The client had an indwelling urinary catheter removed an hour ago and now reports a sense of fullness, discomfort, and dribbling of urine when voiding. What is the first action the PN should take?

The client had an indwelling urinary catheter removed an hour ago and now reports a sense of fullness, discomfort, and dribbling of urine when voiding. What is the first action the PN should take?

• A. Reinsert catheter immediately.
• B. Perform a bladder scan 5 to 15 minutes after the client has voided.
• C. Observe for a fever.
• D. Palpate the bladder.

Answer: (B)

Assessing urinary retention with a bladder scan is the first move after catheter removal when the client reports fullness, discomfort, and urine dribbling. A bladder scan provides a quick, noninvasive estimate of post-void residual—the amount of urine left in the bladder after voiding. This helps determine if the bladder is still full and not emptying properly, which is the likely cause of the symptoms described. By performing the scan a few minutes after the client has voided, you can see whether there is significant residual urine. If the residual is high, it indicates retention and guides the next steps, such as considering recatheterization or intermittent catheterization per protocol. If the residual is low, the symptoms might be due to another issue, and you can investigate further without unnecessary interventions. Observing for fever or palpating the bladder are less informative in this immediate situation. Fever suggests infection but does not address retention directly, and palpation is less reliable and more subjective than a bladder ultrasound, which gives an objective measurement.

Assessing urinary retention with a bladder scan is the first move after catheter removal when the client reports fullness, discomfort, and urine dribbling. A bladder scan provides a quick, noninvasive estimate of post-void residual—the amount of urine left in the bladder after voiding. This helps determine if the bladder is still full and not emptying properly, which is the likely cause of the symptoms described.

By performing the scan a few minutes after the client has voided, you can see whether there is significant residual urine. If the residual is high, it indicates retention and guides the next steps, such as considering recatheterization or intermittent catheterization per protocol. If the residual is low, the symptoms might be due to another issue, and you can investigate further without unnecessary interventions.

Observing for fever or palpating the bladder are less informative in this immediate situation. Fever suggests infection but does not address retention directly, and palpation is less reliable and more subjective than a bladder ultrasound, which gives an objective measurement.