After an appendectomy, a patient has not voided in eight hours. What should the nurse do first?

After an appendectomy, it is essential for the nurse to assess the patient's condition thoroughly before taking further action. Palpating the suprapubic area for bladder distention is the most appropriate initial step in this scenario. This assessment helps determine whether the patient has developed urinary retention, which could be a result of anesthesia, pain medications, or the surgical procedure itself.

Identifying bladder distention can guide the nurse in making an informed decision about the next steps. If distention is present, it may indicate that the patient needs assistance in voiding, either through catheterization or other measures. This assessment allows for a more accurate understanding of the patient's needs without prematurely jumping to interventions that may not yet be necessary.

For instance, while encouraging fluid intake can be beneficial, it may not be effective if the patient is unable to void; this could lead to further complications such as increased bladder distension. Similarly, while inserting a catheter might ultimately be needed, it is usually not the first intervention until an assessment reveals a significant issue. Lastly, notifying the physician may be warranted based on findings, but performing a direct assessment enhances the communication of relevant data regarding the patient's condition.