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