Question

The nurse is caring for a 49-year-old patient, who has been unable to urinate after surgery. A bladder scan reveals that there is urine in the bladder. What medication should the nurse expect will be ordered for this patient?

Select one:
a. Atropine, an anticholinergic agent
b. Carbidopa-levodopa (Sinamet), a dopaminergic agent
c. Bethanechol (Urecholine), a cholinergic agent
d. Phenytoin (Dilantin), a hydantoin

Answer 1

The correct medication for a patient unable to urinate postoperatively, with urine present in the bladder, is Bethanechol (Urecholine), a cholinergic agent that stimulates bladder contractions. Anticholinergic agents like Atropine would not be indicated. Instead, Bethanechol works by engaging the parasympathetic nervous system to promote urination.

Step-by-step explanation:

When a patient is unable to urinate after surgery, despite having urine in the bladder, the nurse should expect a medication that can help stimulate the bladder to contract and facilitate urination. Considering the options provided, the most appropriate medication would be Bethanechol (Urecholine), a cholinergic agent. This medication stimulates muscarinic receptors and mimics the action of the neurotransmitter acetylcholine, which can promote urination by engaging the parasympathetic nervous system to contract the bladder.

An anticholinergic drug such as Atropine would not be indicated in this scenario as it would further inhibit the ability to urinate by blocking the muscarinic receptors. The antidote for atropine or scopolamine poisoning is a muscarinic agonist, specifically pilocarpine, which can reverse the effects of atropine by activating the muscarinic receptors.

In terms of the specific question about what medication to expect for a patient unable to urinate postoperatively, choice 'c' Bethanechol (Urecholine) is the correct answer. This drug is a cholinergic agent that can treat urinary retention by increasing bladder contractions and the ability to void.