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Delirium due to urinary retention — DGM MCQ

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ModerateDeliriumDelirium due to urinary retentionDGM

An 88-year-old man becomes agitated after hip surgery. He has lower abdominal discomfort and has not passed urine for eight hours. Temperature is normal and oxygen saturation is 97% on air. Current medicines include morphine, tamsulosin and paracetamol. What is the most appropriate assessment?

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Correct answer: B — Bladder scan for urinary retention

Urinary retention is a common reversible precipitant of postoperative delirium and should be assessed promptly with bladder scanning. CTPA, B12 testing and lumbar puncture are not first-line without suggestive features, and discharge ignores acute delirium. Pain, constipation and retention should be actively sought in delirious postoperative patients.

Reference: NICE CG103; BGS delirium guidance