A nurse is caring for a group of clients who have been diagnosed with urinary retention. Which of the following underlying conditions place these clients at risk for urinary retention? (Select all that apply.)

 

Choice A reason: While fiber is important in a diet, recommending at least 45 g per day does not specifically address the needs of a patient with diabetic nephropathy.

Choice B reason: Consuming less than 0.8 g/kg of body weight of protein per day is recommended for patients with diabetic nephropathy to reduce the workload on the kidneys.

Choice C reason: Limiting cholesterol intake to 300 mg per day is a general recommendation for heart health but is not specific to diabetic nephropathy dietary management.

Choice D reason: The recommendation to consume less than 45% of total calories from carbohydrates is not specific to diabetic nephropathy, and carbohydrate needs can vary based on individual energy requirements.

The correct answer is D. Urine output 75 mL in 1 hr.

Adequate urine output (at least 30 mL/hr) indicates effective hydration, showing that the kidneys are functioning properly and fluid balance is improving. A urine output of 75 mL in 1 hour suggests sufficient fluid replacement.

Here’s why the other options are incorrect:

• A. Urine specific gravity 1.005 to 1.030 – This range covers both normal and abnormal values. In dehydration, urine specific gravity is usually high (>1.030) due to concentrated urine. Effective treatment should lead to lower urine specific gravity, but the full range does not confirm improvement.

• B. Decreased pulse pressure – Pulse pressure is the difference between systolic and diastolic blood pressure. Dehydration typically causes a narrowed pulse pressure, so improvement should lead to a normal or increased pulse pressure rather than a decrease.

• C. Lightheadedness – Dizziness and lightheadedness are signs of dehydration-related hypotension. Effective hydration should resolve these symptoms, not maintain them.