Catheter Care

Question 1

What are the possible presentations of a urogenital patient?

Answer 1

FLUTD 
Incontinence 
Obstruction 
Trauma 
Neoplasia 
Acute/chronic renal failure

Question 2

What is catheterisation?

Answer 2

Inserting a urinary catheter into the urethra up to the level of the bladder

Question 3

What are some of the possible reasons for catheterising a patient?

Answer 3

Obtaining a urine sample 
Emptying bladder prior to surgery 
Radiography (contrast media) 
Maintain patency of the urethra 
Unblocking 
Monitoring urine output
Prevent urine scalding 
Diverting urine

Question 4

What are the disadvantages of manual expression of the bladder?

Answer 4

Can rupture bladder
Not always possible in tense patients
Not sterile

Question 5

What are the disadvantages of free catch?

Answer 5

Can be time consuming

Not sterile

Question 6

What are the things to consider when performing cystocentesis?

Answer 6

Vets only
Care with other structures
Ultrasound to direct

Question 7

What equipment is needed for cystocentesis?

Answer 7

Clippers/scrub/alcohol
Needles (long)
5ml syringe
Collection pots/lab form/bag

Question 8

What type of catheter is this?
What is it used for?
Can it be used indwelling?

Answer 8

Portex
Clearing blockages back into bladder
Not indwelling

Question 9

What type of catheter is this?
What is it used for?
Can it be used indwelling?

Answer 9

Foley

Soft silicone/latex - can be used for indwelling (not in cats)

Question 10

What type of catheter is this?
What is it used for?
Can it be used indwelling?

Answer 10

Jackson cat (Tom cat)
Good for unblocking 
Not for indwelling (too traumatic and short)

Question 11

What type of catheter is this?
What is it used for?
Can it be used indwelling?

Answer 11

Slippery sam
Good for obstructions (open-ended)
Can be used for indwelling but risk of hub detaching

Question 12

What makes catheterising a bitch/queen more difficult than males?

Answer 12

Anatomy - urethra is hidden within the vestibule (helps to visualise with speculum for bitches and otoscope for queens)

Question 13

What equipment is needed for catheterisation?

Answer 13

Catheter of choice

Diluted iodine solution

Lubricant

Closed system and sterile water (if closed system)

Containers if obtaining a sample

50ml syringe/3 way tap

Sterile gloves and apron

Speculum or otoscope

Question 14

How can infection risk be reduced when a urinary catheter is present?

Answer 14

Wash hands before and after placement

Wipe outlet with spirit swab after emptying

Disinfect prepuce

Keep collection bag off floor

Remove as soon as no longer needed

Monitor for UTI

Avoid patient interference

Question 15

What nursing considerations should be taken for the urogenital patient?

Answer 15

Monitoring of BP and for UTI

Bloods and USG to check renal function

Prevent urine scalding

Post-op care if had surgery

Maintenance of fluid therapy

Question 16

What are the major risks of urinary catheterisation?

Answer 16

Urethral rupture 
Urethral trauma/inflammation
Stricture formation 
Infection 
Blockage/obstruction

Question 17

How often is urine output typically measured? (for hospital patients)

Answer 17

Every 4 hours

Question 18

Why do we need to monitor urine output?

Answer 18

Tell us about renal function

Tell us whether fluid therapy is appropriate

Question 19

What is the most accurate way of measuring urine output?

Answer 19

Closed system collection

Question 20

What is a normal urine production rate?

Answer 20

1-2mls/kg/hour

Question 21

How do we calculate urine output?

Answer 21

(volume of urine / number of hours) / weight (kg)