Impaired urinary elimination nursing diagnosis

Nursing Students Student Assist

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Hi everyone, I'm new to posting on this board, so hopefully I am doing this right! I am a second semester nursing student going through my ob rotation. At clinical the other day, I had a patient that was about 17 hours post-op from a Divinci hysterectomy when I became her student nurse at 8 am. Foley catheter was removed at 7am, voiding had to be done within 6 hours from Foley removal in order to be discharged. Patient voided at 6 hours exactly. In post conference, my instructor asked me my nursing diagnoses for care plans and I picked acute pain r/t surgical incision, and impaired tissue integrity, but she wants me to do impaired urinary elimination instead of the impaired tissue integrity, which is fine with me. I have the whole care plan done with the exception of the r/t part of the nursing diagnosis. I can't figure out if the impaired urinary elimination is r/t the foley catheter placement or the procedure itself (since all of those organs are in the same vicinity). Hoping someone could answer/explain the reason that my patient had impaired urinary elimination! Thanks in advance for your help!

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

HI! Welcome to AN! The largest online nursing community!

I understand why your CI wants you to do impaired urinary elimination....but...technically...... since your patient voided, it isn't a problem any further. ;)

Things to consider......what is a Divinci hysterectomy? Do you mean a hysterectomy done with a Da Vinci robot? What complications can occur with gynecological surgery and the use of the robot? (Is there an extra danger to damage the bladder than with conventional surgery?(Da Vinci Robotic Hysterectomy Complications Result in Lawsuit - AboutLawsuits.com) look up ...causes of urinary retention post operatively.....is this patient on any meds to worsen possible urinary retention...HINT...narcotics/epidural?

Does this help?

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Correct! It is definitely not a problem anymore but "thinking as nurses" (her words) we should identify our primary nursing diagnosis and work on them throughout the day, then write a care plan to tell what we did to solve the problems and hand them in a week from the experience. I will have to spend some time researching the hysterectomy procedure (performed with a davinci robot) and try to find my answer there. Now if I could only find the time to do the research! Thanks for your help!

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And thank you for the links as well, as soon as I get an hour I will research them!

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

A huge part of nursing is if you don't know an answer is to know how to find it......and then apply it to your patient/situation. Everything I gave you will lead you to what you need.

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