Urinary catheterization Flashcards
what are the 2 major purposes of urinary catheterization
- draining urinary bladder
- collecting urine for measurement
what are the perks to using catheters
- Allows a route of direct access to the bladder
- Uncontaminated urinary samples
- Reliable assessment of all urine output
- Bypassing urinary obstructions
what are indications for urinary catheters
- impediment to flow
- diagnostic evaluation
- treatment of GU conditions
what are things that could cause impediment to urinary flow
- Acute urinary retention
- Bladder outlet obstruction
- Severe hematuria with clots
- During and after surgery of the GU tract or adjacent structures
what are diagnostic evaluation indications for catheters
- Urine output measurement
- Acquiring sterile urine sample in pts who cannot provide one
what are the indications for catheterization involving treatment of GU conditions
- Management of immobilized patients
- Neurogenic bladder
- Severe, refractory urinary incontinence
- Improved patient comfort in hospice care
- Intravesical pharmacologic therapy
what are ABSOLUTE contraindications to catheters
urethral injury such as:
- pelvic trauma
- blood at uretheral meatus or gross hematuria in context of trauma
what are RELATIVE contraindications for urinary catheters
- urethral stricture
- recent GU surgery
- artificial urinary sphincter
what are possib le complications for urinary catheterizations
- infections (UTI, epididymitis)
- mechanical (retained balloon fragments)
- bladder damage (fistula, perf, stones)
- urethral damage (trauma)
what are the 4 points of responsible catheter use
- use only when absolutly necessary
- use sterile placement technique
- use non-indwelling if possible
- use for as short a time as possible
what are types of external urinary catheters
- condom catheters (male only)
- urinary pound (primarily for ostomies)
- pureWick (female only)
when are external urinary catheters NOT reccommended
for accurate urine measurement, or obstruction
what are CI for external catheters
- skin ulcerations
- perineal dermatitis
what are advantages to external urinary catheters
- more comfortable
- minimal/no urethral trauma
what are disadvantages to external urinary catheters
- Skin irritation and scarring
- Dislodgement and leakage
- Penile ulceration and tissue loss
- Inaccurate for most clinical diagnostic purposes
what are suprapubic urinary catheters
the most invasive form of catheter, placed through the abdominal wall!
what are the advantages of suprapubic urinary catheters
- Prevents urethral trauma/stricture
- Less bacteriuria
- Increased satisfaction vs. indwelling urethral catheters
- Allows attempts at normal voiding
- Less interference with sexual activity
what are disadvantages of suprapubic urinary catheters
- Requires surgical placement
- May see long-term skin erosion, urinary leakage
what are the intermittent urethral catheters
urethral catheter that is placed and immediatly removed after bladder is drained
AKA “straight cath”
what are the indications for intermittent urethral catheters
- short or long term management of urinary retention
- neurogenic bladder
what are the indwelling urethral catheters also known as
foley catheters
what are the common uses for indwelling urethral catheters
- In-pt hospital setting for short-term bladder drainage (< 3 wks)
- Chronic urinary retention in pts who can’t undergo other interventions
- Chronic urinary incontinence refractory to all other tx methods
what are the disadvantages of an indwelling urethral catheter
assocaited with:
- UTIs
- increased pt discomfort and dissatisfaction
what are the preliminary steps to placing an indwelling catheter
- Introduce self, identify patient
- Explain procedure
- Ensure patient consent for procedure
- Wash hands and don non-sterile gloves
- Assist patient into supine position, with legs spread
- Ensure area (e.g., bed) is clear and treatment area is clean and exposed
what are the steps for preparation for insertion when placing an indwelling urinary catheter
- Apply sterile gloves
- Recommended not to inflate balloon prior to insertion
- Coat distal portion of catheter in lubricant
- Apply sterile drape on patient
- Use non-dominant hand to separate labia or hold the penis
- Cleanse the periurethral tissue with swabs using the dominant hand
whar are the steps to actually placing the indwelling catheter
what is included in post-procedure care for indwelling catheters
- Secure catheter to patient’s abdomen or thigh
- Be sure catheter is connected to drainage system
- Place drainage bag below level of bladder
- Ensure no kinking or potential obstruction of tubing exists
Wow! that one was short!!
