The nurse is teaching the patient with a flaccid bladder. What should the care plan include for this patient.

Appeared in: PGIMER Sangrur NO - 2023

Explanation

A flaccid (atonic) bladder is characterized by a weak detrusor muscle that cannot contract to empty the bladder, leading to urinary retention.
Crede's maneuver involves applying manual pressure over the suprapubic region to mechanically compress the bladder and expel urine.
This technique directly addresses the primary problem of a flaccid bladder, which is the inability to void.
Other interventions like intermittent catheterization are also used, but Crede's maneuver is the correct non-invasive technique listed.

Option A: Kegel exercises strengthen the pelvic floor and sphincter muscles. This is ineffective for a flaccid bladder where the problem is a non-contracting detrusor muscle, not a weak outlet.
Option C: A patient with a flaccid bladder cannot voluntarily empty it, regardless of how frequently they are encouraged to try. They lack the necessary muscle function.
Option D: While adequate fluid intake is important for overall urinary health and preventing UTIs, it does not solve the mechanical problem of urinary retention in a flaccid bladder.

Clinical Relevance

Nursing practice connection: Use the key finding related to Management of Flaccid Bladder to guide bedside assessment, documentation, and the next nursing action.
Proper management of a flaccid bladder is crucial to prevent complications like recurrent urinary tract infections (UTIs), kidney damage (hydronephrosis), and bladder overdistension.
Nurses play a key role in teaching the patient and their family the correct technique for Crede's maneuver, ensuring it is done effectively and without causing injury.
It is important to note that Crede's maneuver is contraindicated in certain conditions, such as pregnancy or after abdominal surgery, and should be prescribed by a healthcare provider.

How to Approach the Question

First, identify the key condition in the question: 'flaccid bladder'.
Recall the pathophysiology of a flaccid bladder: the detrusor muscle does not contract, leading to urinary retention.
The core problem to solve is how to empty the bladder when the muscle cannot do it.
Evaluate each option based on this core problem.
Option A (Kegels) affects the sphincter, not the detrusor muscle. Eliminate it.
Option B (Crede's maneuver) manually compresses the bladder to expel urine. This directly addresses the problem.

Concept Tested & Keywords

QhtoMuxH8PbPxQqZWuLSed

E6 Nursing Fundamentals Potter Perry 12e Part 5 p. 251-253

E6 Nursing Brunner Adult Health 3SA Vol 2 Part 2 p. 113-115

Practise the full PGIMER Sangrur NO - 2023

Attempt every question from this paper in a timed mock, then review the full solution for each one.