Your patient complains of not being able to urinate since 0500. It is now 1900. What should be your next step?

Performing a bladder scan is the most appropriate next step in this scenario because it allows for a non-invasive assessment of the patient's bladder volume. This step is essential in determining whether the patient has urinary retention and how full the bladder is before any invasive measures, such as catheter insertion, are taken. By assessing bladder volume, you can gather critical information about the patient's condition, which guides subsequent decisions about treatment.

If the bladder is found to be distended, it may indicate an urgent need for catheterization to relieve retention. However, if the bladder scan shows minimal volume, the underlying cause of the patient's inability to urinate might need further investigation, potentially without immediate intervention. This approach minimizes patient discomfort and complications associated with catheters.

In contrast, administering pain medication may be appropriate if the patient is in discomfort due to the inability to urinate, but it does not address the underlying problem of urinary retention. Contacting the physician might also be warranted if immediate intervention is necessary, but first, a bladder scan provides essential information that will help determine the urgency of contacting the physician or the need for catheterization.