urinary retention

The state in which the individual experiences incomplete emptying of the bladder. High urethral pressure inhibits voiding until increased abdominal pressure causes urine to be involuntarily lost, or high urethral pressure inhibits complete emptying of the bladder.

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URINARY RETENTION (A) Massive distention of the bladder by two liters of urine. (B) After catheterization of the bladder. PORTABLE URINARY COLLECTION BAG

PATIENT CARE
Ultrasound can be used to measure residual urine after voiding, i.e., to determine postvoid residual urinary retention. Other uses of bladder ultrasound include: identifying an obstruction in an indwelling catheter (indicated by a significant urine volume when the bladder should be almost empty), or the presence of bladder distension and the need for urinary catheterization.

Health care professionals should use standard precautions when a bladder scanner is employed. The procedure, which is painless, should be explained to the patient and appropriate privacy (screening and draping) provided. The probe (also known as the “transducer”) should then be cleansed with a disinfectant. The health care provider then gently palpates the patient’s pubic symphysis and places ultrasound gel or a bladder scan gel pad midline on the patient’s abdomen about 1 to 1½ in (2.5 to 4 cm) above it. The probe is then placed on the gel with its directional icon toward the patient’s head and aimed toward the bladder. Pointing the probe slightly downward toward the coccyx provides an accurate view of the bladder for most patients. The scan button should then be pressed and released. The orientation of the probe is readjusted until the bladder image is centered. The volume of urine in the bladder is calculated by software, and the measurement is displayed. A volume greater than 200 mL is abnormal. The gel should be wiped from the patient’s skin or the gel pad discarded, and the patient made comfortable.

The health care provider should document any patient concerns that led to the scanning, the urine volume indicated, the patient’s response to the scan, any follow-up treatment, and whether the patient’s primary health care provider was contacted.

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