1
Q
Nocturia means
A
having to wake from sleep one or more times at night to pee
2
Q
polyuria means
A
abnormally large volume of urine output over 24 hours
3
Q
Anuria means
A
Virtually no urine output usually less than 100ml per day
4
Q
Cystitis
A
inflammation of urinary bladder most often due to infection
5
Q
urethritis
A
inflammation of urethra often infections causing pain and burning
6
Q
haematuria
A
presence of blood in the urine
7
Q
suprapubic
A
located in the region just above pubic bone in the lower abdomen
8
Q
Dysuria
A
painful, burning or uncomfortable urination
9
Q
UTI
A
infection of any part of the urinary system (kidney, bladder or urethra)
10
Q
Urinary Retention
A
inability to empty the bladder completely which may be acute or chronic
11
Q
Pis-en-deux
A
need to pee twice within short interval to fully empty
12
Q
urgency of micturition
A
a sudden compelling desire to pass urine that is difficult to defer
13
Q
frequency of micturition
A
passing urine more than normal
14
Q
residual volume
A
volume remaining after voiding
15
Q
intermittent catheterisation
A
periodic insertion of catheter into bladder to drain urine
16
Q
intravenous pyelogram
A
xray study of kidney, ureter and bladder preformed after injecting contrast into vein to show urinary tract
17
Q
Most common catheter is
A
foley
18
Q
what does the size of catheter refer to
A
sizes are in french gauge and refer to outside circumference in milimetre of catheter
19
Q
Size range from children, women and men
A
6 to 10 for children
10 to 14 for women
14 to 18 men
always try the smallest for the person
16-20 only if debris in urine
20
Q
when to use 3 way catheter
A
used urologically for washout of bladder
third channel is continuous irrigation used in case of bleeding from bladder or prostate
21
Q
what is listed on the plastic cuff of the sidearm
A
french size and recommended filling volume of catheter retention balloon
22
Q
what are the 3 foley catheter lumens
A
single lumen - drainage no ballon
double lumen- drainage and ballon inflation
triple lumen - drainage, balloon and irrigation
23
Q
3 types of catheter materials
A
latex, simplastic and silastic silicone
24
Q
Indications for IDC Diagnostically
A
monitor urine output
obtain specimen
assessment of post traumatic haematuria
instilling radio-opaque dye for imaging
25
Indications for IDC Therapeutically
urinary obstruction
urinary retention
neurogenic bladder
instilling medications into the bladder
26
Contraindications for IDC
known/suspected urethral injury
pelvic fracture
post-op urological patients
known urethral strictures
presence of tumor
27
What is important to tell patient to reduce their anxiety about IDC
why catheterisation is necessary
how long it is to stay in
sensations felt in the procedure
how person can help in the procedure
28
what are the 2 ways to insert catheters
per urethrum
suprapubic - through skin reached the bladder
29
What equipment is in a catheter pack
2 long trays
5 plain gauze squares
sterile fenestrated drape
2 x forceps
10ml sterile water for inflation of balloon
30
what equipment outside of catheter pack is needed
sterile gloves
normal gloves
extra guaze
bottle or sachet of saline
q0ml syringe
10ml 2% lignocaine
catheter drainage bag
tape or dressing
catheter
specimen pot
absorbent pad
31
steps to Prep Patient and Pre-inspection
wash hands
check the patient identity
explain the procedure - why, how long. sensations
consent
ensure privacy
raise the bed,
position patient with absorbent pad underneath
cover pt abdomen
give soap warm wash
inspect genitalia
32
what position patient needs to be for pre-inspection
male - supine with genitalia exposed
female - supines with knees flexed, hips abducted and heels touching
33
Setting up Equipment - unsterile
clean the trolley
open the catheter pack
place the equipment in the centre of sterile field
remove drainage bag - unsterile check clamp is closed
place speciem jar within reach
preform sterile hand wash
34
setting up equipment sterile
don sterile gloves
tear way plastic cover of catheter
fix the cap on lignocaine
dip 3 gauze in saline
draw up 10ml water
inform patient your ready
35
1st part of catherisation procedure
place sterile drape over pt
place blue tray with saline gauze and blue tray with catheter and lube on the drape
with non-dominant hand hold two dry gauze
36
Procedure of Inserting the Catheter - Male
Position the ‘blue’ tray directly between person’s legs to collect any spills of urine.
Inform the person that you are ready to start and ask them to take a deep breath and
exhale to facilitate sphincter relaxation and reduce sphincter irritation
Lift the penis to a vertical position. Insert the nozzle of the lignocaine gel into the urethra and inject the gel – use the whole amount; 10 mL. Gently squeeze the tip of the penis
together to prevent the gel from escaping. Hold for at least 2-3 minutes to allow the anaesthetic to work.
Hold the penis perpendicular to the body.
Insert the tip of the catheter into the meatus and advance slowly but firmly.
On entering the bladder urine should flow.
Advance the catheter to the bifurcation to ensure the catheter balloon is entirely in the
bladder.
