The nurse is caring for a 68-year-old male client following a laparoscopic cholecystectomy 8 hours ago. The client has not urinated since surgery. Which would be the most appropriate initial intervention?

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Urinary retention occurs frequently after surgery due to administration of opioids (eg, morphine) and anesthesia, and in older men, who often have an enlarged prostate gland or benign prostatic hyperplasia (BPH). Up to 50% of men over age 60 have an enlarged prostate. Body position can also contribute to urinary retention. Most men are used to urinating when standing up; therefore, the nurse or assistive personnel should help the client out of bed rather than offer a urinal for use in bed (Option B). Providing privacy may also aid in relaxation and urination. benign prostatic hyperplasia (BPH) (Option A) The second intervention should be a bladder scan. If the client is unable to urinate, an ultrasound scan can be used to noninvasively assess the volume of urine in the bladder. It can also be used to determine the residual bladder volume after the client has urinated to assess the amount of retention. (Option C) An indwelling catheter is not currently indicated for this client. Catheter-associated urinary tract infection (CAUTI) is a significant hospital-acquired infection. The risk of CAUTI can be reduced by using an indwelling catheter only when other interventions have failed to produce desired outcomes. (Option D) Intermittent catheterization would be the third intervention if the client has been unable to urinate or has significant urinary retention (>300-400 mL). Educational objective: Urinary retention after surgery is common and often made worse by existing benign prostatic hyperplasia in older men. If a client has difficulty urinating, the nurse should first try noninvasive methods to help the client urinate in a normal position and provide privacy to help the client relax.

The Nurse Is Caring for a 68-Year-Old Male Client Following