Urinary Retention PLEASE HELP!!

[New 2 iceeYouRN]

Hello everyone!

I'm doing a care plan on urinary retention for my patient. She is a 74 y/o F who is 6 days post op from having modified radical hysterectomy with bilateral salpingo oopherectomy and retroperitoneal lymphadenectomy. Since this surgery she has been unable to void or defecate. She is on Demerol and Vicodin which could be causing the constipation, also the surgery could have. Xray of the abd shows SBO vs Ileus. She is getting NS with 20mEq 125cc/hr and her intake is 916cc/day and output (when cathed) of 1550. She is unable to void without being straight cathed. the doctor has written an order to no longer straight cath her unless he says so. I'm doing a diagnosis of

Urinary retention r/t _________ as evidenced by lack of urine output.

I know the r/t should be either blockage, high urethra pressure caused by weak detursor, inhibition of reflex arc or strong sphincter but how do I know which one it is?!

Please help!!

[Daytonite, BSN, RN]

urinary retention r/t _________ as evidenced by lack of urine output.

the related factors listed in the nanda taxonomy are a guideline. where ever possible we need to itemize and specify those related factors. this lady had a retroperitoneal lymphadenectomy along with the modified radical hysterectomy with bilateral salpingo oopherectomy. why was this surgery done? sounds like they did some extensive work and manipulation when they had her open on the surgical table. with surgery there is tissue damage and the body reacts by initiating the inflammatory response immediately. the cardinal symptoms of the inflammation response are redness, heat,

swelling

and pain. you can't see edema of the ureters, a possible result of the surgery, with your naked eye. swelling of the ureters is one type of blockage. urinary retention is also a side effect of demerol and vicodin that slows or inhibits the reflex arc.

lack of urine output

is not how i would describe the patient's symptoms of her urinary retention.

lack of urine output

is a symptom of

deficient fluid volume

and that was the first thing i though of when i saw that. describe her urinary retention. . .that she is unable to urinate, complains that she has the sensation of a full bladder and that she needs to urinate.

better:

urinary retention related to pelvic edema and side effect of opioids as evidenced by need to urinate but unable to begin voiding.