A postoperative patient has not voided for 7 hours after return to the postsurgical unit. Which action should the nurse take first?

• A. Notify the surgeon.
• B. Perform a bladder scan.
• C. Assist the patient to ambulate to the bathroom.
• D. Insert a straight catheter as indicated on the PRN order.

Answer: (B)

Postoperative urinary retention is common due to anesthesia and opioid use, so the first step is to assess bladder status with a noninvasive bladder scanner. This quickly tells you how much urine is in the bladder and helps distinguish true retention from other causes of not voiding. If the scan shows a significant residual volume, you can escalate to appropriate interventions (per protocol) such as catheterization or physician notification. If the bladder is not distended or the residual is small, you can pursue less invasive strategies to facilitate voiding, such as encouraging ambulation, adequate fluids, or adjusting analgesia. Jumping straight to catheterization or calling the surgeon without knowing the bladder volume risks unnecessary invasive intervention and delays in care.