Clin Skills 6 GU Instrumentation Flashcards
__ catheter
To get urine from someone who can’t provide it for you. Also to keep it sterile.
No balloon, it’s simply being inserted as a one time event to collect urine and then throw it away.
Robinson Catheter
Mc cause of sepsis is:
GU infection
3 Way Foley Catheter also does what?
CBI – continuous bladder irrigation. Doesn’t allow for clots to collect b/c it’s continuously irrigating it out.
it’s an iv pole with 2 large bags of normal saline that go into bladder by gravity (picc sez it’s not a machine)
Must be continuously monitored by nursing.
For patients that have bladder-neck obstruction (mc due to BPH). This is used after a failed attempt to insert a regular foley catheter.
This is usu inserted by the GU service.
Coude Catheter
Goes on just like a condom (therefore can only be used w/ male patients).
It does not lessen chance of UTI.
Other problems w/ keeping this on.
Texas Condom Catheter
If inserting a catheter, but you realize there’s a stricture. next do?
what if it’s due to trauma?
requires operative intervn → cystoscopy to dilate that area so a catheter can be inserted
if due to trauma:
insertion of catheter suprapubically: suprapubic cystostomy.
Males with pelvic trauma have disruptions with what part of urethra?
membranous urethra. It’s not supported and freq gets injured.
if indicated, do __ to check patency of urethra
retrograde cystogram
Used freq w/ pelvic surgery.
Also for obstructions: stone, clot, tumor blocking a ureter.
Pigtail (Curley Q’s on ends) used to bypass the obstruction.
These are taken out after surgery on the first or second post-op day.
used if hydronephrosis (kidney enlarged, calices (pyraimds) of kidney are blunted.
Ureteral Stents
After ureteral stent removal, patient can get __. why?
post-renal azotemia: b/c some trauma to ureter & bleed forming clot in ureter.
Most important thing to do when using dye (KUB)
make sure they’re euvolemic. Cannot be dehydrated b/c kidneys will go into Acute Tublar Necrosis & they’ll die.
mc imaging test to look for kidney stones
CT with contrast
What must you check on this patient before you do Nephrostomy (wire & needle put into kidney)
Coag studies. Make sure INR <1.5, normal platelet count.
2014 Protocol regarding catheters:
Must send off UA & Urine Culture & Sensitivity. To make sure they didn’t have a UTI when they came in (for documentation)
Foley Catheter Indications (6)
Not for incontinence
Obtain sterile culture Monitor I & O’s Instillation of Medications Neurogenic bladders Bypass obstruction Post-op to GU Procedures
