A postpartum patient has a full bladder of about 1000 mL. Which action is most appropriate to relieve retention?

A postpartum patient has a full bladder of about 1000 mL. Which action is most appropriate to relieve retention?

• A. Insert an intermittent catheter and drain the bladder.
• B. Let her void spontaneously.
• C. Insert an in-dwelling catheter for 24 hours.
• D. Warm bath to help void.

Answer: (A)

Relieving bladder distension promptly is essential after delivery to support proper uterine involution and prevent postpartum hemorrhage. A bladder holding about 1000 mL is significantly distended and unlikely to empty on its own, so relieving that pressure quickly is the priority. Draining the bladder with an intermittent catheter directly addresses the retention, restores normal bladder function, and allows the uterus to contract normally. Using an indwelling catheter for 24 hours adds infection risk and isn’t needed once the bladder is emptied and the patient can void; waiting for spontaneous voiding or warming the bath do not resolve the substantial retention efficiently. After drainage, reassess the ability to void and monitor for recurrence of retention or signs of infection.

Relieving bladder distension promptly is essential after delivery to support proper uterine involution and prevent postpartum hemorrhage. A bladder holding about 1000 mL is significantly distended and unlikely to empty on its own, so relieving that pressure quickly is the priority. Draining the bladder with an intermittent catheter directly addresses the retention, restores normal bladder function, and allows the uterus to contract normally. Using an indwelling catheter for 24 hours adds infection risk and isn’t needed once the bladder is emptied and the patient can void; waiting for spontaneous voiding or warming the bath do not resolve the substantial retention efficiently. After drainage, reassess the ability to void and monitor for recurrence of retention or signs of infection.