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NRSG 301 > Catheters > Flashcards

Catheters Flashcards

1
Q

define frequency

A

needing to urinate more than 8 times during the day or more than 2 times at night

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2
Q

define urgency

A
  • overactive bladder
  • also called OAB
  • causes frequent/ sudden urge to urinate that can be difficult to control
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3
Q

define dysuria

A

pain or discomfort during urination

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4
Q

define nocturia

A

abnormally increased production of urine during the night leading to an unusually frequent need to urinate

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5
Q

define incontinence

A

inability to control urine flow, resulting in involuntary discharge or leakage

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6
Q

define polyuria

A

increased rate of urine production

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7
Q

define oliguria

A
  • low output of urine
  • 300-500ml/day
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8
Q

define anuria

A
  • absence of urine
  • below 50mL/day
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9
Q

define hematuria

A

presence of blood in urine

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10
Q

define retention

A

accumulation of urine within the bladder because of the inability to urinate

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11
Q

What are the indications for urinary catheterization for indwelling?

A
  • Acute urinary retention
  • bladder outlet obstruction
  • Accurate measurements of urinary output
  • Decubitus ulcers
  • Prolonged immobilization
  • Improve comfort for end of life care
  • Hematuria
  • Obstruction
  • Urological surgery
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12
Q

describe decubitus ulcers

A

open sacral or perineal pressure ulcer

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13
Q

When would you use an in/out urinary catheter?

A
  • Used to drain bladder then removed
  • Collection of sterile urine sample in select situations
  • Instillation of medications into bladder
  • Urodynamic testing
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14
Q

What are the different types of catheters?

A
  • foley
  • silicone
  • silastic
  • in/out (intermittent)
  • Coude tip
  • 3-way
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15
Q

describe a foley catheter

A
  • indwelling with balloon
  • latex
  • used for about 1 month
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16
Q

describe a silicone foley catheter

A
  • indwelling with balloon
  • used when people have an allergy to latex
  • used for 8-12 weeks
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17
Q

describe a silastic foley catheter

A
  • indwelling with balloon
  • used when people have an allergy to latex
  • used for 8-12 weeks
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18
Q

describe an in/out catheter

A
  • intermittent
  • one time use
  • does not stay in
  • used to drain bladder then removed
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19
Q

describe a coude tip foley catheter

A
  • used if having difficulty inserting a straight catheter
  • used for people who have urethral blockages or BPH
  • used for about 1 month
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20
Q

what does BPH stand for?

A

benign prostatic hyperplasia

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21
Q

describe a 3-way catheter

A
  • used for bladder irrigation
  • indwelling with balloon
  • has 3 tips
  • used for about 2-12 weeks
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22
Q

What are the 3 tips on a 3-way catheter used for?

A
  • One with blue on it is used to inflate balloon
  • Middle one is used to collect urine
  • Top or right is used to flush
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23
Q

describe best practices to prevent urinary tract infections

A
  • Peri care twice a day
  • Catheter care twice a day
  • Keep drainage bag below bladder
  • Empty drainage bag several times/ shift
  • Inspect for kinks in the line
  • Wash hands before/ after catheter/ peri care
  • Try and increase fluid intake for pt if not on fluid restriction
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24
Q

What is the difference between intermittent and indwelling catherization?

A

intermittent
- inserted through urethra into bladder to empty
- inserted/ removed several times/ day

indwelling
- inserted through urethra or stomach wall into bladder
- left in place for period of time

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25
Q

What is the difference between straight and foley catheters?

A

straight
- do not attach to collection bags
- do not have balloon
- used in bathroom/ other places where urine can be disposed of
- short term use

foley
- long term use
- drain into bag
- stay in situ with balloon

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26
Q

How do you determine the size of catheter needed?

A
  • size varies on person’s anatomy and the catheter use
  • women uretheral catheter size 12-14F
  • men urethral size 14-16F
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27
Q

How do you determine how much fluid to use to inflate the balloon of a catheter?

