I took care of a patient last week who had almost zero urinary output on my night shift. I bladder scanned her and it read 601 ml, so I called her MD who ordered a foley catheter. I inserted the foley and only got 250 ml return. We tried repositioning her, having her stand, etc. and there was no further output. I flushed the foley and the sterile water returned in the collection bag, but it was very dilute and didn't appear to have much urine in it, also only returned about the same amount that I flushed it with. There was no moisture underneath the patient after I flushed it, so I know that the foley was still in the bladder and the balloon inflated perfectly when I checked it before inserting the foley so I believe that it was still inflated in the patient's bladder. It came time for the day shift to take over and I offered to remove the foley and place a different one before I left but the day shift nurse said not to worry about it, she would check it out, and I never found out what happened with it because I have not worked on that floor again since that shift. (I am a float nurse with our company's internal agency). I should add that this patient denied an urge to void both before and after I placed the foley.
I have been an RN for 23 years and have never had anything like this happen before. My question is, have you ever seen a bladder scanner measure inaccurately, and if so, to this degree, which would have been about a 350 ml difference between what it read and what drained from the patient's bladder when I inserted the foley? I have inserted literally hundreds of foleys, so I know that my technique is okay, but I am baffled by this, especially since we repositioned the patient and had her stand and the foley flushed and returned freely. I don't have tons of experience using a bladder scanner because, at least where I practice, it seems to be a relatively new procedure that became common during the years that I was a hospice nurse in the field and never used one. However, it's very simple and pretty hard to mess up, right?