(U)- Catheters

Question 1

When are catheters used?

Answer 1

Urinary retention due to a lower urinary tract obstruction
Neurogenic bladder- intermittent self-catheterisation in multiple sclerosis
Surgery
Output monitoring -acutely unwell patients, sepsis or intensive care
Bladder irrigation - wash out blood clots in bladder
Delivery of medications - chemotherapy, bladder cancer

Question 2

What is used to measure volume of urine in the bladder?

Answer 2

Bladder scanner

Question 3

What volume post-voiding may indicate the need for a catheter?

Answer 3

500ml or more

Question 4

What are the different types of urethral catheters?

Answer 4

Intermittent catheters – simple catheters to drain urine, then immediately removed

Foley catheter (two-way catheter) – “standard” catheter with inflatable balloon to hold it in place

Coudé tip catheter– curved tip to navigate past obstruction during insertion

Three-way catheter – Three tubes used for inflating the balloon, injecting irrigation and drainage

Question 5

When is a Coudé tip catheter used?

Answer 5

In men with obstruction, Foley catheters can get stuck, use if Foley is too difficult

Question 6

What happens in a TWOC?

Answer 6

Removal of urethral catheter to see if patient can manage

Urine output is monitored, bladder scanner is used to make sure minimal urine is left in the bladder

Question 7

What happens if TWOC fails?

Answer 7

Another catheter is inserted

Question 8

Where do you obtain urine samples from if there is a catheter in place and a UTI is suspected?

Answer 8

Sample port using aseptic technique

Catheter bag may be contaminated

Question 9

When are antibiotics given for catheter-associated UTIs?

Answer 9

Only for patients with symptoms, patients without symptoms do not generally need antibiotics

Question 10

How long is antibiotic treatment given for in catheter-associated UTIs?

Answer 10

7 days

Oral antibiotics

If severe, hospital admission and IV antibiotics