What are the main indications for a urinary catheter
retention due to
- surgery
- urethral trauma
- obstruction
and incontinence
- management of incont.
- pressure sores that wont heal
- in and out for urine sample
6 signs of urinary retention
bladder distention, absence of urine for several hours, severe pain (or pressure if epidural/spinal anaesthetic) in pelvic area, restlessness, diaphoresis, overflow (voiding small amounts several times a hour)
6 medications that can cause urinary retention
- anticholinergics (atropine)
- antipsychotics (haloperidol)
- Antihistamines (diphenhydramine)
- Muscle relaxants (diazepam)
- morphine and all opioids
- Anesthetic agents
Where should the nurse palpate to access for a distended bladder
above the symphysis pubis
what methods can be used to assess bladder size/distention
palpation, percussion and bladder scanner
are UTIs more common in indwelling catheters or in and out catheters
they are more common in indwelling caths
What does HOUDINI stand for
- hematuria
- obstruction
- urologic surgery
- Decubitus ulcers
- input and output monitor
- not for resuscitation (end of life care)
- immobility due to physical restraints
Are male or females at a greater risk for CAUTI
males, due to longer and curved urethra (use lidocaine gel)
What angle should the nurse hold a penis when inserting a catheter
Hold penis 90 degree with upward traction to straighten the urethra
What size catheter should you use on a female?
What about male?
Female: 12 Fr,
Male: 14 Fr
How long can a latex catheter be used for?
about 1 month
How long can a silicone catheter be used for?
8-12 weeks
How long can a silastic catheter be used for? (silicone on the outside)
8-12 weeks
What position should you put a male client in for catheter insertion, how about female clients?
Supine position for males, dorsal recumbent for female
When inserting a catheter the nurse sees urine return, what should you do next?
insert 2 inches
What should the nurse do if they notice that the patient is retaining more than 700 mL
insert in and out foley and pinch catheter periodically while draining to avoid spasms occurring as can collapse bladder
how long should a catheter be clamped when collecting a urine specimen
10-15 minutes but no more than 30
If instructed to cut a catheter due to being inable to deflate the balloon, where should the nurse cut?
just below the valve used to fill the balloon (remember: this is LAST resort)
What tricks should the nurse try if they are unable to advance a catheter in a male client?
have the patient try to relax and deep breath, ask patient to try and void, ask patient to cough, try a twisting motion,
If the nurse can not get a catheter in a male client and they tried several tricks, what should the nurse do next
try a coude tip
When is continuous bladder irrigation most often seen
following a TURP for tmt of BPH
if a patient is on CBI, and the nurse notices the urine is bright red and contains clots, what should they do
speed up the irrigation
if the nurse is caring for a patient on a CBI and notices that the urine is clear, what should the nurse do
slow down the irrigation
when doing closed intermittent irrigation, how much sterile saline should the nurse inject into the port?
30 mL
