Urinary retention in nursing is a health condition that occurs when a person is not able to relieve or empty their bladder completely even after urination. This means the bladder cannot be emptied and continues holding urine gradually. This condition can be termed as chronic, acute, or just unavoidable circumstances like immediate change.

Urinary retention can develop from some of the following factors. BPH, hysterectomy, immobility, and even certain medications like antihistamines are being administered into our bodies. It is these factors that will form the basis of your nursing assignment paper. Urinary retention occurs when the nerves responsible for urination through sphincter relaxation are damaged. It is important to note that if left untreated it can lead to severe health issues like kidney failure and damage to the bladder. People with urinary retention should seek medical care immediately.

Signs and symptoms of urinary retention

Urinary retention can be either acute or chronic. Thus it is important to pay attention to the different signs and symptoms that manifest in a patient to ensure they are correctly diagnosed.

Acute urinary retention

• urination incapacity
• severe pain in the lower abdomen
• pressing urination needs
• the lower abdomen swells up
• repeated urinary tract infections

Chronic urinary retention

• ineffectiveness of completely emptying the bladder
• urinating frequently in bits
• has a hard time initiating urination
• the urine stream is slowed down
• feels like urinating all the time to but is unable
• discomforts occur in the lower abdomen

causes of urinary retention

Urinary retention can be a result of many causes. Below we will mention a few

• urinary incontinence
• availability of previous infections
• edema or abdominal swelling
• nerve problems that lead to communication disruption between the nervous system and the urinary tract
• pain
• Decay of the detrusor musculature
• medicine prescribed for other diseases
• complications that arise after surgery
• prescriptions are taken to recuperate after a surgery

More causes

1. Medications

Some medicines when taken have been known to bring about urinary retention. Below is a few examples

• Drugs used for hormones regulation
• Drugs used for muscle relaxation
• Drugs used for high blood pressure regulation
• Antihistamines
• Antipsychotics
• Anticholinergics

2. Obstruction

When there is a blockage in the bladder and urethra preventing the free flow of urine it leads to urinary retention. Sometimes the prostate gland in men presses on the urethra preventing the flow of urine thus leading to chronic urine retention. Women with cystoceles are prone to develop urinary retention. Urinary retention can also occur in the case where the rectum pushes on the vagina’s back wall.

3. Surgery

Some surgeries may lead to urinary retention because of the pre and post-operation sedatives. These surgeries can include, joint replacement, hip replacement, and spine surgery amongst others.

4. Nerve damage

Nerve damage is a problem brought about by conditions such as stroke, pelvis injuries, diabetes, and spine injuries.  Nerve problems normally lead to urinary retention because the brain’s commands to eliminate the urine from the bladder are not received.

Diagnosis nursing care plan for urinary retention

Urinary retention diagnosis

1. Physical examination entails observing characteristics that appear if a person has the symptoms of urinary retention. Most of the physical analysis entails observation of the genitalia.
2. You can conduct blood tests to determine if urine retention is present.
3. Use examples of urine and analyze it concerning wanting to know about urinary retention in the patient.
4. CT scans can assist you to have a view of the urinary pathway and determine if there is the presence of rocks that are causing the blockage.
5. Use of Urodynamic testing which is a process that determines the volume of urine present in the bladder of a patient.
6. Ultra-sounds are also another procedure that can be used to determine the amount of urine remaining in the bladder of a patient.
7. Another test used in the determination of the amount of urine in the bladder is the Post-void residual test. The process is usually done after the patient urinates.
8. Cystoscopy is a process that entails the placement of a tube that has cameras through the urinary tract to see the inside of the bladder. Through this process, we can view the blockage done by stones and the positioning.

Urinary retention assessment

1. Assess the patient’s urinary retention risk factors

By looking into a patient’s history with previous surgeries, medical conditions, and prescriptions you can access their risk of developing urinary retention.

2. Assess urine removal pattern

The frequency of urination and in small amounts can indicate urinary retention.

3. Assess the abdomen

You can examine the bladder by feeling it to determine whether there is tenderness or distention in the bladder.

4. Assess the characteristics of the urine

The presence of an infection can cause urinary retention. Testing the urine by looking at its color, components, odor, and clarity will help you determine the possibility of disease development.

5. Assess residuals post-void

Urine quantity in the bladder after urination will help the nurse figure out whether the constant need to urinate is a result of urinary retention and the threat level.

6. Assess the list of medicine prescription

Patients respond differently to medication. It is important to check whether the patient is reacting to the medicine thus developing urinary retention. Change the medications immediately and offer safe alternative solutions.

Interventions for urinary retention

1. Come up with ways to induce routine voiding

Taking up certain measures like privacy, listening to water sounds, and looking for comfortable urinating positions helps a patient relax their perineal muscles promoting successful voiding.

2. Promote cleansing of the perineal

Perineal cleansing reduces the risks of developing urinary retention thus it should be encouraged often.

3. Catheter care

If the patient has a catheter inserted make sure they are taking good care of it to avoid infections that can lead to urinary retention.

4. Propose catheterization of patients

When urine retention is detected a healthcare provider can propose the insertion of a catheter on the patient.

5. Catheter patency

In case the catheter blocks then urine cannot be drained appropriately. Make sure the catheter is being monitored regularly to avoid any complications that can lead to urinary retention.

6. Provide education on the catheter

Patients and their loved ones need to be taught how to take care of their catheters and their importance. This will stop the patient from getting further complications or urinary retention.

7. Get bladder scans

If in any case, you suspect that you have urinary retention disorder, you should conduct a scan to determine if there is residual that is post-void. The scan is a study to a conclusion on whether the patient has the disorder.

8. Medication

In any case, it is determined that the patient has bladder issues, of huge importance is to ensure that the medicine provided to solve the issue is administered at the correct time and in precise dosage. This will ensure that the patient has normal bladder function.

Urinary retention prevention

Lifestyle changes have always helped in disease prevention

• Consume your fluids in fixed intervals. This will help you control your urination
• Do pelvic floor strengthening exercises like kegel exercises? This will help your sphincters gain better control
• Take up exercises that work on your bladder. These exercises will help you build muscles and thus your bladder can hold and release urine with ease.

Urinary retention treatment

Acute urinary retention is easier to control by inserting a catheter into the patient. Chronic urinary retention is more severe and thus requires extensive measures, below are a few options

1. Catheterization

Catheters can be used in acute urinary retention to help in urination. Sometimes they are painful but anesthetics are used to help ease the pain. As much as catheters are great for draining the urine they can bring out infections or blockage and thus require a great care plan of cleansing and monitoring.

2. Medicine

Some medicines are used to prevent the acceleration of the disease if not cured. Antibiotics treat UTIs and relaxants for the prostate and sphincter are useful.

3. Urethra dilation and stent installation

Using tubes can increase the diameter of the urethra easing the process of urination. Ballons are also great for enlarging the urethra and just like the stent they help the patient pass large amounts of urine.

4. Surgery

This is always the last option in medical issues. If the patient fails to improve after changing their lifestyle and using medicine minor surgeries can be conducted to help and major surgeries if the patient is not in a good state. Examples

• Urethrotomy
• Prostate removal
• Turp

To wrap up

Nursing care plan for urinary retention is a broad topic. You will venture into sub-topics like nursing care plan for acute urinary retention, urinary retention risk factors, and diagnosis nursing care plan for urinary retention amongst others. As a nursing student, this can give you a hard time.

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