[ktwlpn]

one of our local urologists always has us attempt to pass a straight cath before we send the resident out to the ed in the middle of the night.Our foley caths are soft -the straight caths in our kits are firmer and sometimes you need that to get past a prostate (under doc's orders,of course) It sounds like your guy needs to be seen by a uro asap.

[EDValerieRN]

Try a coude tip, and it also helps to get a bigger french catheter. The little ones will not hold as well as the bigger french, especially if the patient has had a catheter for a while. Use lido instead of KY, the guy is going to hurt.

I wonder if the cath had slipped out of the bladder and just needed advanced? Sometimes those urethras stretch out when they've accomodated a cath for so long. I don't think I would have removed the first cath until urology came to look at it, but then again, some hospitals don't have the luxury of urology 24/7, I'm a lucky one.

What ended up happening?

[SitcomNurse]

I've seen suction caths passed, in an emergency, you need to get it empty....get the smalllest FR. available....heck, Id try to pass anything for my guys..
and yes, coude is most effective for many reasons...

[doingourbest]

Originally Posted by WantobeRN

I know this is a basic question, but what do you do if patient's bladder is very distended and full, but cant insert foley in male patient?

Does your facility have a bladder scanner? If so, do a bladder scan. If not, you neeed to straight cath him and find out how much urine is in his bladder. Why can't you insert a foley. Is his prostate in your way? Some times you have to push fairly hard to get past the prostate. Anyway, if the man can't urinate, you will have to call the DR and document that in the chart. He will most likely tell you to put in a catheter.

Shana

[canoehead]

A Coude or a firmer catheter in a small size may work. We also have lidocaine jelly that you can "inject" into the urethra and use as a lubricant and numbing lotion. I've had lots of success with that when I can't get past an obstruction- the patient relaxes and there is a little more room.

[Barb101]

Hmmmmmmmmmm not being able to advance the catheter would really tick me off but some times getting the experts is the best answer even if it does cause initial embrassment. Hey it can always be justified as pt comfort and safety!