A nurse is caring for a group of clients on a medical surgical unit. Which of the following clients is at risk for urinary retention?

Choice A rationale General anesthesia and the use of certain medications during surgery, such as opioids, can significantly impair detrusor muscle contraction and/or interfere with the sensation of bladder fullness, leading to temporary urinary retention. Surgical manipulation in the pelvic area can also contribute to temporary nerve dysfunction, which subsequently impairs the normal voiding reflex. Choice B rationale Liver failure, while causing numerous systemic effects, primarily affects clotting factors, drug metabolism, and albumin synthesis. It does not directly cause an increased risk of acute urinary retention through a known physiological mechanism; the risk of acute kidney injury from hepatorenal syndrome is an entirely separate and distinct complication. Choice C rationale A diet high in calcium oxalate is a risk factor for the formation of calcium oxalate kidney stones (nephrolithiasis). While kidney stones can potentially cause obstruction leading to post-renal acute kidney injury or urinary retention, the diet itself is not the primary direct risk factor for retention compared to immediate post-operative effects. Choice D rationale Glomerulonephritis is an inflammatory disease of the kidney glomeruli, often following an infection like streptococcal pharyngitis (not staphylococcal). This primarily leads to hematuria, proteinuria, and decreased glomerular filtration rate, not specifically an increased risk for acute urinary retention, which is a lower urinary tract issue. —.