Medical Surgical Urinary retention vs Incontinence #4

Question

The nurse provides care for a client who just voided and states, “I feel like I never empty my bladder.” The nurse assesses the client’s bladder and elicits dullness by percussion. Which interpretation of this finding is accurate from the nurse?

Answers

  1. Dullness over the bladder is a normal finding.
    • Rationale:

      This answer is not correct because dullness over the bladder is not normal if the client had just voided. It may be present with a full bladder, but the question indicates the client just voided.

  2. Dullness over the bladder indicates an enlarged kidney.
    • Rationale:

      This answer is not correct because percussion was performed over the client’s bladder, not the kidney. Dullness over the bladder may indicate urinary distention or retention of urine.

  3. Dullness over the bladder indicates ureteral obstruction.
    • Rationale:

      This answer is not correct because a distended bladder may indicate obstruction higher in the ureters but it is not possible to hone in on the ureter area with only bladder percussion (and to determine the issue is in the ureters).

  4. Dullness over the bladder indicates urinary distention and possible retention.
    • Rationale:

      This answer is correct because a dull sound produced by percussion of the client’s bladder indicates fluid, therefore urinary retention or urinary distention.

Overview

Percussion is a method of tapping body parts with fingers, hands, or small instruments as part of a physical examination. Dullness over the bladder may indicate urinary distention or retention of urine.

Explanation

Learning Outcomes

Percussion is performed approximately 2 inches (5 cm) above symphysis pubis. Percussion is systematic toward the bladder’s base. Dullness over the bladder may indicate urinary distention or retention of urine. It may also be found in mid-term pregnancy and with uterine abnormalities.

Test Taking Tip

Consider the implications of the different sounds that can occur with percussion, and their meaning to answer this question correctly.

Video Rationale