Catheter problems and Retention Flashcards
1
Q
What bloods would you want to check before inserting a suprapubic catheter in?
A
Coagulation screen
2
Q
What are important aspects to the management of suprapubic catheters?
A
- Don’t change in first 6 weeks - allow track to epithelialise
- After this - change as regularly as urethral catheter
- If they fall out - insert with same asceptic technique as urethral catheter
3
Q
What is important to remember to do once you insert a catheter?
A
Reposition the foreskin - risk of paraphimosis if not
4
Q
What patients are most at risk of paraphimosis?
A
- Young boys
- Old men with catheters
5
Q
What are causes of urinary retention?
A
- Obstructive - BPE, Urethral stricture, COnstipation, clot retention, Pelvic mass
- Inflammatory - UTI, Prostatitis
- Drugs - Alcohol, Diuretics, Spinal/epidrual, opiods
- Neurogenic - Cauda equina, CES, MS, Parkinson’s Pelvic trauma, Pelvic surgery
- Post-op
6
Q
What is regarded as a low risk retention patient?
A
- <1000 ml
- U+E’s normal
- Uncomplicated retention
7
Q
How would you manage a low risk retention patient?
A
Discharge
- Alpha-blockers
- Consider Antibiotics
- Consider Laxatives if constipated
8
Q
What are regarded as high-risk retention patients?
A
- >1000 ml
- Abnormal U+E’s
- Complicated e.g. UTI
9
Q
What is there a risk of when catheterising someone with urinary retention?
A
Post catheterisation diuresis
10
Q
How would you manage a high risk pateint with urinary retention?
A
Admit
- Catheterise
- Hourly urine output - IV fluids if >200ml/hr for 2 hrs
- Investigate cause
- Monitor daily U+E’s
