Catheters Flashcards
What is another word for intermittent cath?
straight cath
how long do we leave a straight cath in for?
5-10 min
where do we insert a catheter?
urethra
In hospital we use sterile technique to help reduce hospital infections. What do people in the community use?
Clean technique
How do people in the community clean their catheters?
soap and water
air dry
What is another name for a Foley?
Indwelling catheter
What is the Foley catheter held in place by?
a small balloon
What do we fill the foley balloon with? What do we NOT fill it with?
Sterile water (SW) - yes
normal saline (NS) - no b/c of crystalization over time and can’t deflate the balloon fully - damage to urethra on the way out
Is foley an open or closed system?
Closed- always attached to a bag
What are two lumen catheters for?
- urine
- sterile water to inflate or deflate the balloon
What are three lumen catheters for?
- Urine
- sterile water to inflate/deflate balloon
- irrigation
What type of irrigation is the three lumen used for?
continuous
What type of saline runs through the catheter during irrigation?
Normal saline (not sterile water - that’s for the balloon)
Where is the volume capacity of the balloon indicated?
on the balloon port
How long can triple lumens be used?
short term
long term
What is the coude tip catheter used for?
male patients that have an enlarged prostate that partly obstructs the urethra
What are the French sizes used for children, adult females, adult males?
8-10 Fr - children
10-12 Fr- female adults
12-16 Fr - male adults
(always use smallest
What material is best for long term and why?
Silicone
less encrustation at urethral meatus
What material is good for intermittent only?
plastic - more stiff
What are 4 reasons that urine might leak around a catheter?
- bladder spasms due to constipation or fecal impaction
- too large catheter ballon 30mL or >18 fr = irritation
- UTI
- catheter kink, bladder neck trauma from balloon traction
What are 3 things we can do if there is leaking around the catheter?
- change lumen size
- anticholinergic meds
- urologist referral
what is CAUTI?
catheter associated urinary tract infection
What is one of the highest risks with urinary catheters?
infection
How often should indwelling catheters be changed?
evidence informed practice says (not routinely) :
1. infection
2. obstruction
3. close system is compromised
4. 30 days as per manufacturer
How many days is short term catheter ?
less than 14 days
What are the 6 indications of short-term indwelling catheter?
- some surgical procedures/postoperative care
- need accurate I&O for critically ill
- long immobilization due to trauma
- meds into bladder
- acute urinary retention or bladder outlet obstruction
- end of life - comfort care if requested
What are some indications of long-term indwelling catheter use?
- bladder outlet obstruction pre-surgery or can’t have surgery
- neurological issue (if intermittent is not possible)
- stage 3 or stage 4 sacral pressure injury or perineal skin breakdown in incontinent patients
- last resort for other unsuccessful methods
three indications for intermittent catheter
- bladder not contractile well/sphincter issues
- spinal cord injury/spinal bifida
- collect sterile urine (if midstream can’t be retrieved)
What reason for a catheter is NOT indicated and why?
incontinence alone
due to risk of infection and urethral damage
which void do we assess carefully after catheter removal?
the first one and time and amount over 24-48 hours
What symptoms must we assess after catheter removal?
- frequency
- bladder distension
- abdominal pain
- dribbling
- incontinence
- sensation of incomplete emptying
how many hours elapse before we contact the provider if there is no voiding or if patient has discomfort?
8 hours (DTV - due to void)
