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Obtaining a Post-Void Residual Urine Volume

Overview: To assess bladder function related to urine retained after voiding.

Preparation
● Assess patient’s and/or caregiver’s understanding and ability to participate in the procedure.
● Make sure patient understands that catheterization occurs immediately post-void and bladder will be drained.
● Determine if specimen is needed.
● Voided and residual urine volumes are attained.

Special Considerations
• Patients who have had recent gynecologic surgery need careful handling because the perineum may still be in the healing process.

Elderly, Physically, or Mentally Challenged Patients
• May need more assistance for procedure.

Pediatric Patient
• Explanation of procedure should be appropriate for age/developmental level and involve parents as much as possible.

Relevant Nursing Diagnoses
● Altered urinary elimination related to bladder trauma, surgery, and/or neuromuscular dysfunction
● Pain related to bladder distention or edema in perineum
● Potential for Infection related to increased microorganism growth due to urinary retention

Expected Outcomes
● Obtained residual urine volume is accurate
● Patient expresses minimal discomfort during and following procedure
● Patient will not develop a urinary tract infection
● Patient’s concerns and questions are adequately addressed

Implementation
1. Review prescriber’s orders.
Rationale: Determines if patient can ambulate, and frequency of residual urine volume measurement.

2. Explain procedure and its purpose to patient; provide privacy. Include caregiver when indicated.
Rationale: Clear explanations reduce patient anxiety and facilitate patient/caregiver cooperation and understanding of procedure. Maintains patient’s dignity.

3. Gather all equipment.
Rationale: Enhances organization and patient safety.

4. Wash hands and don clean gloves.
Rationale: Reduces transmission of organisms.

5. Insert “hat” into toilet or bedside commode and assist patient to bathroom or bedside commode, or with bedpan/urinal if needed, and have patient void.
Rationale: To collect voided urine for measurement. Facilitates voiding in manner most comfortable or necessary for patient.

6. Have patient lay flat and use the bladder scanner to check for residual urine (if indicated by facility protocol).
Rationale: Facilitates performance of procedure and justifies bladder is not empty.

7. If there is a significant residual, prepare to catheterize the patient.
Rationale: Empty bladder and determine amount of residual urine.

8. Wash hands.
Rationale: Reduces transmission of organisms.

9. Perform straight catheterization, maintaining aseptic technique and being careful to completely empty bladder.
Rationale: Reduces transmission of organisms. Ensures accurate residual urine volume measurement.

10. Clean and dry perineum and assist patient to a comfortable position.
Rationale: Reduces transmission of organisms and promotes patient comfort.

11. Measure voided and residual urine.
Rationale: Provides pertinent information regarding bladder status.

12. Obtain a specimen, if ordered, and then dispose of urine.Dispose of contaminated equipment in appropriate receptacles.
Rationale: A specimen may be ordered to monitor for urinary-tract infection. Reduces transmission of organisms.

Evaluation and follow up activities
● Assess accurately both voided and residual urine volumes
● Assess color, clarity, odor, and character of both voided and residual urine
● Assess patient’s comfort level during and following procedure
● Address patient’s questions and concerns
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