how do you handle this?

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

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.

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!