Ensure urine is flowing before the balloon is inflated with the 10 mL of water (or the amount specified on the catheter itself) through the catheter side arm
37
Procedure of Inserting the Catheter - Female
Position the ‘blue’ tray directly between person’s legs to collect any spills of urine.
Inform the person that you are ready to start and ask them to take a deep breath and
exhale to facilitate sphincter relaxation and reduce sphincter irritation
Keeping the labia apart, insert the nozzle of the xylocaine gel into the urethra and inject the gel – only will need to use 4 -5 mL. Wait 2-3 minutes for the anaesthetic to work.
Insert the catheter into the meatus in the anatomical direction of the urethra. (i.e. parallel to the bed, then slightly downward).
If the catheter has been advanced for 10 to 12 cm without any urine return, it is probably in the vagina. Do not remove this catheter. Open another catheter and try again. You will
need to go above where the current catheter is inserted to locate the urethra.
When the urine begins to flow, advance a further 6 to 8 cm.
Ensure urine is flowing before the balloon is inflated with the 10 mL of water (or theamount specified on the catheter itself) through the catheter side arm
38
collecting the urine sample
Obtain a sterile urine specimen after allowing the first several millilitres to drain into the blue tray.
Pinch the catheter and hold the distal end over the specimen jar until the required amount is collected.
Pinch the end again and return the distal end to the kidney dish.
Attach the draining tube and the bag to the catheter.
Remove the drape by ripping down the middle.
Replace the foreskin in males and assist females to reposition legs as required.
Secure catheter to person’s leg to prevent pulling or accidental displacement.
Cover person, assist with dressing if needed.
Record the residual urine volume in the person’s chart.
Document what you have done clearly in person’s notes including catheter size, date of
insertion, urine volume, any complications and specimen collected
39
Removal of an IDC - equipment required
An absorbent pad - Wrap all items in bluey to dispose of appropriately
Unsterile Gloves.
10mL syringe.
Urine specimen jar
40
collecting sample of urine in removal process
Clamp catheter tubing with gauze and a pair of artery forceps
Remove drainage bag
Place sterile urine specimen jar at distal end of catheter
Unclamp the artery forceps
Collect an amount of urine in specimen jar
Re-clamp artery forceps around catheter tubing
41
1st part of the removal of catheter
Perform procedural hand wash.
Check person’s identity, explain procedure and obtain verbal consent.
Don unsterile gloves.
Position person and yourself: Raise bed to comfortable working height.
Cover person’s abdomen with a sheet – expose as little as possible.
Both males and females should assume a supine position with legs slightly apart.
Position ‘Bluey’ under the person’s buttocks.
Open 10mL syringe.
Prepare urine specimen jar within easy reach if required– again loosen the top of jar but do
not remove.
Remove tape or dressing securing catheter
42
2nd part of catheter removal
Insert 10mL syringe into the injection port of the catheter and withdraw the fluid/water from
the balloon.
DO NOT pull the catheter while the balloon is inflated; doing so may injure the urethra.
After all the fluid is withdraw, gently withdraw the catheter and place it on the bluey (a
kidney dish can also be used).
Inspect the genitalia for evidence of trauma or infection.
Measure the urine in the drainage bag.
Dispose of all equipment appropriately.
Remove gloves and wash hands.
Document: time the catheter was removed; amount, colour and clarity of urine; and the
intactness of the catheter
43
what is good practice after the catheter is removed
it is good practice to give the person a washer to clean their pubic area or assist them to the
bathroom.
some people may experience difficulty returning to their normal urinary elimination patterns.
The time and amount of the first void is documented
44
What are some reasons for urinalysis
Routine health screening (e.g., pre‑employment assessments).
Suspected urinary tract infection (UTI) based on symptoms.
Abnormal‑appearing urine (colour, odour, clarity, or presence of visible sediment).
Monitoring in people with diabetes.
Assessment during pregnancy.
Baseline assessment on admission to hospital
Preoperative evaluation.
Post insertion of IUC.
On removal of IUC
45
what are the 3 types of urine specimens
1. midstream urine
2. Clean voided specimen
3. IDC Obtained
46
equipment for a urinalysis
Urine dipstick test strips with colour comparison chart for interpretation.
Fresh urine specimen.
Clean, non-sterile gloves.
Paper towel
Pen and paper
Timer
47
procedure of urinalysis
Perform hand hygiene.
Put on clean gloves.
Check the expiry date on the dipstick container.
Remove one dipstick without touching the reagent pads to avoid contamination which can
result in a false result.
Immediately replace the lid on the container to protect strips from moisture.
Immerse the reagent pads (dipstick) fully into the urine specimen.
Remove the strip, tap gently and place on a paper towel to remove excess urine.
14
Allow the strip to react for the manufacturer specified time.
Compare each pad with the colour chart on the container.
Dispose of the used dipstick and specimen according to clinical waste protocols.
Remove gloves and perform hand hygiene.
Document the results accurately
48
wha
CS
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