76-year-old admitted for pneumonia, now with recurrent urinary retention after two in-and-out catheterisations overnight.
Bed 3 is Mr. Thompson, 76-year-old admitted two days ago for community-acquired pneumonia. History of BPH and hypertension. Around 0200 he became increasingly restless and was trying to get out of bed. At that time he reported lower abdominal pressure and difficulty voiding. Bladder scan showed 680 mL retained. An in-and-out catheter was done per order and 650 mL was drained. He reported relief afterward. Around 0500 he again complained of pressure. Repeat bladder scan showed 520 mL. A second in-and-out catheter was performed, draining 500 mL. The order reads: In-and-out catheterization x2 PRN for retention >400 mL. Insert indwelling catheter if retention persists >400 mL after second episode. At 0630 he voided approximately 60 mL spontaneously. No bladder scan has been repeated since the second catheterization. Vitals have remained stable overnight: BP 134/78, HR 94, RR 20, O₂ sat 94% on 2L nasal prongs. Temp 37.8°C. He remains on IV Ceftriaxone for pneumonia. He's more settled now but says he still feels some mild pressure.
Preview — Step 1 of 1: Situational Awareness