Urinary Catheters

Question 1

Why do we catheterise a patient?

Answer 1

Obtain a urine sample
Empty bladder prior to surgery and prevent contamination during op
Instil contrast media into bladder for radiography procedures
Maintain patency of urethra or unblock
Monitor urine output
Divert urine
Prevent urine scalding

Question 2

What alternatives do we have for collecting a urine sample?

Answer 2

Manual expression
Free catch
Cystocentesis

Question 3

Name the four types of urinary catheter.

Answer 3

Portex
Foley
Jackson cat (Tom cat catheter)
Slippery sam

Question 4

Describe a Portex catheter.

Answer 4

Rigid
Single use
Side holes
Not designed to be indwelling

Question 5

Describe a Foley catheter.

Answer 5

Soft silicone / latex
Inflatable balloon filled with sterile water holds it in place
Preferred option for indwelling

Question 6

Describe a Jackson cat (Tom cat) catheter.

Answer 6

Good for unblocking as easy to handle and rigid
Side holes - can cause problems with distal obstruction
Not good for indwelling - too traumatic and short

Question 7

Describe a Slippery Sam catheter.

Answer 7

Good for unblocking obstructions as open-ended
Maybe indwelling as atraumatic - but only short-term use, risk of hub detaching
May still be too short, especially in big cats

Question 8

What is the technique for catheterisation of a dog/tomcat?

Answer 8

Patient restrained, possibly sedated
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 if indwelling, inflate bulb with desired amount and attach to collection bag/bung

Question 9

What is the technique for catheterisation of a bitch?

Answer 9

Chemical restraint likely
Usually sternal recumbency
Clip and clean around vulva
Insert speculum until urethral orifice can be seen
If no speculum then manually insert with catheter alongside and should feed into the urethral orifice
Rest is same as for dog

Question 10

What equipment do we need for catheterisation?

Answer 10

Catheter of choice
Diluted iodine solution (1:100) and swabs
Lubricant
Closed system (if indwelling)
Sterile water for injection (if indwelling)
Containers if obtaining a sample
50ml syringe / 3 way tap (if emptying bladder)
Sterile gloves and apron
Speculum (for bitch)

Question 11

What are the golden rules of urinary catheter care?

Answer 11

Wash hands before and after
Empty bag as needed and measure amount of urine produced
Check insertion site for discomfort/swelling
Check line for kinks or blockages
Keep collection bag off floor but ensure bag is lower than patient
Remove asap
In cases of urine scalding clip hair and clean
Monitor for UTI
Avoid patient interference

Question 12

What are the nursing considerations for urogenital patients?

Answer 12

Monitoring of BP
Bloods to check renal function - urea/creatinine/electrolytes
Urine specific gravity
Prevent urine scalding
Post-op care if had surgery
Cleaning and care especially for cats with buster collars
Maintenance for fluid therapy
Monitor for UTI

Question 13

What are the risks of urinary catheterisation?

Answer 13

Urethral rupture
Urethral trauma/inflammation
Urethral stricture formation
Infection
Blockage/obstruction in catheter