URINARY RETENTION
Urinary retention/ ischuria, is the inability to empty
the bladder.
Causes
·
Urethral obstruction
·
Decreased stimulation
of muscle bladder
·
Lack of muscle tone
and muscle spam
·
Pressure on the
bladder by fetus in utero, pelvic tumors etc.
·
Surgery and trauma on
the urinary structures
·
Some medications like
analgesics and CNS depressants
Signs and symptoms
·
Intermittent Flow
·
Sense of Incomplete
Voiding
·
Hesitancy (a delay
between trying to urinate and the flow actually beginning).
·
Nocturia (need to
urinate at night)
Managing Urinary Retention
Ø Inducing
natural urination
Ø Crede's
method/maneuver
Ø Urinary
catheterization
Ø Inducing natural
urination
·
Assist patient to his
or her normal position for voiding
·
Provide privacy
·
Offer a bedpan or
urinal that is warm bedpan that is cold to touch may cause contraction of
perineal muscles
·
Local application of
heat to the perineum and lower abdomen by pouring warm water or by the
application of hot water bottles, sitz bath ,gentle massage of lower abdomen
can foster muscle relaxation there by the act of micturition
·
Micturition is a
conditioned reflex. Running water within hearing of the patient can stimulate
this reflex
·
Give fluids freely
unless contraindicated Simple diuretics such as lemon drinks, weak coffee, tea
is given to induce micturition.
Crede's method/maneuver:
Clients who have a flaccid bladder (weak, soft and lax
bladder muscles) may use manual pressure on the bladder to promote bladder emptying.
This is known as Crede's maneuver or Crede's method.
It is not advised without a physician or nurse
practitioner's order and is used only for clients who have lost and are not
expected to regain voluntary bladder control.
Urinary catheterization
Urinary catheterization is the introduction of a
catheter into the urinary bladder.
This is usually performed only when absolutely
necessary, because the danger exists of introducing microorganisms into the
bladder.
COMMENTS