A
  • catheter will tell you on it how much water is needed to fill balloon
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28
Q

What causes urinary retention?

A
  • surgical genito-urinary trauma can cause swelling/ bleeding
  • anesthesia
  • bladder outlet obstruction
  • deficient detrusor contraction strength
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29
Q

in regards to urinary retention causes, describe anesthesia

A

allows bladder to fill more completely than normal before the urge to urinate is felt

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30
Q

in regards to urinary retention causes, describe deficient detrusor contraction strength

A

muscle no longer has the strength to contract with enough force or for long enough to completely empty the bladder

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31
Q

what is post-void residual?

A

the amount of urine left in bladder after urinating

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32
Q

What are the signs of catheter blockage?

A
  • no urine draining
  • no urine in bag
  • urine leaking around catheter
  • client has stomach cramps/ feels the urge to urinate
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33
Q

if you suspect a catheter blockage what should you do?

A
  • check for kinks
  • check position of catheter and drainage bag
  • make sure bag is bellow bladder
  • check leg straps fitted correctly
  • assess for bladder spasms
  • assess catheter in situ/ not being pulled on
  • get pt to cough
  • complete bladder scan
  • notify MRP
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34
Q

what are the signs of urinary infection?

A
  • cloudy urine
  • hematuria
  • strong urine odor
  • urine leakage around catheter
  • chills/ fever
  • unexplained fatigue
  • vomiting
  • burning sensation around catheter
  • pressure, pain/ discomfort in lower back or stomach
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35
Q

If you suspect a UTI what should you do?

A
  • urinalysis
  • urine culture
  • C&S test
  • review results/ report findings to MRP/ ask for antibiotics
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36
Q

if a UTI goes untreated what is the pt at risk of?

A
  • kidney infection
  • kidney damage
  • decreased immune function > could lead to further infections
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37
Q

what does TURP stand for?

A

Transurethral Resection of the Prostate

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38
Q

What does CBI stand for?

A

continuous bladder irrigation

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39
Q

What are the complications following a TURP and having CBI?

A
  • bleeding
  • clot retention
  • bladder spasms
  • dilution hyponatremia associated with irrigation
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40
Q

what can RNs do with or without an order for the purpose of assessment or treating a condition through a nursing diagnosis?

A

insert, maintain and remove a urinary catheter including coude

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41
Q

what can RNs administer prior to catheterization at the beside upon nursing assessment of client’s needs?

A

administer lidocaine 2% gel (topical anesthetic)

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42
Q

Who should lidocaine be used for especially?

A

males if they exhibit anxiety

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43
Q

What are the different types of incontinence?

A
  • stress
  • urge
  • mixed
  • overflow
  • functional
  • reflex
44
Q

in regards to the different types of incontinence, describe stress incontinence

A

Urine loss during activities
- coughing
- sneezing
- laughing
- jumping
- lifting

Common during pregnancy and after childbirth

45
Q

in regards to the different types of incontinence, describe urge incontinence

A
  • occasional sudden need to urinate with large volume urine loss
  • can exist without incontinence
  • common in neurologic diseases
46
Q

in regards to the different types of incontinence, describe mixed incontinence

A

Combination of stress and urge incontinence

47
Q

in regards to the different types of incontinence, describe overflow incontinence

A
  • frequent dribble of urine due to inefficient bladder emptying
  • symptoms similar to stress incontinence
  • common in diabetic or enlarged prostate patients
48
Q

in regards to the different types of incontinence, describe functional incontinence

A
  • Urine loss not associated with any pathology or problem in the urinary system
  • common in patients with head injury or Alzheimer’s
49
Q

in regards to the different types of incontinence, describe reflex incontinence

A
  • also known as spastic bladder
  • bladder fills with urine and involuntary reflex causes it to contract in an effort to empty
  • common in patients with spinal injuries above T12
50
Q

define urinary retention

A
  • inability to void
  • can be chronic or acute
  • can be caused by surgery, urethral trauma, obstruction
51
Q

what are the signs and symptoms of urinary retention?

