Suprapubic Catheter Care
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Questions and Answers

What is the primary reason for assessing the perineal anatomical landmarks during catheter insertion?

  • To visualize the urinary meatus
  • To ensure proper placement of the drainage bag
  • To improve accuracy and speed of catheter insertion (correct)
  • To reduce the risk of patient discomfort

    • What is the correct procedure for opening the inner sterile wrap covering the catheterization supplies tray?

  • Opening each flap one at a time, with the last flap opened toward you (correct)
  • Not opening the inner sterile wrap at all
  • Opening all flaps simultaneously
  • Opening each flap one at a time, with the last flap opened away from you

    • What is the primary purpose of raising the bed to an appropriate working height during catheter insertion?

  • To facilitate visualization of the urinary meatus
  • To improve patient comfort
  • To maintain sterility principles (correct)
  • To reduce the risk of infection

    • Why is it essential to remove gloves and perform hand hygiene again after inspecting the perineal region?

    <p>To reduce the risk of infection transmission</p> Signup and view all the answers

    What is the correct procedure for draping a female patient during catheter insertion?

    <p>Draping in a diamond fashion over the perineum</p> Signup and view all the answers

    What is the primary purpose of providing peri-care and placing a waterproof pad/blue pad under the patient during catheter insertion?

    <p>To protect the patient's skin and bedding from potential drainage</p> Signup and view all the answers

    Why is it essential to determine if the patient will be able to cooperate during the procedure or if extra help will be necessary?

    <p>To ensure the patient's safety and comfort during the procedure</p> Signup and view all the answers

    What is the primary purpose of performing hand hygiene before and after applying clean gloves during catheter insertion?

    <p>To reduce the risk of infection transmission</p> Signup and view all the answers

    What is the primary goal of assessing the catheter insertion site during suprapubic catheter care?

    <p>To monitor for signs of infection</p> Signup and view all the answers

    What should the healthcare provider do if the suprapubic catheter becomes dislodged?

    <p>Cover the site with sterile dressing and notify the healthcare provider</p> Signup and view all the answers

    What is the primary purpose of keeping the drainage bag below the level of the bladder during suprapubic catheter care?

    <p>To prevent urine reflux</p> Signup and view all the answers

    What should the healthcare provider do if the patient develops symptoms of a urinary tract infection (UTI) during suprapubic catheter care?

    <p>All of the above</p> Signup and view all the answers

    What is the primary purpose of documenting the character of urine and type of dressing change during suprapubic catheter care?

    <p>To provide accurate information for healthcare providers and caregivers</p> Signup and view all the answers

    What should the healthcare provider do if the skin surrounding the catheter exit site becomes red or irritated during suprapubic catheter care?

    <p>All of the above</p> Signup and view all the answers

    What is the primary goal of patient education during suprapubic catheter care?

    <p>To promote patient comfort and independence</p> Signup and view all the answers

    What is the primary purpose of securing the catheter to the lateral abdomen with tape or a Velcro multipurpose tube holder during suprapubic catheter care?

    <p>To prevent catheter displacement</p> Signup and view all the answers

    What is the primary consideration for positioning the urinary drainage bag when a patient is ambulating?

    <p>The bag should be carried below the level of the patient's bladder</p> Signup and view all the answers

    What is the purpose of inflating the balloon with sterile water during catheter insertion?

    <p>To secure the catheter in place</p> Signup and view all the answers

    What should be reviewed before performing urinary catheterization?

    <p>The patient's chart for allergies and pathological conditions</p> Signup and view all the answers

    What is the recommended position for females during catheterization?

    <p>Dorsal recumbent position (on back with knees flexed)</p> Signup and view all the answers

    What should be used to secure the catheter in place?

    <p>Statlock</p> Signup and view all the answers

    Why is it important to use a flashlight or additional light source during catheterization?

    <p>To illuminate the perineal area</p> Signup and view all the answers

    What is the purpose of the cotton balls and cleaning solution in the catheter tray?

