Urine collection Flashcards
which urine of the day is best for collection?
1st urine of the morning
it is best for accuracy of urinalysis since it doesn’t have cellular components
how do you locate the bladder for expression?
mentally draw an X over the last 2 sets of mammary glands, bladder located in the middle of the X
feels like a water balloon
what should you do before collecting a voided sample?
clean the prepuce/vulva with diluted antiseptic
why do we perform manual expressions?
to relieve the bladder when patient is unable or for routine testing
when not to do manual expression
obstructed patients, pyometras, abdominal surgery patients
what position should the patient be in for manual expression of the bladder?
while patient is standing or can do laying down for cats
why do we use urinary catheters?
for repeat testing urinalysis, constant emptying of bladder, to monitor urine output, to relieve obstruction, and for cystography using contact
why would we not use a urinary catheter?
could cause trauma
where are urinary things located in the body
ventrally
where are reproductive things located in the body?
dorsally
how long should a urinary catheter be left in for?
maximum 24 hours to prevent a UTI from developing
indications for urine collection
concerns with bladder or kidney
types of catheters
polypropylene, tom cat, red rubber, foley
types of urinary catheter systems
open or closed
sizes for catheter tubing
cats: 3.5 french
small dogs: 5 french
medium dogs: 8 french
large dogs: 10-12 french
procedure for putting in a urinary catheter
- clip long hair
- cleanse area
- flush 5 times with 0.05% chlorohexidine (1 mL in smaller patients, 10 mL in larger patients)
- don sterile gloves and check foley if using
- lubricate
- cut end of package near insertion tip
- cut another ~1-2” away from 1st cut
how is a urinary catheter placed for a female?
sedated patient in ventral recumbency with pelvic limbs draped over end of the table
use a rolled towel to support hip region
visualization method of placing a urinary catheter
use speculum to open vaginal vault and insert catheter under the “button”
digital method of placing a urinary catheter
occlude vestibule by placing finger dorsal to urethral opening, insert catheter ventral to finger and guide into urethral orifice
*catheter shouldn’t be palpable under finger if placed correctly
closed collection drainage system
in-dwelling catheters should be attached to a sterile closed collection bag
prevents urine scalding, skin infections, facilitates bladder emptying, and can measure output
keep bag below patient
csytocentesis
percutaneous aspiration of urine from the bladder
why would we do a csytocentesis?
sterile urine sample, #1 for culture
why would we not do a csytocentesis?
insufficient urine in the bladder, patient resisting restraint, recent abdomen surgery, pyometra, bleeding disorder
disadvantages of a csytocentesis
can lacerate bladder, cause trauma or laceration to other anatomy (like descending aorta, caudal vena cava), cause iatrogenic hematuria, cause isolated disease to a specific part of urinary tract
how do you perform a csytocentesis?
palpate before poking
can be ultrasound guided: aim needle towards trigone to minimize trauma to ureters and abdominal vessels
can see uroliths and thickened bladder wall on ultrasound too
what to monitor for in urine cases
urine output (should be ~ 1 mL/kg/hr or 20 mL/kg/day), water intake, mentation especially for polyuric patients (because electrolyte imbalances), fluid overload