A
  • bladder distention
  • absence of urine output over several hours
  • severe pain/ pressure in pelvic area
  • restlessness
  • diaphoresis
  • urgency
52
Q

define incontinence

A

inability to control the release of urine

53
Q

How do you determine if someone’s bladder is full?

A
  • palpate
  • complete bladder scan
54
Q

What do you need to input into the bladder scanner prior to using it?

A
  • sex
  • if person has had a hysterectomy
55
Q

at what volume do you need to help someone empty their bladder?

A

300mL

56
Q

if someone has a catheter how long after are they at risk for a CAUTI?

A

within 48hrs

57
Q

what does CAUTI stand for?

A

Catheter Associated Urinary Tract Infection

58
Q

how do you avoid causing urethral trauma when inserting a catheter?

A
  • use lots of lube
  • advise pt to inform RN if they feel any pain during procedure (they should not)
59
Q

What does HOUDINI stand for?

A

H - hematuria
O - obstructed
U - urologic surgery
D - decubitus ulcers
I - input/output monitoring
N - not for resuscitation/ end of life
I - immobility due to physical restraints

60
Q

how do you remove an indwelling catheter?

A
  • explain procedure to client
  • perineal hygiene
  • check volume of water in balloon
  • apply blue pad under genital area/ provide perineal privacy
  • deflate balloon
  • get pt to breath in and on their ex-hale gently put catheter out
  • provide peri care again
  • remove statlock
  • get pt to notify when they urinate and encourage fluid intake
  • document
61
Q

What do you do if the balloon of the catheter will not deflate?

A
  • try and advance catheter but must clean tube prior
  • check for kinks
  • let physician know
62
Q

Once you report to the physician that the balloon of a catheter will not deflate what are you expecting they might say?

A
  • leave catheter alone for a few hours and then try removing again
  • might order catheter to be cut, drained and removed
63
Q

After you remove a catheter what must you include in your charting?

A
  • time or procedure
  • integrity of balloon and catheter tip
  • size of catheter
  • volume of fluid removed from balloon
  • pt’s tolerance
  • type of urine sample collected prn
64
Q

what are the steps in collecting a urine specimen sample from an indwelling catheter?

A
  • clamp for 30 mins
  • cleanse port
  • attach lure lock syringe
  • withdraw sample from above tubing
  • disconnect
  • place sample in sterile container
  • unclamp
  • label sample, place in biohazard bag, send to lab
65
Q

When you go in to collect a urine sample from a catheter and the patient complains for discomfort, cramping and urge to void what is your first step?

A

check for kinks in tubing

66
Q

How much urine should be produced per hour?

A

30mL/hr

67
Q

How much fluid can your bladder hold?

A

300-500mL

68
Q

How much urine per day does your body produce?

A

1-2L/day

69
Q

How much fluid is in your bladder when your body triggers you to go pee?

A

150mL

70
Q

prior to inserting a catheter what are the 2 things you should always ask your patient?

A
  • are you allergic to latex
  • are you allergic to iodine
71
Q

What position do you put men and women in when inserting a catheter?

A

men
- supine

women
- dorsal recumbent (on back with legs in frog position towards the sides)

72
Q

Why do you put women in a dorsal recumbent position when inserting a catheter?

A

opens pubic floor

73
Q

how far do you insert an indwelling catheter?

A

2 inches past urine return

74
Q

what should you tell your patient to do during a catheter insertion procedure?

A
  • relax
  • take deep breaths
  • if you feel pain let me know but it shouldn’t hurt
75
Q

what do you do if there is more than 700mL of urine retention via bladder scan?

A

pinch catheter periodically while draining to avoid spasms occurring > can cause collapsed bladder

76
Q

What do you do if a catheter will not insert on a male pt?

A
  • get them to take deep breaths
  • hold penis at 90 degree angle > if not going in re-angle penis
77
Q

What do you do if a catheter will not insert on a female pt?

A

get them to take deep breaths and relax

78
Q

After inserting a Cather what do you need to include in your documentation?