    <p>To clean the patient's perineal area</p> Signup and view all the answers

    What is the primary indication for inserting a 3-way catheter?

    <p>To irrigate the bladder</p> Signup and view all the answers

    What should be done if the catheter is contaminated during insertion?

    <p>Use a new catheter and sterile gloves</p> Signup and view all the answers

    Why is it important to assess the patient's knowledge of and prior experience with urinary catheterization?

    <p>To educate the patient on proper catheter care</p> Signup and view all the answers

    What should be done if the catheter is inserted into the vagina during catheterization?

    <p>Leave the catheter in the vagina as a landmark, cleanse the urinary meatus again, and reinsert another sterile catheter into the meatus</p> Signup and view all the answers

    Why is it essential to replace gloves and start over if the patient touches the sterile field during catheterization?

    <p>To prevent cross-contamination and maintain sterility</p> Signup and view all the answers

    What should be documented during catheterization?

    <p>The type and size of catheter, amount of fluid used to inflate balloon, and specimen collection</p> Signup and view all the answers

    What should be done if the patient experiences persistent catheter-related pain during catheterization?

    <p>Report the pain to a healthcare provider and document</p> Signup and view all the answers

    Why is it essential to secure the catheter tubing to the inner thigh using a Statlock device?

    <p>To allow enough slack to prevent tension on the catheter</p> Signup and view all the answers

    What should be done with the drainage bag during catheterization?

    <p>Attach the drainage bag to the bedframe, positioning it lower than the bladder</p> Signup and view all the answers

    Why is it important to document the amount of urine on the intake and output (I&O) flow sheet?

    <p>To track the patient's fluid intake and output</p> Signup and view all the answers

    What should be done if the foreskin is not replaced after catheterization in uncircumcised men?

    <p>Replace the foreskin to prevent discomfort and edema</p> Signup and view all the answers

    What is the primary objective of coiling excess tubing on the bed during suprapubic catheter care?

    <p>To facilitate easy drainage</p> Signup and view all the answers

    What should the healthcare provider do if the patient develops symptoms of UTI during suprapubic catheter care?

    <p>Monitor vital signs, I&amp;O, and observe urine characteristics</p> Signup and view all the answers

    What is the primary reason for securing the catheter to the lateral abdomen with tape or a Velcro multipurpose tube holder?

    <p>To prevent the catheter from becoming dislodged</p> Signup and view all the answers

    What should the healthcare provider do if the skin surrounding the catheter exit site becomes red or irritated?

    <p>Notify the healthcare provider and change the dressing more frequently</p> Signup and view all the answers

    What is the primary goal of documenting the character of urine and type of dressing change during suprapubic catheter care?

    <p>To evaluate the effectiveness of catheter care</p> Signup and view all the answers

    What should the healthcare provider do if the suprapubic catheter becomes dislodged?

    <p>Cover the site with a sterile dressing and notify the healthcare provider</p> Signup and view all the answers

    Why is it essential to keep the drainage bag below the level of the bladder during suprapubic catheter care?

    <p>To promote easy drainage</p> Signup and view all the answers

    What should the healthcare provider do if the patient develops symptoms of catheter site infection?

    <p>Monitor vital signs, I&amp;O, and observe urine characteristics</p> Signup and view all the answers

    What is a common complication of long-term catheterization?

    <p>Urinary tract infection</p> Signup and view all the answers

    What should be done if a patient develops bladder spasms after catheterization?

    <p>Report to the healthcare provider if it persists</p> Signup and view all the answers

    What is a common symptom of a urinary tract infection in an older person?

    <p>Lethargy</p> Signup and view all the answers

    What should be done if a catheter becomes obstructed?

    <p>Notify the healthcare provider immediately</p> Signup and view all the answers

    What is a common problem associated with indwelling catheters?

    <p>Leakage around the catheter</p> Signup and view all the answers

    What should be monitored in a patient with a catheter?

