NURSING CARE PLAN
ASSESSMENT DATANURSING DIAGNOSISDESIRED OUTCOMES
Mr. John Baker is a 68-year-old shopkeeper who was admitted tothe hospital with urinary retention, hematuria, and fever. The ad-mitting nurse gathers the following information when taking anursing history. Mr. Baker states he has noticed urinary frequencyduring the day for the past 2 weeks, and that he doesn’t feel hehas emptied his bladder after urinating. He also has to get up twoor three times during the night to urinate. During the past fewdays, he has had difficulty starting urination and dribbles after-ward. He verbalizes the embarrassment his urinary problemscause in his dealings with the public. Mr. Baker is concernedabout the cause of this urinary problem. He is diagnosed with be-nign prostatic hypertrophy (BPH) and referred to a urologist whosuggests a transurethral resection of the prostate (TURP) in sev-eral months. He is placed on antibiotic therapy.
Impaired Urinary Elimination
(retention and overflow inconti-nence) related to bladder neck obstruction by enlargedprostate gland (as evidencedby dysuria, frequency, nocturia,dribbling, hesitancy, and blad-der distention)Urinary Continence  asevidenced by:
Able to start and stopstream
Empties bladder completelyKnowledge: Treatment Regi-men  as evidenced bysubstantial:
Description of self-care re-sponsibilities for ongoingcare
Description of self-monitoringtechniques
Urinary Incontinence Care 
Monitor urinary elimination, including consistency, odor, volume,and color.Help the client select appropriate incontinence garment or padfor short-term management while more definitive treatment isdesigned.Instruct Mr. Baker to limit fluids for 2 to 3 hours before bedtime.Instruct him to drink a minimum of 1,500 mL (six 8-ounceglasses) fluids per day.Limit ingestion of bladder irritants (e.g., colas, coffee, tea, andchocolate).
These parameters help determine adequacy of urinary tract function. Appropriate undergarments can help diminish the embarrassingaspects of urinary incontinence.Decreased fluid intake several hours before bedtime will de-crease the incidence of urinary retention and overflow inconti- nence, and promote rest.Increased fluids during the day will increase urinary output and discourage bacterial growth. Alcohol, coffee, and tea have a natural diuretic effect and are bladder irritants.
Height: 185.4 cm (6
)Weight: 85.7 kg (189 lb)Temperature: 38.1°C (100.6°F)Pulse: 88 BPMRespirations: 20/minuteBlood pressure: 146/86 mm HgCatheterization for urinary re-tention yielded 300 mL amberurine, Foley left in place for2 days
CBC normal; urinalysis: amber,clear, pH 6.5, specific gravity1.025, negative for glucose,protein, ketone, RBCs, and bac-teria; IVP: evidence of enlargedprostate gland
Urinary Retention Care 
Instruct Mr. Baker or a family member to record urinary output.Catheterize for residual urine, as appropriate.Implement intermittent catheterization, as appropriate.
Serves as an indicator of urinary tract and renal function and of fluid balance. An enlarged prostate compresses the urethra so that urine is re-tained. Checking for residual urine provides information about bladder emptying.Helps maintain tonicity of the bladder muscle by preventingoverdistention and providing for complete emptying.