Question

Your patient is 4 hours post open appendectomy and has not voided yet. You note his lower abdomen is distended. What should you do NEXT?

1) Administer a diuretic
2) Insert a urinary catheter
3) Encourage the patient to drink more fluids
4) Monitor the patient's vital signs

Answer 1

The next step in managing a post-appendectomy patient who has not voided and has a distended lower abdomen is to insert a urinary catheter to relieve bladder distension and ensure proper emptying.

Step-by-step explanation:

If a patient is 4 hours post open appendectomy and has not voided yet with a noted distended lower abdomen, the next appropriate step would be to insert a urinary catheter. This is because urinary retention can be a common postoperative complication, particularly after procedures in the pelvic area. Inserting a urinary catheter will relieve the bladder distension, ensure proper bladder emptying, and help avoid further complications like bladder overdistension or urinary tract injury.

While monitoring vital signs is important in all postoperative patients, it does not directly address the immediate issue of the distended bladder. Additionally, administering a diuretic or encouraging the patient to drink more fluids may exacerbate the problem if the patient is unable to void due to urinary retention.