Urinary Retention for Certified Emergency Nursing (CEN)

A 35-year-old woman arrives at the ED complaining of nausea, vomiting, malaise, and a decreased urine output. She recently completed a 2-week course of cephradine (Velosef) for a UTI. Urinalysis reveals a sodium level of 40 mEq/L with a urine specific gravity of 1.0. Urine sediment includes casts, with few red blood cells (RBCs) or white blood cells (WBCs). Other laboratory findings include a serum BUN level of 40 mg/dL and a serum creatinine level of 4 mg/dL. Which condition is suggestive of the patient’s assessment findings?

Which nursing diagnosis would be appropriate for a patient who has undergone percutaneous nephrostomy:

The physician determines the need for a percutaneous nephrostomy. The initial goal in caring for this patient would be to:

A 58-year-old male has arrived at the ED complaining that he has not been able to urinate for 3 days. After inserting an indwelling urinary catheter and draining 2,500 mL of urine from the patient’s bladder, the nurse formulates a nursing diagnosis of:

A 48-year-old male arrives at the ED complaining of a decreased urine output. Which assessment finding is the most accurate indicator of this patient’s renal function?

Which laboratory finding is an indirect measurement of a patient’s glomerular filtration rate (GFR)?

The nurse notes that no urine has drained from a patient’s catheter for 2 hours. Which is the most appropriate nursing action to take?

A 62-year-old man arrives at the ED after being unable to urinate for the past 2 days. He appears slightly confused and complains of nausea, vomiting, and swollen ankles. His history reveals no renal dysfunction but a history of benign prostatic hypertrophy. Laboratory findings indicate a serum BUN level of 38 mg/dL and a serum creatinine level of 4 mg/dL. The nurse suspects that this patient is exhibiting signs and symptoms of:

The IVP reveals 100% obstruction of the right ureter with severe hydronephrosis in the right kidney. The physician determines the need for percutaneous nephrostomy. Which is the most appropriate explanation the nurse can offer the patient about this procedure:

The physician determines the need for percutaneous nephrostomy. Which test will provide the health care team with the most valuable diagnostic information in this situation?