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Mr. Rivera was admitted post-operatively after a laparoscopic right inguinal herniorrhaphy under general anesthesia. He's received...

Mr. Rivera was admitted post-operatively after a laparoscopic right inguinal herniorrhaphy under general anesthesia. He's received 1,000 mL IV fluids over the last 8 hours. His foley catheter is removed and emptied for 400 mL of amber urine. Consider the following questions:

  • At what point should the nurse anticipate Mr. Rivera should be able to void?
  • What factors could impair his ability to void after foley removal?
  • How will the nurse differentiate between surgical pain and the discomfort of bladder distension?

Solutions

Expert Solution

1.Postoperative urinary retention is common maily in patient who undergone pelvic surgeries.There are several dimensions for the condition,but generally if there is no other complication is anticipated then the patient will void after 8-9hours.However it may go long as 4 weeks as the postoperative effect.The retention beyond 4 weeks are too rare.

2.FACTORS INVOLVED IN IMAPAIR OF VOIDING AFTER FOLEY REMOVAL.

  • Patient age
  • Sex: Older males
  • History of BPH
  • Micturation nerve damage.
  • Pre existing urinary retention
  • General anesthesia
  • Fluid intake after surgery
  • Neurogenic bladder
  • Some pain medications

3.To differentiate between surgical pain and discomfort with bladder retension is very hard to understand.A gentle papation of bladder may help.The area of pain will be suprapubic area  where you may feel tendered and fluid filled kind feeling while palpating and percussion if possible.Bladder discomfort will appear along with intense urge to void and sweling and pain in the stomach.Whereas in surgical pain will exactly locate around the surgical wound site.

Nightingale answered 2 years ago
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