    <p>All of the above</p> Signup and view all the answers

    Why is it important to remove catheters as soon as possible?

    <p>To promote mobility and prevent complications</p> Signup and view all the answers

    What should be done if a patient's urine output is cloudy or has a strong odour?

    <p>Notify the healthcare provider immediately</p> Signup and view all the answers

    What is the primary indication for inserting a 3-way catheter?

    <p>To irrigate the bladder continuously</p> Signup and view all the answers

    Why is it essential to assess the patient's knowledge of and prior experience with urinary catheterization?

    <p>To ensure the patient can cooperate during the procedure</p> Signup and view all the answers

    What should be done if the catheter is contaminated during insertion?

    <p>Remove the contaminated catheter and start over</p> Signup and view all the answers

    What is the primary consideration for positioning the urinary drainage bag when a patient is ambulating?

    <p>Keeping the bag below the level of the bladder</p> Signup and view all the answers

    Why is it essential to document the character of urine and type of dressing change during suprapubic catheter care?

    <p>To monitor for signs of infection</p> Signup and view all the answers

    What should be done if the patient develops symptoms of a urinary tract infection (UTI) during suprapubic catheter care?

    <p>Notify the healthcare provider and follow their instructions</p> Signup and view all the answers

    What is a common complication of long-term catheterization?

    <p>All of the above</p> Signup and view all the answers

    Why is it essential to keep the drainage bag below the level of the bladder during suprapubic catheter care?

    <p>To allow for gravitational flow</p> Signup and view all the answers

    What should be done if a patient develops bladder spasms after catheterization?

    <p>Notify the healthcare provider and follow their instructions</p> Signup and view all the answers

    What is the primary purpose of inflating the balloon with sterile water during catheter insertion?

    <p>To secure the catheter in place</p> Signup and view all the answers

    What is a potential complication of inadequate bladder drainage?

    <p>Kidney infection</p> Signup and view all the answers

    What is the primary purpose of using a Coude catheter in men?

    <p>To navigate past an enlarged prostate with urinary obstruction</p> Signup and view all the answers

    What is the recommended size of an in-dwelling catheter for most adults to minimize trauma and risk for infection?

    <p>14 to 16 Fr</p> Signup and view all the answers

    What is the purpose of using a closed drainage system in in-dwelling catheterization?

    <p>To prevent infection</p> Signup and view all the answers

    What is a common complication associated with long-term catheterization?

    <p>Urinary tract infection</p> Signup and view all the answers

    Why is it important to choose a catheter based on factors such as latex allergy and history of complications?

    <p>To minimize trauma to the bladder neck and urethra</p> Signup and view all the answers

    What is the purpose of intermittent catheterization?

    <p>To manage chronic urinary retention</p> Signup and view all the answers

    Why is it important to insert an in-dwelling catheter with a balloon in place?

    <p>To secure the catheter in place</p> Signup and view all the answers

    What is the primary indication for short-term catheterization in patients who have undergone urological surgery?

    <p>Critically ill patients requiring accurate measurement of urinary output</p> Signup and view all the answers

    What is the primary complication of long-term catheterization?

    <p>Urinary tract infection</p> Signup and view all the answers

    What is the primary purpose of securing the catheter to the lateral abdomen with tape or a Velcro multipurpose tube holder?

    <p>To prevent the catheter from becoming dislodged</p> Signup and view all the answers

    Why is it essential to keep the drainage bag below the level of the bladder during suprapubic catheter care?

    <p>To prevent backflow of urine into the bladder</p> Signup and view all the answers

    What is the primary goal of documenting the character of urine and type of dressing change during suprapubic catheter care?

    <p>To monitor for signs of urinary tract infection</p> Signup and view all the answers

    What is the primary purpose of using sterile water to inflate the balloon during catheter insertion?

    <p>To prevent catheter-associated urinary tract infection</p> Signup and view all the answers

    What is the primary consideration for positioning the urinary drainage bag when a patient is ambulating?

