The nurse is performing a physical assessment for a client who underwent a hemorrhoidectomy the previous day.The nurse notes that the client has lower abdominal distention accompanied by dullness to percussion over the distended area.Which is the nurse's priority action?

Question

Quizplus · Accepted Answer

Assessment findings indicate that the client may have an overfull bladder.In the immediate postoperative period,the client may experience difficulty voiding owing to urinary retention.A rectal tube should not be inserted for a client who had a hemorrhoidectomy the previous day.The client's vital signs may be checked after the nurse determines the client's last void.The nurse should document all findings and actions in the client's medical record.

The Nurse Is Performing a Physical Assessment for a Client