Male and female catheterisation prep Flashcards
indications for catheterisation
- 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
It is important to check for allergies when catheterising a patient, especially for:
- latex
- chlohexidine
- alcohol
- lignocaine
Overall Assessment
- History
- Examination
- Investigations
- Diagnosis
- Implementation
- Evaluation
bladder scanning
access urinary retention
potential complications
- 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
paraphimosis
result of foreskin not being replaced following catheterisation
autonomic dysreflexia
- spinal injuries above T6
- muscular reflex
- medical emergency
- BP increases rapidly, patient complains of headaches and sweating
types of catheters
indwelling
non indwelling (intermittent catheter)
suprapubic
non indwelling catheter
just for some time then taken out
suprapubic
via abdominal wall into bladder
Standard length male catheter
40-45cm
- can be inserted into both
Short length catheters
20-26cm
- cannot be inserted into males!
catheters should not be left in for longer than…
4 weeks
except longterm catheters that can stay fo 12 weeks.
what system is used for gauging cathetier size
french catheter gauge system
Foley catheter
indwelling catheter
whistle tip
- better for drainage of clots and viscous urine
- open ended catheter
Tieman or Coude Tip
- pateints with enlarged prostate?
3 types of catheter tips
- whistle tip
- standard tip
- Tieman or Coude tip
how to clean female patient
- 2 guaze swaps over labia majora
- clean with saline from top to bottom
how to clean male patient
clean the glans penis
swab
once you insert anaesthetic into lubricated urethra how long should you wait?
3 to 5 minutes
- you can remove your gloves, wash hands and don second pair of drugs
insert catheter until
- you see urine coming through
- then insert a couple cm further to advance the catheter
- inflate balloon with water
warn the patient that
the lubricating gel is a bit cold
hold penis up right so that the anaesthetic gel wont slip out
first specimen of urine
should be sent as a midstream specimen
documentation
- 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)
