Question

You are working in the emergency department, and your attending asks you to see a 65-year-old male presenting with abdominal pain. In gathering the history, the patient tells you that he has had two to three days of progressive generalized "achy" abdominal pain, along with decreased appetite and decreased urine output. On further clarification, he reports not urinating in the past two days. On exam, vital signs are normal. He is alert, oriented, and in no acute distress. His exam is benign with the exception of mild abdominal distention, a palpable bladder, and an enlarged prostate on digital rectal exam. Which of the following is the next best step? A. Computed tomography (CT) of his abdomen and pelvis B. Foley catheter placement C. Intravenous (IV) diuretics D. IV fluids E. Renal ultrasound

Answer 1

B. Foley catheter placement.

Step-by-step explanation:

This patient is likely suffering from acute urinary retention caused by benign prostatic hyperplasia (BPH).

As an enlarged prostate obstructs urine flow, the bladder cannot fully empty, leading to urinary symptoms and potential complications. The best immediate management is placement of a Foley catheter to drain the bladder and relieve obstruction. This provides temporary relief while allowing us to monitor urine output and obtain samples for analysis.

Hope this helps you! :)