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N342 > Week 9 &10: urinary catheterization > Flashcards

Week 9 &10: urinary catheterization Flashcards

1
Q

What is urinary catheterization?

A

placement of tube through the urethra into the bladder to remove urine

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2
Q

How long is a catheter in situ for?

A

short term (less than 2 weeks) or Long term (more than 2 weeks)

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3
Q

What are some conditions that require the use of urinary catheters?

A

when you need to monitor urine output; relief of urinary obstruction; post-op care; bladder that empties inadequately as a result of a Neuro condition

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4
Q

What does excessive accumulation of urine in the bladder put the pt at increased risk for?

A

UTI and can cause backward flow of urine up the ureters to the kidneys, causing kidney infection and/or damage

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5
Q

What is intermittent catheterization?

A

used to measure post-void residual (PVR) when a bladder scanner is not available or as a way to manage chronic urinary retention.

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6
Q

When are single-lumen catheters used?

A

for intermittent catheterization

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7
Q

when are double-lumen catheters used?

A

designed for indwelling catheters, provide one lumen for urinary drainage and a second lumen to inflate a balloon that keeps the catheter in place

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8
Q

When are triple-lumen catheters used?

A

for CBI, or when it becomes necessary to instill meds into the bladder. one lumen drains the bladder, second lumen is used to inflate the balloon, and third lumen delivers irrigation fluid

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9
Q

what factors do you take into consideration when choosing a catheter?

A

latex allergy, hx of catheter encrustation, and suspectibilty to infection

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10
Q

What is the most common size for catheter and why?

A

14-16 French to minimize trauma and risk for infection

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11
Q

When would you use a caode catheter?

A

for men with enlarged prostate and urinary obstruction; it has a slightly bent tip

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12
Q

What risks are associated with larger-catheter diameters?

A

increase risk for trauma to the bladder neck and urethra

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13
Q

What size urinary catheters are used for infants and which ones are used for children?

A

5-6 French; 8-10 French

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14
Q

what is the balloon size for children and for a CBI?

A

3 ml; 30 mL

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15
Q

what is the recommended balloon size for an adult?

A

5 mL balloon (filled with 10mL)

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16
Q

What has long-term use of larger balloons (30 mL) been associated with?

A

increased pt discomfort, irritation, and trauma; increased risk of catheter expulsion; and incomplete emptying of the bladder bc of urine that pools below the level of the catheter drainage lumen

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17
Q

When do we typically try to remove a catheter?

A

when a pt can void

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18
Q

Where should you hang a catheter bag?

A

below the level of the bladder so urine drains down

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19
Q

Why do you need to review medical record for pathological condition that may impair passage of a catheter?

A

obstruction of urethra may prevent passage of catheter into bladder.

20
Q

Why should you clean the perineal area prior to insertion?

A

hygiene before initiating aseptic catheter insertion removes secretions, urine, and feces that could contaminate sterile field and increase risk for CAUTI

21
Q

what position should a female be in for catheter insertion?

A

Dorsal recumbent position (on back with needs flexed); alternative position: side-lying SIMS with upper legs flexed at knee and hip

22
Q

what position should a male be in for catheter insertion?

A

position supine with legs extended and thighs slightly abducted.

23
Q

Why is light necessary during insertion?

A

adequate visualization of urinary meatus helps with speed and accuracy of catheter insertion

24
Q

Why is it necessary to use sterile supplies and antiseptic solution?

A

to reduce risk of CAUTI.

25
Q

why is lubrication necessary?

A

to minimize trauma to urethra and discomfort during insertion. NOTE: male catheter needs enough lubricant to cover length of catheter inserted.

26
Q

Why do we not pretest a balloon anymore?

A

testing the balloon may distort and stretch it and lead to damage, causing increased trauma on insertion

27
Q

what does closure of the labia during cleaning mean?

