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

Choice A rationale:
The physical dimension encompasses the tangible, biological aspects of an individual, including age, race, gender, genetic inheritance, anatomy, and physiological processes.
Here's a detailed breakdown of how each of these factors aligns with the physical dimension in the context of the patient's hypertension:
Age:
Hypertension is more prevalent in older adults due to natural changes in the cardiovascular system, such as stiffening of arteries and decreased elasticity.
The patient's age of 68 years places him within this higher-risk category.
Race:
African Americans have a disproportionately higher risk of hypertension and related complications compared to other racial groups.
This disparity is attributed to a complex interplay of genetic, environmental, and socioeconomic factors. Gender:
While both men and women experience hypertension, men tend to develop it earlier in life and have a higher lifetime risk.
This difference is partially due to hormonal influences and lifestyle factors.
Genetic inheritance:
Hypertension often has a significant genetic component.
Individuals with a family history of hypertension are more likely to develop the condition themselves, suggesting a role of inherited genes in blood pressure regulation.
Choice B rationale:
The emotional dimension focuses on psychological and mental aspects, including feelings, thoughts, behaviors, and coping mechanisms.
While emotions can certainly influence blood pressure and overall health, they are not directly categorized under the physical dimension in this context.
Choice C rationale:
The environmental dimension addresses external factors that impact health, such as access to healthcare, social support, exposure to pollutants, and community resources.
While these factors can indirectly contribute to hypertension risk, they are not inherent physical characteristics of the individual.
Choice D rationale:
The holistic dimension encompasses a comprehensive view of health, integrating physical, emotional, spiritual, social, and environmental aspects.
While holistic care is essential for managing hypertension, the question specifically asks about the dimension that age, race, gender, and genetic inheritance exemplify, which is most accurately aligned with the physical dimension.

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.