nur prac Flashcards
If patient is allergic to latex urine catheter, what to use instead?
Silicon catheter
What position to prep patient in for catheterization?
Dorsal recumbent position (supine with knees flexed & legs apart) or lateral with a knee-chest position (if unable to tolerate supine/obese)
Catheterization: TESTING balloon integrity should be ____mls of _______
10mls of air and sterile water
Lubricate distal part of catheter about ______cm
5-7.5
After draping sterile sheet, clean each side from ______ → (part with non-dominant hand) ______ → ______ (top to bottom towards anus, separate cotton ball with each stroke)
clean each side from labia majora → (part with non-dominant hand) labia minora → urinary meatus (top to bottom towards anus, separate cotton ball with each stroke)
Insert catheter till ____________, then advance another ____cm to ensure balloon is inside the bladder not the urethra
Insert catheter till urine is observed, advance another 2cm to ensure balloon is inside the bladder not the urethra
If patient complains sudden pain of catheter, what should you do?
Withdraw the solution and advance the catheter further, slowly & gently, re-inflate balloon
What is continuous bladder irrigation?
- a medical procedure that flushes the bladder with sterile liquid → continuous flushing of the bladder over 24h after prostate/bladder surgery with 0.9% normal saline (1L/pack)
- sterile solution enters the bladder through a thin tube, then the fluid is removed and collected in a bag
What is the purpose of continuous bladder irrigation?
to prevent/remove blood clots in the bladder after urinary surgery such as transurethral resection of the prostate (TURP).
Is continuous bladder irrigation a sterile procedure?
All equipment involved in CBI is sterile.
Before continuous bladder irrigation, you must have a catheter placed in the ______.
It has three ports (openings), each with a different function:
• Drain ______ and other liquid from your body
• Inflate a balloon to keep your bladder ______ as the catheter is placed
• Send solution into your bladder to flush it out
bladder;
- Drain urine and other liquid from your body
- Inflate a balloon to keep your bladder open as the catheter is placed
- Send solution into your bladder to flush it out
Continuous bladder irrigation: how many bags on the IV pole?
2
Continuous bladder irrigation:
When should you report an abnormal colour of urine?
heavy blood-stained urine (for early detection of haematuria)
Negative balance of CBI:
Ensure that amount of drainage is equal or more than the solution infused
CBI: why pt cannot pull catheter?
can cause bleeding, hence clot
The healthcare provider will end continuous bladder irrigation once you have:
clear or only slightly pink urine
Complications of CBI
Generally very safe, but there are some rare complications:
- Catheter blockage
- Urinary tract infection
- Paraphimosis
- Bladder perforation or tear
Only sterile water is used in balloon to prevent
crystallisation
Catheter can be in-situ for ___ days. If more than day, then there will be _____
14 days, infection
Wound drainage should diminish within
3-4 days
What do the colours of the wound mean?
Red:
Yellow:
Black:
Red: normal healing
Yellow: colour of exudate produced by microorganisms in an open wound
Black: necrosis; provided a site for microorganisms to proliferate
Stage 4 wound is usually
full thickness tissue loss with exposed bone, tendon or muscle
Wound dressing: start from _____ to ______
wound bed to peri-wound
Wound: as time goes by, the amount of exudate ______ and colour gets ______. If still bright red after sometime, indicates _______
decreases, darker, haemorrhage
After OT, check active drainage every ____ to see if got any fresh blood.
hour