    <p>The drainage bag should be kept below the level of the bladder</p> Signup and view all the answers

    What is the primary indication for inserting a Coude catheter?

    <p>Urethral stricture</p> Signup and view all the answers

    Study Notes

    Urinary Catheterization

    • Apply drain dressing around catheter and tape in place
    • Secure catheter to lateral abdomen with tape or Velcro multipurpose tube holder
    • Coil excess tubing on bed, ensuring drainage bag is always below level of bladder
    • Dispose of supplies in an appropriate receptacle
    • Remove gloves and perform hand hygiene

    Suprapubic Catheter Care

    • Monitor vitals signs, I&O, observe amount, color, consistency of urine, and assess site if patient develops symptoms of UTI or catheter site infection
    • Cover site with sterile dressing and notify healthcare provider if suprapubic catheter becomes dislodged
    • Notify healthcare provider and change dressing more frequently to keep site dry if skin surrounding catheter exit site becomes red or irritated or develops open area

    Documentation

    • Document and report character of urine and type of dressing change, including assessment of insertion site and patient’s comfort level
    • Record urine output on the I&O flow sheet, separately documenting outputs from suprapubic and urethral catheters if applicable
    • Evaluate patient and caregiver learning

    In-Dwelling Catheters

    • Come in various balloon sizes (3ml to 30ml) and are attached to a urinary drainage bag
    • Bag should always hang below the level of the bladder to facilitate gravitational flow

    Types of Catheters

    • Intermittent or “Straight” catheter (In and Out)
    • Indwelling “Foley” catheter
    • 3-Way Catheter
    • Coude Catheter

    Indications and Contraindications

    • Indications: relieve urinary retention or incontinence, obtain a sterile collection of urine, irrigate the bladder, pre/post-operative care, and monitoring input and outputs
    • Contraindications: current urinary tract infection, urethral strictures, prostate and/or bladder surgery, urethral trauma, and severe pelvic fractures

    Equipment

    • Catheter Tray/Kit (Straight or In-dwelling)
    • Sterile drainage tubing and bag (Small “leg bag”, large “night bag”, Urometer bag)
    • Device to secure catheter (Statlock)
    • Basin with warm water, washcloth, towel, and soap for perineal care
    • Flashlight or additional light source
    • Additional catheter and sterile gloves (in case of contamination)

    Procedure/Steps

    • Confirm MD’s order and facility policy regarding urinary catheters
    • Review patient’s chart for allergies, medical record, and prior experiences with urinary catheterization
    • Assess patient’s knowledge, positioning, and potential need for extra help
    • Provide privacy, perform hand hygiene, and inspect perineal region
    • Drape patient, position light source, and open sterile wraps and catheter kit tray

    Catheter Care and Management

    • If equipment or supplies become contaminated, replace with sterile items or start over with a new sterile kit.
    • Monitor catheter output for color, clarity, odor, and amount.
    • Be aware of unexpected findings, such as bladder discomfort, and notify the healthcare provider.

    Complications and Risks

    • Catheterization comes with risks, and long-term catheterization is not recommended.
    • Infection is a common complication, and observe patient's urine for concentration, color, and odor.
    • Urethral trauma can occur from improper care or insertion technique, leading to bleeding or infection.
    • Obstruction can occur due to infection or other conditions, and report to the doctor immediately.
    • Bladder spasms are common with catheterization, and report to the healthcare provider if they persist.
    • Leakage around the catheter is another problem associated with indwelling catheters.

    Procedure and Steps

    • Connect drainage tubing/bag to catheter port.
    • Secure catheter tubing to inner thigh using a Statlock device.
    • For uncircumcised men, replace foreskin back to its normal position.
    • Clip drainage bag tubing to the edge of the mattress, and position it lower than the bladder.
    • Dispose of supplies in appropriate receptacles.
    • Remove gloves and perform hand hygiene.
    • Document the procedure and patient's response.

