NOTE: Do not ambulate patient if he is hypotensive when dangling. Report this event
to the Charge Nurse.
4-15. URINARY SYSTEM
As previously mentioned, anesthetics temporarily depress urinary bladder tone.
Urinary bladder tone usually returns within six to eight hours after surgery. The length
of time a patient may be permitted to go without voiding after surgery varies
considerably with the type of surgery performed. However, in the mean time, nursing
responsibilities in relation to urinary elimination are those listed below.
a.
Report to the Charge Nurse if the patient without a Foley catheter has not
voided within eight hours of return to ward from the recovery room.
(1)
Patients who have had abdominal surgery, particularly if in the lower
abdominal and pelvic regions, often have difficulty voiding after surgery.
(2)
Operative trauma in the region near the bladder may temporarily
decrease the sensation of needing to void (urinate).
(3)
The fear of pain may cause tenseness and difficulty in voiding.
b.
Palpate patient's bladder for distention and assess patient's response.
(1)
The patient will tell you if he has to void (he will feel a sense of
fullness and urgency).
(2)
Report this event to the Charge Nurse.
c.
Assist the patient to void.
(1)
Position the patient comfortably on bedpan, with urinal, or in
bathroom.
(2)
Provide the patient with privacy.
d.
Measure and record the patient's urinary output.
e.
Notify the Charge Nurse if less than 30 cc of urine is voided during first
experience after surgery.
f.
Report to the Charge Nurse if the patient complains of bleeding when
voiding or urine shows blood.
g.
Follow ward infection control SOP for care of a patient with a Foley
catheter.
MD0915
4-8