A
  • time of procedure
  • type and size of catheter
  • volume of water used to inflate balloon
  • characteristics/ volume of urine output
  • any difficulties
  • pt’s tolerance
  • presence of drainage
  • specimens collected prn
79
Q

What do you use to inflate a balloon for an indwelling catheter?

A

water and not normal saline b/c it crystallizes over time

80
Q

What is a nephrostomy?

A

artificial opening created into renal pelvis to allow urinary diversion

81
Q

what are the indications for a nephrostomy?

A
  • removal of renal calculi
  • decompression of obstructed system
  • maintain/ improve renal function following ureteral obstruction
82
Q

What are some complications related to nephrostomies?

A
  • kidney infection
  • skin breakdown
83
Q

what do you need to monitor when someone has nephrostomy complications?

A
  • urea
  • electrolytes
  • creatinine
84
Q

if someone has a kidney infection what are some signs and symptoms?

A
  • pain in kidney area
  • fever
  • chills
  • changes in appearance in urine
85
Q

What is a suprapubic catheter?

A

catheter surgically placed through abdominal wall into bladder

86
Q

What are some indications for a suprapubic catheter?

A
  • anatomical issues with urethra
  • pelvic organ prolapse
  • spinal injuries/ trauma
  • lower body paralysis
  • MS
  • long term catheter use
  • acute prostatitis
87
Q

Why might a suprapubic catheter be seen in a younger population?

A
  • person not a candidate for prostate surgery
  • person is a quad or peripalegic > doesn’t get in the way during sexual activity
88
Q

describe the care of a supra public catheter

A
  • same as indwelling catheter as well as dressing around insertion site
  • observe for S&S of infection
  • monitor skin integrity at insertion site
89
Q

When is a continuous bladder irrigation most often seen?

A

following a TURP treatment of BPH

90
Q

When a CBI is running do you need to make sure of?

A
  • irrigation bags do not run dry
  • should have 2 hanging at different levels
91
Q

What is inside the bags that are used for CBIs?

A

NaCl 3L

92
Q

why do we regulate the flow for CBIs unless ordered by the doctor?

A

minimize formation of blood clots

93
Q

what do you do to the flow rate over time for CBIs?

A

gradually reduce flow rate as bleeding diminishes

94
Q

Can pts go home with a CBI?

A

no, will be taken out prior to discharge

95
Q

What is the flow of a CBI based on?

A

colour or fluid coming out

96
Q

will urine output be measured if someone is on CBI?

A

may or may not be depending on hospital policy

97
Q

Where in a CBI system installed?

A

placed in situ in OR

98
Q

Where does a CBI system drain into ?

A
  • large night bag with open end into large bucket to avoid back flow into bladder
  • some facilities have closed system to prevent infection
99
Q

What if your CBI pt has bright red urinary drainage that is not slowing down?

A

incase flow and if it doesn’t change apply traction and notify physician

100
Q

describe open intermittent irrigation

A
  • allows irrigation of catheter through opening system
  • increased infection risk despite sterile procedure being used
101
Q

How much fluid do you insert while performing an open intermittent irrigation? What else do you need to assess?

A
  • 30mL sterile saline into catheter with 60mL syringe
  • watch to make sure there is 30mL fluid return
102
Q

How many times can you perform an open intermittent irrigation at once

A

repeat up to 4 times

103
Q

Do you need an order to perform an open intermittent irrigation?

A

yes

104
Q

describe a closed intermittent irrigation

A

irrigation of catheter without opening the system

105
Q

What is the preferred method for intermittent irrigation?

A

closed intermittent irrigation

106
Q

How much fluid do you insert while performing an open intermittent irrigation? How do you complete this task?

A

instill 30mL sterile saline into injection port on catheter tubing while clamping drainage system
- watch to make sure 30mL of fluid returns

107
Q

How many times can you perform a closed intermittent irrigation at once

A

can repeat up to 4 times

NRSG 301 (5 decks)

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