    Documentation

    • Document and report the reason for catheterization.
    • Record the type and size of catheter, amount of fluid used to inflate the balloon, and specimen collection (if applicable).
    • Document the characteristics and amount of urine, and patient's response to the procedure.
    • Document urine output on the intake and output (I&O) flow sheet and/or chart.

    Unexpected Findings and Outcomes

    • Report persistent catheter-related pain, inadequate urine output, and discomfort to the healthcare provider.
    • If the catheter is inserted into the vagina, leave it as a landmark, cleanse the urinary meatus again, and reinsert another sterile catheter into the meatus.
    • If sterility is broken during catheterization, replace gloves if contaminated and start over.

    Suprapubic Catheter Care

    • Monitor vitals signs, I&O, and observe the amount, color, and consistency of urine, and assess the site.
    • Notify the healthcare provider if the patient develops symptoms of UTI or catheter site infection.
    • Cover the site with a sterile dressing and notify the healthcare provider if the suprapubic catheter becomes dislodged.
    • Change the dressing more frequently to keep the site dry and consult with a wound care nurse if the skin surrounding the catheter exit site becomes red or irritated.

    Documentation - Suprapubic Catheter Care

    • Document and report the character of urine and type of dressing change.
    • Document the assessment of the insertion site and patient's comfort level with the catheter and dressing change.
    • Document urine output on the I&O flow sheet, and separately for each catheter if there is both a suprapubic and urethral catheter.
    • Evaluate the patient and caregiver learning.

    In-Dwelling Catheters

    • Come in various balloon sizes, ranging from 3 ml for children to 30 ml for continuous bladder irrigation (CBI)
    • The size of the balloon and catheter is printed on the catheter port (most commonly 10 ml)

    Urinary Drainage Bag

    • Attached to an in-dwelling catheter to collect the continuous flow of urine
    • Should always hang below the level of the bladder on the bedframe or chair, using gravitational flow

    Types of Catheters

    • Intermittent or "Straight" catheter (In and Out)
    • In-dwelling "Foley" catheter
    • 3-Way Catheter
    • Coude Catheter

    Indications and Contraindications

    • Indications: relieve urinary retention or incontinence, obtain a sterile collection of urine, irrigate the bladder, pre/post-operative care, monitor input and outputs
    • Contraindications: current urinary tract infection, urethral strictures, prostate and/or bladder surgery, urethral trauma, severe pelvic fractures

    Equipment

    • Catheter Tray/Kit (Straight and In-dwelling)
    • Sterile drainage tubing and bag (Small "leg bag", large "night bag", Urometer bag)
    • Device to secure catheter (Statlock)
    • Basin with warm water, washcloth, towel, and soap for perineal care
    • Flashlight or other additional light source

    Procedure/Steps

    • Confirm MD's order and verify facility's policy regarding urinary catheters
    • Review patient's chart for allergies and medical history
    • Assess patient's knowledge and experience with urinary catheterization
    • Determine patient's positioning for catheterization (dorsal recumbent for females, supine with legs extended for males)
    • Urine output should be 30 ml or greater per hour

    Importance of Urinary Catheterization

    • Conditions that require use of urinary catheters include monitoring urine output, relief of urinary obstruction, postoperative care, or a bladder that empties inadequately due to neurological conditions
    • Excessive accumulation of urine in the bladder increases the risk for UTI and can cause kidney infection or damage

    Catheter Selection

    • Based on factors such as latex allergy, history of complications, and susceptibility to infection
    • In-dwelling catheters are made of latex or silicone
    • Straight or intermittent catheters are made of rubber or polyvinyl chloride
    • Catheter size is based on the French (Fr) scale, with most adults requiring a size of 14 to 16 Fr to minimize trauma and risk for infection

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    Skills III Urinary Catheterization.pptx

    Description

    Learn about the proper procedures and precautions for suprapubic catheter care, including dressing, securing, and monitoring for potential complications.

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