A

that the area is contaminated and requires cleaning procedure to be repeated

28
Q

What order do you clean the labia?

A

labia fold and then directly oveer centre of urethral meatus

29
Q

What should you explain to the patient that is normal to experience as a catheter is inserted?

A

feeling of burning, pinching, or pressure may be experienced

30
Q

why should you ask a pt to bear down gently during insertion?

A

bearing down may help visualize urinary meatus and promotes relaxation of external urinary sphincter, aiding in catheter insertion

31
Q

what Does underinflation cause?

A

balloon distortion and potential bladder damage

32
Q

What should you do if a pt complains of sudden pain during inflation of a catheter balloon or when resistance is felt when inflating the balloon?

A

stop inflation, allow the fluid from the balloon to flow back into the syringe, advance catheter farther, and re-inflate balloon. the balloon may have been inflating in the urethra. if pain continues, remove catheter and notify HCP

33
Q

Why should you secure a catheter?

A

it reduces risk of urethral erosion, CAUTI, or accidental catheter removal

34
Q

Catheter goes into vagina. What do you do?

A

leave the catheter in the vagina. Clean urinary meatus again. using another catheter kit, reinsert sterile catheter into meatus. remove catheter in vagina after successful insertion of second catheter.

35
Q

Sterility is broken during catheterization by nurse or pt. What do you do?

A

replace gloves if contaminated and start over. If pt touches sterile field but equipment and supplies remain sterile, avoid touching that part of sterile field. If equipment and/or supplies become contaminated, replace with sterile items or start over with new sterile kit.

36
Q

Pt complains of bladder discomfort, and catheter is patent as evidenced by adequate urine flow. What do you do?

A

check catheter to ensure that there is no traction on it. Notify hop. pt may be experiencing bladder spasms or symptoms of UTI. monitor catheter output for colour, clarity, odour, and amount.

37
Q

What should you teach a pt after catheter insertion?

A

discuss with pt routine care of catheter and drainage system, which includes avoiding any kinking in the drainage tubing, keeping the drainage bag dependent, avoiding pulling on the catheter, and daily hygiene. explain that adequate fluid intake helps prevent catheter blockage.

38
Q

what’s a trick you can do when inserting a catheter into a child?

A

teaching young children to blow into a straw or pinwheel can help relax the pelvic muscles.

39
Q

Why might the urethral meatus of an older woman be difficult to find?

A

because of urogenital atrophy

40
Q

Symptoms of UTI in an older adult may be difficult to recognize and may only be indicated by…?

A

a change in mental status or fever

41
Q

What should you teach pts/caregivers IN HOMECARE regarding a catheter?

A

how to properly position the drainage bag; empty the urinary drainage bag; and observe urine colour, clarity, odour, and amount

42
Q

What is a suprapubic catheter?

A

a urinary drainage tube inserted surgically into the bladder through the abdomen wall above the symphysis pubis

43
Q

how is the catheter mounted lol?

A

may be sutured to the skin, secured with an adhesive material or retained in the bladder with fluid-filled balloon similar to an indwelling catheter

44
Q

When are suprapubic catheters placed?

A

when there is a blockage of the urethra (eg. enlarged prostate, urethral stricture, after urologic surgery) and when a long-term urethral catheter causes irritation or discomfort or interferes with sexual functioning

45
Q

pt develops symptoms of UTI or catheter site infection. what do you do?

A

increase fluid intake to at least 2200 mL in 24 hours. monitor VS, I&O; observe amount, colour, consistently of urine; assess site; notify HCP

46
Q

Suprapubic catheter becomes dislodged. what do you do?

A

cover site with sterile dressing. notify HCP. if newly established catheter, it will need to be reinserted immediately.

47
Q

Skin surrounding catheter exit site becomes red or irritated and/or develops open areas. what do you do?

A

notify HCP. change dressing (if used) more frequently to keep site dry. consult with wound care nurse.

N342 (7 decks)

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