Urinary catheterization

Question 1

what are the 2 major purposes of urinary catheterization

Answer 1

• draining urinary bladder
• collecting urine for measurement

Question 2

what are the perks to using catheters

Answer 2

• Allows a route of direct access to the bladder
• Uncontaminated urinary samples
• Reliable assessment of all urine output
• Bypassing urinary obstructions

Question 3

what are indications for urinary catheters

Answer 3

• impediment to flow
• diagnostic evaluation
• treatment of GU conditions

Question 4

what are things that could cause impediment to urinary flow

Answer 4

• Acute urinary retention
• Bladder outlet obstruction
• Severe hematuria with clots
• During and after surgery of the GU tract or adjacent structures

Question 5

what are diagnostic evaluation indications for catheters

Answer 5

• Urine output measurement
• Acquiring sterile urine sample in pts who cannot provide one

Question 6

what are the indications for catheterization involving treatment of GU conditions

Answer 6

• Management of immobilized patients
• Neurogenic bladder
• Severe, refractory urinary incontinence
• Improved patient comfort in hospice care
• Intravesical pharmacologic therapy

Question 7

what are ABSOLUTE contraindications to catheters

Answer 7

urethral injury such as:
- pelvic trauma
- blood at uretheral meatus or gross hematuria in context of trauma

Question 8

what are RELATIVE contraindications for urinary catheters

Answer 8

• urethral stricture
• recent GU surgery
• artificial urinary sphincter

Question 9

what are possib le complications for urinary catheterizations

Answer 9

• infections (UTI, epididymitis)
• mechanical (retained balloon fragments)
• bladder damage (fistula, perf, stones)
• urethral damage (trauma)

Question 10

what are the 4 points of responsible catheter use

Answer 10

• use only when absolutly necessary
• use sterile placement technique
• use non-indwelling if possible
• use for as short a time as possible

Question 11

what are types of external urinary catheters

Answer 11

• condom catheters (male only)
• urinary pound (primarily for ostomies)
• pureWick (female only)

Question 12

when are external urinary catheters NOT reccommended

Answer 12

for accurate urine measurement, or obstruction

Question 13

what are CI for external catheters

Answer 13

• skin ulcerations
• perineal dermatitis

Question 14

what are advantages to external urinary catheters

Answer 14

• more comfortable
• minimal/no urethral trauma

Question 15

what are disadvantages to external urinary catheters

Answer 15

• Skin irritation and scarring
• Dislodgement and leakage
• Penile ulceration and tissue loss
• Inaccurate for most clinical diagnostic purposes

Question 16

what are suprapubic urinary catheters

Answer 16

the most invasive form of catheter, placed through the abdominal wall!

Question 17

what are the advantages of suprapubic urinary catheters

Answer 17

• Prevents urethral trauma/stricture
• Less bacteriuria
• Increased satisfaction vs. indwelling urethral catheters
• Allows attempts at normal voiding
• Less interference with sexual activity

Question 18

what are disadvantages of suprapubic urinary catheters

Answer 18

• Requires surgical placement
• May see long-term skin erosion, urinary leakage

Question 19

what are the intermittent urethral catheters

Answer 19

urethral catheter that is placed and immediatly removed after bladder is drained

AKA “straight cath”

Question 20

what are the indications for intermittent urethral catheters

Answer 20

• short or long term management of urinary retention
• neurogenic bladder

Question 21

what are the indwelling urethral catheters also known as

Answer 21

foley catheters

Question 22

what are the common uses for indwelling urethral catheters

Answer 22

• In-pt hospital setting for short-term bladder drainage (< 3 wks)
• Chronic urinary retention in pts who can’t undergo other interventions
• Chronic urinary incontinence refractory to all other tx methods

Question 23

what are the disadvantages of an indwelling urethral catheter

Answer 23

assocaited with:
- UTIs
- increased pt discomfort and dissatisfaction

Question 24

what are the preliminary steps to placing an indwelling catheter

Answer 24

• Introduce self, identify patient
• Explain procedure
• Ensure patient consent for procedure
• Wash hands and don non-sterile gloves
• Assist patient into supine position, with legs spread
• Ensure area (e.g., bed) is clear and treatment area is clean and exposed

Question 25

what are the steps for preparation for insertion when placing an indwelling urinary catheter

Answer 25

* Apply sterile gloves * Recommended not to inflate balloon prior to insertion * Coat distal portion of catheter in lubricant * Apply sterile drape on patient * Use non-dominant hand to separate labia or hold the penis * Cleanse the periurethral tissue with swabs using the dominant hand

Question 26

whar are the steps to actually placing the indwelling catheter

Answer 26

Question 27

what is included in post-procedure care for indwelling catheters

Answer 27

* Secure catheter to patient’s abdomen or thigh * Be sure catheter is connected to drainage system * Place drainage bag below level of bladder * Ensure no kinking or potential obstruction of tubing exists

Question 28

Wow! that one was short!!

Answer 28