I had a patient come back from a TKA at 1500. I'm a new grad, and this was my first fresh ortho surgical that I've had. He received a Duramorph spinal as well as general anesthesia. The patient did not have a foley. I asked if the patient peed in recovery, the surgical nurse stated no. He had 2400 mL of fluids in during the surgery and he was a very large gentleman and had peed before they took him in at 1200, which the surgical nurse told me it was fine if he didn't pee for awhile. I had the patient try to pee at about 1830, even though he couldn't feel like he had to pee. The patient had full sensation back from his spinal (another story all together). The doctor came in at 1845 and was furious he hadn't peed yet. How long is it OK to wait for a patient to pee after getting a spinal?? Any thoughts? I felt terrible!
Look at the whole intraop I & O. A lot of stuff is sucked out. But I wouldn't go over say 3 hours. Before that make sure you have a cath order.....never wait til end of shift and wake a doctor for something you could have handled earlier and especially one he should have covered in the post op orders. If they do void you still want at LEAST 30cc an hour. MINIMUM. US Bladderscan will usually lead you to the right decision. but learn how to palpate with and without listening to an echo with your steth. Kinda sounds boing slush.
Last edit by P_RN on Feb 26, '12