After surgery, a post-operative patient has not urinated for 8 hours.
Where should the nurse check for bladder distention?

Palpate between the symphysis pubis and the umbilicus

Palpate over the costovertebral region of the flank

Palpate in the left lower quadrant of the abdomen

Palpate between ribs 11 and 12 and the umbilicus

Answer and Explanation

The Correct Answer is A

Anatomy: The bladder is a hollow, muscular organ located in the lower abdomen, just behind the pubic bone. It stores urine until it is emptied through urination. The area between the symphysis pubis (the joint where the two pubic bones meet) and the umbilicus (belly button) is directly over the bladder, making it the most appropriate place to palpate for bladder distention.

Signs of bladder distention: When the bladder is distended, it can be felt as a firm, round mass in the lower abdomen. The patient may also experience discomfort, pressure, or an urge to urinate.

Nursing assessment: Palpation is a key nursing assessment skill used to evaluate the size, shape, and position of organs within the abdomen. In this case, palpation helps the nurse to determine if the bladder is distended and to assess the severity of the distention.

Clinical significance: Bladder distention can occur for a variety of reasons, including:

Postoperative urinary retention due to anesthesia or pain medications

Urinary tract obstruction (e.g., from a kidney stone or enlarged prostate)

Neurological conditions that affect bladder function (e.g., spinal cord injury, multiple sclerosis)

Dehydration

Certain medications (e.g., diuretics, anticholinergics)

Prompt intervention: Bladder distention can lead to complications such as urinary tract infections, kidney damage, and discomfort. It's important for the nurse to identify and address bladder distention promptly to prevent these complications.

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Correct Answer is C

Explanation

The formula for calculating flow rate is:

Flow rate (gtt/min) = (Total volume (mL) ÷ Time (min)) × Drop factor (gtt/mL)

Plugging in the values:

Flow rate (gtt/min) = (130 mL ÷ 120 min) × 60 gtt/mL

Flow rate (gtt/min) = 65 gtt/min

Step 3: Round the flow rate to the nearest whole number.

The calculated flow rate is 65 gtt/min. Rounding to the nearest whole number gives a flow rate of 65 gtt/min.

A. The urine may be brown or black. B. The urine may be orange or orange-red. C. The urine may be green or blue-green. D. The urine may be blood-tinged.

Correct Answer is B

Explanation

Choice A rationale:

Brown or black urine is not a typical observation associated with Levodopa use. It can indicate other potential causes, such as: Dehydration

Liver disease

Rhabdomyolysis (muscle breakdown)

Certain medications like metronidazole or iron supplements

Hematuria (blood in the urine)

It's essential to rule out these conditions if brown or black urine is observed.

Choice C rationale:

Green or blue-green urine is also not common with Levodopa. It can be caused by:

Medications like amitriptyline, indomethacin, propofol, or methylene blue

Certain food dyes

Urinary tract infections caused by Pseudomonas bacteria

Familial benign hypercalcemia (a rare genetic condition)

Choice D rationale:

Blood-tinged urine (hematuria) is not a direct effect of Levodopa. It can signal underlying urinary tract issues, such as: Infections

Kidney stones

Bladder or kidney tumors

Trauma to the urinary tract

Strenuous exercise

Choice B rationale:

Orange or orange-red urine is the most common observation in patients taking Levodopa. This discoloration is due to: Breakdown of Levodopa into dopamine and other metabolites

These metabolites can impart an orange or reddish hue to the urine

The color intensity may vary depending on dosage and individual metabolism

It's generally harmless and doesn't require medical intervention

However, it's essential to inform healthcare providers about any urine color changes to ensure proper monitoring and rule out other potential causes.

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After surgery, a post-operative patient has not urinated for 8 hours. Where should the nurse check for bladder distention?

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Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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After surgery, a post-operative patient has not urinated for 8 hours.
Where should the nurse check for bladder distention?