Question

You are working in the emergency department when M.B., a 72-year-old man, enters with a chief com-plaint of the inability to void. His initial vital signs (VS) are 168/92, 88, 20, 98.2° F (36.8° C). 1. Given M.B.'s chief complaint, what would you expect to find during your initial assessment? Voiding characteristics would be increased frequency of urination, lower volume of urine and possible incontinence. Blood tests might show a high prostate specific antigen. 2. What are your priorities for this patient? An assessment should be done which should include palpation and percussion of the lower abdomen. Patient should be taught techniques to void easier. Some techniques include standing up to use the bathroom and keeping a schedule of urinating. Patient should be taught to avoid drinks such as hot tea and coffee to reduce retention.

3.What can you delegate to the NA?

Answer 1

1.The initial assessment can be easily found out by palpation of the bladder This can suggest of urinary retention. This occurs on case of prostate enlargement in older patient. This often leads to urinary retention by urethral stricture, weakening of bladder muscle. There are high incidence of increased PSA level

2.After assessing the patient teaching techniques to void can help patient but before this patient should be encouraged to avoid tea,coffee, alcohol, sweetened beverages which can cause urinary retention

3.The NA can be delegated the following task like

• assisting in toileting
• Monitoring vital signs and reporting
• Provide personal hygienic care to the patient