Male and female catheterisation prep

Question 1

indications for catheterisation

Answer 1

• acute urinary retention
• chronic urinary retention (months and years)
• acute monitoring of fluid balance
• pre-post op
• for instillation of drugs
• urodynamic studies
• patients with spinal injruy

Question 2

It is important to check for allergies when catheterising a patient, especially for:

Answer 2

• latex
• chlohexidine
• alcohol
• lignocaine

Question 3

Overall Assessment

Answer 3

• History
• Examination
• Investigations
• Diagnosis
• Implementation
• Evaluation

Question 4

bladder scanning

Answer 4

access urinary retention

Question 5

potential complications

Answer 5

• infection
• trauma to urethral mucosa
• use lubrication
• haematuria
• creation of a false passage (around vulva or prostatic part of urethra)
• urethral stricture
• epididymitis, prostatitis, abscess
• balloon inflated in urethra

Question 6

paraphimosis

Answer 6

result of foreskin not being replaced following catheterisation

Question 7

autonomic dysreflexia

Answer 7

• spinal injuries above T6
• muscular reflex
• medical emergency
• BP increases rapidly, patient complains of headaches and sweating

Question 8

types of catheters

Answer 8

indwelling

non indwelling (intermittent catheter)

suprapubic

Question 9

non indwelling catheter

Answer 9

just for some time then taken out

Question 10

suprapubic

Answer 10

via abdominal wall into bladder

Question 11

Standard length male catheter

Answer 11

40-45cm

- can be inserted into both

Question 12

Short length catheters

Answer 12

20-26cm

- cannot be inserted into males!

Question 13

catheters should not be left in for longer than…

Answer 13

4 weeks

except longterm catheters that can stay fo 12 weeks.

Question 14

what system is used for gauging cathetier size

Answer 14

french catheter gauge system

Question 15

Foley catheter

Answer 15

indwelling catheter

Question 16

whistle tip

Answer 16

• better for drainage of clots and viscous urine

- open ended catheter

Question 17

Tieman or Coude Tip

Answer 17

• pateints with enlarged prostate?

Question 18

3 types of catheter tips

Answer 18

• whistle tip
• standard tip
• Tieman or Coude tip

Question 19

how to clean female patient

Answer 19

• 2 guaze swaps over labia majora

- clean with saline from top to bottom

Question 20

how to clean male patient

Answer 20

clean the glans penis

swab

Question 21

once you insert anaesthetic into lubricated urethra how long should you wait?

Answer 21

3 to 5 minutes

• you can remove your gloves, wash hands and don second pair of drugs

Question 22

insert catheter until

Answer 22

• you see urine coming through
• then insert a couple cm further to advance the catheter
• inflate balloon with water

Question 23

warn the patient that

Answer 23

the lubricating gel is a bit cold

hold penis up right so that the anaesthetic gel wont slip out

Question 24

first specimen of urine

Answer 24

should be sent as a midstream specimen

Question 25

documentation

Answer 25

• catheter type and size
• mount of water in balloon
• batch no.
• expiry date
• reasons for catheterisation
• any difficulty on insertion
• residual volume (after 15 minutes)