Urinary Elimination: Urinary Retention



Urinary retention/ ischuria, is the inability to empty the bladder.
·        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.



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notes.nursium.com: Urinary Elimination: Urinary Retention
Urinary Elimination: Urinary Retention
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