase the client’s risk for urinary retention. Clients who undergo surgery for pelvic or orthopedic procedures are at risk for postoperative urinary retention (PUR).

Explanation

Learning Outcomes

Clients who undergo surgery for pelvic or orthopedic procedures are at risk for postoperative urinary retention (PUR). In addition, the method of anesthesia (spinal) also increases this client’s risk for PUR. Another potential factor for PUR is the use of opioid analgesics as a known side effect is urinary retention.

Test Taking Tip

Consider the client’s surgery, the type of anesthesia, and the method of pain control to answer this question correctly.

Video Rationale