| Summary |
The purpose of this study is to examine the various approaches to the nursing management of acute urinary retention in hospitalized patients. A longstanding controversy exists in relation to whether prompt, total evacuation or staged emptying of the distended urinary bladder is appropriate. At issue is whether total bladder emptying could induce complications such as shock, frank blood in the urine, and lightheadedness. Since most persons completely empty their bladders upon urination, it would seem reasonable to completely drain the bladder when passing a urinary catheter. Yet many practicing nurses and nurse educators advocate gradual emptying of the distended bladder, which is inconsistent with modern medical knowledge and beliefs. A quasi-experimental study was designed to compare the two methods of bladder emptying with respect to immediate subsequent changes in arterial blood pressure and heart rate and the occurrence of bloody urine and patient reports of light- headedness. In addition, a survey of eastern North Carolina hospitals was conducted to determine whether some community standard exists concerning the nursing management of acute urinary retention. The results of the quasi-experimental study were of limited usefulness, in that after several months only three subjects were obtained. The incidence of complications fol- lowing bladder catheterization was fairly evenly distributed between the total bladder emptying and gradual bladder emptying groups. Due to the small sample size, no conclusions could be drawn to reject or support the hypothesis that there is no difference between rapid, total bladder emptying and gradual bladder emptying with respect to immediate subsequent complications such as those described. Among 18 area hospitals, fully one-third cite no written policy on bladder catheterization for acute urinary retention. Among those hospitals that carry a policy, no one method is preferred, but it seems that larger hospitals (over 100 beds as opposed to less than 100 beds) tend to advocate total bladder emptying. |
