The nurse educates a patient diagnosed with a UTI.
Which diet choices should be avoided to prevent bladder irritation?

Choice A rationale

Identifying renal artery bruits typically involves auscultation, not palpation. Bruits are abnormal sounds produced by turbulent blood flow through a narrowed or constricted artery, which are heard with a stethoscope placed over the renal arteries. Palpation is not an effective method for detecting vascular sounds.

Choice B rationale

Assessing for ureteral peristalsis is challenging and not routinely done through external palpation. Ureteral peristalsis involves rhythmic contractions of the smooth muscle in the ureters that propel urine from the kidneys to the bladder, which is an internal physiological process not directly palpable through the abdominal wall.

Choice C rationale

Palpation is a standard physical assessment technique used to detect bladder distention. An overfilled bladder rises above the symphysis pubis and can be felt as a firm, rounded mass in the suprapubic area, indicating urinary retention or incomplete emptying, which is a common post-catheter removal assessment.

Choice D rationale

Determining kidney function primarily involves laboratory tests, such as serum creatinine, blood urea nitrogen (BUN), and glomerular filtration rate (GFR) calculations, rather than physical palpation. While kidney palpation can assess size and tenderness, it does not directly measure the physiological efficiency of filtration and waste removal.

Choice A rationale

Inserting an indwelling urinary catheter prematurely without assessing for bladder distension or attempting other less invasive interventions is not the first step. Catheterization carries risks like infection and trauma. A bladder scan provides objective data to guide further interventions.

Choice B rationale

Positioning the patient on their left side is not a primary intervention for urinary retention after catheter removal. While position can sometimes aid voiding, it is not a direct solution for a patient who has not voided for 8 hours and does not address the underlying issue of bladder fullness.

Choice C rationale

Performing a bladder scan is the most appropriate next nursing action. A bladder scan non-invasively measures the volume of urine in the bladder. If the bladder volume is significant (e.g., >200-400 mL, normal post-void residual is <50-100 mL), it indicates urinary retention, guiding further interventions.

Choice D rationale

Instructing the patient to drink fluids without assessing for bladder distension can exacerbate the problem if the patient is already experiencing retention. Increasing fluid intake without adequate outflow can lead to overdistension of the bladder, causing further discomfort and potential bladder damage.