catheterization

Question 1

Indications for indwelling catheterization

Answer 1

Relief of urinary retention
bladder and decompression preop or postop
facilitate surgery
facilitate healing
accurate I and O (critical care)
Stage III or IV pressure ulcer
Terminal illness

Question 2

Indications for intermittent catheter

Answer 2

relief of urinary retention
diagnostic study
urodynamic testing
sterile specimen
medication instillation
measure PVR

Question 3

Unacceptable reasons for catheterization

Answer 3

routine urine specimen

convenience for nurse or patient’s family

Question 4

Copmlications of long term catheter use

-what is considered “long term” catheter use?

Answer 4

CAUTI - most common HAI
Also bladder spasms, periurethral abcess, chronic pyelonephritis, urosepsis, urethral trauma or erosion, fistula or stricture formation, and stones

Question 5

Types of catheter (based on routes)

Answer 5

Urethral
Ureteral
Suprapubic (have to insert needle)
Nephrostomy tube (inserted through skin into kidney)

Question 6

Types of indwelling catheters

Answer 6

Normal with inflated balloon
Tiemann = slightly curved to deal with prostatic curve in males
Three-way indwelling catheter for irrigating bladder

Question 7

Preventing CAUTI

Answer 7

• determine need for catheter: HCP must order
• chose appropriate size and type
• insert in patient with urethral trauma, pain, or obstruction
• develop plan of care to decrease risk of infection
• teach catheter care to patient; esp if ambulatory
• use steril, closed drainage system
• don’t disconnect system except for irrigation

Question 8

When are catheter change necessary?
What technique is used to open system?
what do you use to get a urine culture? how do you prepare the puncture site?
What kind of bag should you use for long term use? precautions?

Answer 8

Unnecessary if there for under 2 weeks; if longer, determine necessity based on assessment, not routine

Sterile technique

use catheter sampling port –> prepare with antiseptic solution

Use leg bag –> if reusing collection bag, clean thoroughly

Question 9

What do you need to make sure the nursing assistant does to prevent CAUTIs?

Answer 9

• maintain unobstructed downhill flow of urine
• empties collecting bag regularly and records output
• provides perineal care 1-2 times a day and PRN
• Does not use lotion or powder near catheter
• uses a securement device to prevent catheter movemet and urethral tension