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JJ > Urinary Catheter Care > Flashcards

Urinary Catheter Care Flashcards

1
Q

what are some of the potential presentations of the urogenital patient?

A 
FLUTD
incontinence
obstruction
trauma
neoplasia
kidney issues (renal failure, nephrectomy)
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2
Q

define polyuria

A

increased volume of urine

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3
Q

define pollakiuria

A

passing small amounts of urine often

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4
Q

what is catheterisation?

A

inserting a urinary catheters into the urethra up to the level of the bladder

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5
Q

what are the 2 potential options for duration of catheter placement?

A

temporary - removed immediately following procedure

indwelling - left in

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6
Q

why do we catheterise a patient?

A

to obtain a urine sample
to empty the bladder prior to surgery and prevent contamination during perioperative period
to instill contrast media into the bladder for radiography
to maintain patency of the urethra or unblock
to monitor urine output
to divert urine (cystotomy tube)
to prevent urine scalding

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7
Q

what are the alternative ways to sample urine (apart from catheterisation)?

A

manual expression
free catch
cystocyntesis

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8
Q

what are the disadvantages of manual expression of the bladder?

A

care required as can rupture the bladder
not always possible in tense / fat animals
not sterile

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9
Q

what are the disadvantages of free catch of urine?

A

can be time consuming

not sterile

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10
Q

what are the disadvantages of cystocentesis?

A

vets only

ultrasound guided to avoid other structures

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11
Q

what happens during cystocentesis?

A

sterile needle into the bladder - urine is drawn up in a syringe

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12
Q

what is the equipment list for cystocentesis?

A 
clippers / scrub / alcohol
needles (1 inch - longer)
syringe
collection pots
lab form
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13
Q

in what position can cystocentesis be performed?

A

dorsal and lateral recumbancy

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14
Q

what must the animal be allowed to do following cystocentesis?

A

void urine

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15
Q

what are the 2 methods of cystocentesis?

A

blind

ultrasound guided

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16
Q

in order to perform blind cystocentesis the bladder must be ___?

A

palpable

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17
Q

what are the main types of urinary catheters?

A

portex
foley
jackson cat (Tom Cat)
slippery sam

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18
Q

are portex catheters designed to be indwelling?

A

no - single use/temporary

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19
Q

where are the holes located in portex catheters?

A

side holes

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20
Q

what is the preferred type of indwelling catheter?

A

Foley

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21
Q

what material is a Foley catheter made of?

A

silicone or latex

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22
Q

how is the Foley catheter held in place once it is in the bladder?

A

inflatable balloon on the proximal end of the catheter is filled with sterile water

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23
Q

what animals can a foley catheter be used for?

A

dogs only as not small enough for cats

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24
Q

what is the jackson cat (Tom Cat) catheter useful for?

A

unblovking as easy to handle and rigid

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25
Q

what features of the jackson cat (Tom Cat catheter) can cause problems with distal obstruction?

A

side holes in catheter

26
Q

is jackson cat (Tom Cat catheter) used for indwelling?

A

not really as too traumatic and short so may not reach bladder.
can be sutured in for a short period of time

27
Q

what is a slippery sam catheter used for?

A

unblocking obstructions as open ended

28
Q

can slippery sam be used as an indwelling catheter?

A

yes is atraumatic but care must be taken as there is risk of the hub detatching

29
Q

what animals are usually considered relatively easy to catheterise?

A

male dogs and cats

30
Q

why are bitches and queens not as straightforwards to catheterise as male dogs or cats?

A

anatomy is different and urethral oriface is hidden

31
Q

how is the urethral orifice in bitches usually visualized?

A

using a speculum (can be done blind)

32
Q

how is the urethral orifice in queens usually visualized?

A

using an otoscope as speculum may be too large

33
Q

describe the technique for placement of a urinary catheter in the dog/tomcat?

A

patient restrained (possibly with sedation)
wash hands and put on sterile gloves and apron
expose penis from prepuce and prep with dilute iodine
lubricate urinary catheter
insert catheter into urethra and feed in until urine is seen in the catheter (do not force)
empty bladder and remove or inflate bulb with desired amount and attatch to collection bag/bung

34
Q

what equipment is needed for catheterisation?

A 
sterile gloves and apron
diluted iodine solution (1:100) and swabs
lubricant (potentially lidocaine gel) 
catheter of choice
50ml syringe 
3 way tap
container for sample
closed system (if indwelling)
sterile water for injection (if indwelling)
speculum (for bitch)
35
Q

describe the technique for catheterisation of the bitch

A

chemical restraint likely (and analgesia)
sternal recumbancy
clip and clean vulva
insert speculum until urethral oriface can be seen
if no speculum then manually insert with catheter alongside and should feed into the urethral orifice
(same process as for dog)

36
Q

what must happen before and after handling urinary catheters?

A

wash hands

37
Q

when should the bag be emptied and what should be done with the urine when it is emptied?

A

every 4 hours

amount of urine should be measured

38
Q

what does urine output measure?

A

kidney function

fluid therapy efficacy

39
Q

what should you do with the catheter bag once emptied?

A

wipe the outlet with a spirit swab

40
Q

what should you check for around the insertion site?

A

discomfort and swelling

41
Q

what should the catheter line be checked for?

A

kinks / blockages

42
Q

where should the catheter bag be kept?

A

off the floor (e.g. in lined litter tray) with bag lower than the patient

43
Q

when should urinary catheter be removed?

A

as soon as no longer needed

44
Q

what should be done to manage urine scalding?

A

clip hair away and clean

45
Q

what monitoring should patients with urinary catheters have?

A

UTI presence (temp, culture samples, urine appearance, pyrexia)

46
Q

what must be avoided in patients with a urinary catheter?

A

interference - buster collar

47
Q

when should antibiotics be used for patients with a urinary catheter?

A

no blanket use due to potential to create multi drug resistance
culture and treat specific infection

48
Q

what are the key nursing considerations for the uro patients?

A 
monitor BP
bloods for renal function (urea, creatinine, electrolytes)
USG
prevent urine scalding
post op care if surgery
personal cleaning and care esp for cats with buster collars
maintain fluid therapy
monitor for UTI
49
Q

what are the risks of urinary catheterisation?

A 
urethral rupture
urethral trauma/inflammation
urethral stricture formation
infection
blockage/obstruction of urinary catheter
50
Q

what is urethral stricture?

A

scar tissue which narrows the lumen of urethra which is very narrow

51
Q

when is urinary diversion used?

A

when we need to divert urine from either urethra (cystotomy) or ureters (nephrostomy)

52
Q

where is a cystotomy tube placed?

A

from bladder to outside via the abdominal wall

53
Q

where is a nephrostomy tube placed?

A

from kidney to outside

54
Q

when patients are in hospital how often is urinary output measured?

A

every 4 hours

55
Q

why should urine output be monitored?

A

tells us about renal function

tells us whether fluid therapy is appropriate

56
Q

how can we measure the volume of urine our patients have produced?

A

closed system collection

57
Q

what is normal urine production for animals?

A

1-2mls/kg/hour

58
Q

how should a value for urine output be given?

A

as a range to reflect 1-2mls

59
Q

how do you calculate urine output?

A

volume of urine/number of hours/weight

60
Q

how do you calculate an animals expected urine output?

A

BW(kg) x normal UOP per hour (1-2mls) x number of hours

JJ (33 decks)

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