Did I choose the right thing to do as a nurse on my test?

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In a nutshell, the patient had just returned surgery earlier that day and hadn't void 6 hours later, the question did not state what type of surgery was performed. I answered to call the Dr. and notify him, and obtain an order to do a straight cath on the patient. One of the other POSSIBLE answer options was to perform a bladder scan, however I know that whenever performing a bladder scan the patient should void first, so that the nurse can really see how much urine is being retained. Was I right?

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We have standing orders for a bladder scan, so that makes me think you need an order for a bladder scan...so I'd let the doctor know?

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We have standing orders for a bladder scan, so that makes me think you need an order for a bladder scan...so I'd let the doctor know?

I don't think you need an order to perform a bladder scan according to my book and instructor it's an independent nursing intervention. I just still felt like even if I did the bladder scan first I would still have to notify the Dr and obtain an order to straight cath the patient. Plus the patient had not voided at all, 6hours post-op...sounds serious enough to me to call the doctor, no matter the surgery.

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Specializes in Critical Care.

Bladder scan then call the doctor. I would like to call the doctor and be able to say "so and so had their surgery 6 hours ago, they have yet to void post surgery. Bladder scan revealed 999mL. Can I get an order to straight cath?"

Or what if you bladder scan and the patients only has 120ml of fluid? Does that volume warrent a straight cath?

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Bladder scan then call the doctor. I would like to call the doctor and be able to say "so and so had their surgery 6 hours ago, they have yet to void post surgery. Bladder scan revealed 999mL. Can I get an order to straight cath?"

Or what if you bladder scan and the patients only has 120ml of fluid? Does that volume warrent a straight cath?

You're right. I guess I got that one wrong :( I just figured like they said it's ideal for the patient to urine before doing the bladder scan.

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Specializes in Critical Care, Med-Surg.

I think bladder scan may have been the correct choice; generally try the least invasive intervention first. As stated, this will also give you information to provide the doc when you call.

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Specializes in retired LTC.

And remember that your pt has been NPO for how long? Only rec'd fluids in OR and some post-op, so there may not be any great volume.

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I figure notify the Doctor and inform him/her going to do bladder scan. Do blood work (Hopefully if ordered; check BUN level), straight cath, monitor intake/output, recheck vitals, but ha probably not an option.

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Specializes in Medical-Surgical, Telemetry.

Bladder scan first. It's a nursing intervention you can do on your own first without an order. The pt may not even be making urine, thus why they are not voiding, which would then warrant that call to the doctor, if bladder scan showed zero. The doctors where I work used to actually get attitude with you if you called about no voiding and didn't do a bladder scan. Now we have a protocol in place that lets the nurse straight cath without a physician order, dependent upon what the BS volume is. Also, when I was in school, we were always taught to not always be drawn first to the option that is "call the doctor" because they said that will never be the answer on NCLEX because they want to know what the nurse can/will do :)

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