HLTEN504A - INCP

Urinary Catheterisation

Urinary catheterisation

IndicationsDiscomfort of chronic and acute urinary retention.End of life care to promote comfort.Preoperative emptying of bladderPost operative intensive careParalysisUrine specimen collectionUrodynamic investigationsUrinary incontinence (last resort)

Complications associated with IDC

Urinary Tract Infection (UTI)Urine bypassingTrauma / dislodgement of catheterUrethritisUrethral erosionFistula formationEncrustationNon patent urinary catheter

Nursing care for patient with IDC

Minimise the risks of trauma to bladder neck and urethra

Minimise risk of ascending infection

Minimise the risk of by passing and / or obstruction to urinary flow.

Nursing care for patient with IDC

Fluid intake of 2-3 litres/day unless contraindicated

Acidify urine with• Vitamin C 250-500mgs QID• Cranberry juice 1 glass BD

Ensure the catheter is not obstructed

Position the collecting bag below the level of patient’s bladder

Secure the catheter to prevent in-out movement

Nursing care for patient with IDC

Practice standard infection control measures

Treat infections if patient is symptomatic

Thorough perineal /penile hygiene BD

Observe for bypassing of catheter

Burettes may be used if precise measurement and frequent recordings are required.

Maintain closed drainage system

Problems with draining

Constipation

Kinked tubing

Catheter position

Fluid intake

Blocked catheter- remove and replace

Leaking of bypassing constipation

Condom drainage for men

Ensure that the tape is not too tight to cause oedema

Ensure that the tip of penis does not touch the condom

If left on for longer than 24 hours watch for maceration of skin

Clean and dry the area daily

Ensure that the condom is not twisted and the tubing has free drainage

Condom drainage application

Appliance used for urinary stoma