Following rectal surgery, a patient voids about 50 mL of urine ...

[laurencescou]

Following rectal surgery, a patient voids about 50 mL of urine every 30 to 60 minutes for the first 4 hours. Which nursing action is most appropriate?
 
  a. Monitor the patient's intake and output over night.
  b. Have the patient drink small amounts of fluid frequently.
  c. Use an ultrasound scanner to check the postvoiding residual volume.
  d. Reassure the patient that this is normal after rectal surgery because of anesthesia.

Question 2

A 55-year-old woman admitted for shoulder surgery asks the nurse for a perineal pad, stating that laughing or coughing causes leakage of urine. Which intervention is most appropriate to include in the care plan?
 
  a. Assist the patient to the bathroom q3hr.
  b. Place a commode at the patient's bedside.
  c. Demonstrate how to perform the Cred maneuver.
  d. Teach the patient how to perform Kegel exercises.

[Bison]

Answer to Question 1

ANS: C
An ultrasound scanner can be used to check for residual urine after the patient voids. Because the patient's history and clinical manifestations are consistent with overflow incontinence, it is not appropriate to have the patient drink small amounts. Although overflow incontinence is not unusual after surgery, the nurse should intervene to correct the physiologic problem, not just reassure the patient. The patient may develop reflux into the renal pelvis and discomfort from a full bladder if the nurse waits to address the problem for several hours.

Answer to Question 2

ANS: D
Kegel exercises to strengthen the pelvic floor muscles will help reduce stress incontinence. The Cred maneuver is used to help empty the bladder for patients with overflow incontinence. Placing the commode close to the bedside and assisting the patient to the bathroom are helpful for functional incontinence.

[laurencescou]

TYSM

[aliotak]

Excellent