Podcast
Questions and Answers
A bladder scan utilizes which type of device to provide a virtual 3D image of the bladder?
A bladder scan utilizes which type of device to provide a virtual 3D image of the bladder?
- MRI scanner
- Invasive catheter
- X-ray machine
- Noninvasive, portable ultrasound (correct)
Retained urine in the bladder can act as a reservoir for bacteria and pathogens.
Retained urine in the bladder can act as a reservoir for bacteria and pathogens.
True (A)
Besides acute care, long-term care, and rehab centers, where else are bladder scans commonly used?
Besides acute care, long-term care, and rehab centers, where else are bladder scans commonly used?
Physicians' offices
A bladder scan is an alternative to invasive "in and out" urinary ___________.
A bladder scan is an alternative to invasive "in and out" urinary ___________.
Match the following conditions with their potential impact on urinary function:
Match the following conditions with their potential impact on urinary function:
What is the recommended maximum postvoid residual (PVR) volume that a bladder scan should ideally indicate?
What is the recommended maximum postvoid residual (PVR) volume that a bladder scan should ideally indicate?
A bladder scan typically consists of three components: an ultrasound monitor, a handheld scanner, and a printer.
A bladder scan typically consists of three components: an ultrasound monitor, a handheld scanner, and a printer.
What type of waves does the transducer in the handheld scanner send out to bounce off the bladder?
What type of waves does the transducer in the handheld scanner send out to bounce off the bladder?
Before performing a bladder scan, ensure the patient does not have abdominal _______ over the midline lower abdominal area.
Before performing a bladder scan, ensure the patient does not have abdominal _______ over the midline lower abdominal area.
Match each condition with its potential effect on a patient's ability to void:
Match each condition with its potential effect on a patient's ability to void:
Why might edema in the abdomen, resulting from post-operative intervention, lead to urinary retention?
Why might edema in the abdomen, resulting from post-operative intervention, lead to urinary retention?
Bladder scans are primarily used to diagnose the presence of kidney stones or renal masses.
Bladder scans are primarily used to diagnose the presence of kidney stones or renal masses.
What landmark on the lower abdomen is used as a guide when positioning the bladder scanner?
What landmark on the lower abdomen is used as a guide when positioning the bladder scanner?
Patients with ____________ may not have the sensation or urge to void, which can lead to urinary retention.
Patients with ____________ may not have the sensation or urge to void, which can lead to urinary retention.
Match the following medications with their potential to cause urinary retention:
Match the following medications with their potential to cause urinary retention:
Which condition might result in impaired bladder emptying due to anomalies of the renal structures, infection, or neurologic conditions?
Which condition might result in impaired bladder emptying due to anomalies of the renal structures, infection, or neurologic conditions?
If a female patient has undergone a hysterectomy, the 'female' setting should still be used on the bladder scanner.
If a female patient has undergone a hysterectomy, the 'female' setting should still be used on the bladder scanner.
What specific type of solution should be used to decontaminate the bladder scanner after each use?
What specific type of solution should be used to decontaminate the bladder scanner after each use?
An airtight seal between the bladder scanner and the skin is created by the application of _______ ______.
An airtight seal between the bladder scanner and the skin is created by the application of _______ ______.
Match each patient scenario with the appropriate adjustment to bladder scanning technique:
Match each patient scenario with the appropriate adjustment to bladder scanning technique:
Why is it important to avoid moving the transducer scanning tip once the bladder is visualized during a scan?
Why is it important to avoid moving the transducer scanning tip once the bladder is visualized during a scan?
Documenting how the patient tolerated the procedure is an optional, but recommended, step after completing a bladder scan.
Documenting how the patient tolerated the procedure is an optional, but recommended, step after completing a bladder scan.
What should the healthcare provider be notified of after scanning if the bladder scan results indicate?
What should the healthcare provider be notified of after scanning if the bladder scan results indicate?
Placing the scanner one inch above the ______ _______ helps ensure correct placement for an accurate bladder scan.
Placing the scanner one inch above the ______ _______ helps ensure correct placement for an accurate bladder scan.
Match conditions with why bladder scanning may be considered:
Match conditions with why bladder scanning may be considered:
What benefit does using a bladder scanner offer compared to urinary catheterization?
What benefit does using a bladder scanner offer compared to urinary catheterization?
The primary goal of using ultrasound gel during a bladder scan is to lubricate the skin for easier movement of the scanner.
The primary goal of using ultrasound gel during a bladder scan is to lubricate the skin for easier movement of the scanner.
What action should be taken to ensure correct scanner placement in a patient with a large amount of loose skin?
What action should be taken to ensure correct scanner placement in a patient with a large amount of loose skin?
After the bladder is visualized during a scan, the transducer scanning tip should (never/always) __________ move until the scan is complete to ensure accurate readings.
After the bladder is visualized during a scan, the transducer scanning tip should (never/always) __________ move until the scan is complete to ensure accurate readings.
Match each medication with the specific mechanism by which it can cause urinary retention:
Match each medication with the specific mechanism by which it can cause urinary retention:
What is the MOST IMPORTANT step to perform immediately after completing a bladder scan to prevent potential spread of pathogens?
What is the MOST IMPORTANT step to perform immediately after completing a bladder scan to prevent potential spread of pathogens?
Bladder scanners should be stored uncovered, to allow the machine to air out.
Bladder scanners should be stored uncovered, to allow the machine to air out.
If a bladder scan is indicated and your patient has just voided, about how long should you wait before you perform the scan?
If a bladder scan is indicated and your patient has just voided, about how long should you wait before you perform the scan?
When placing the scanner, tilt it (upward/downward) ______________ towards the bladder to ensure correct placement.
When placing the scanner, tilt it (upward/downward) ______________ towards the bladder to ensure correct placement.
Match the following conditions with their relevance to bladder scanning:
Match the following conditions with their relevance to bladder scanning:
Which of the following actions is MOST important when preparing a patient for a bladder scan?
Which of the following actions is MOST important when preparing a patient for a bladder scan?
After completing a bladder scan, the digital image should be immediately deleted to protect patient privacy.
After completing a bladder scan, the digital image should be immediately deleted to protect patient privacy.
Name the author of the article.
Name the author of the article.
Retained urine leads to urethral damage, pain, and ___________
Retained urine leads to urethral damage, pain, and ___________
Match bladder scanning contraindications with special considerations
Match bladder scanning contraindications with special considerations
What is the primary function of a bladder scanner?
What is the primary function of a bladder scanner?
When using a bladder scanner, it is important to select the button that indicates whether or not the patient has a uterus, as it will cause the machine to recalibrate accordingly.
When using a bladder scanner, it is important to select the button that indicates whether or not the patient has a uterus, as it will cause the machine to recalibrate accordingly.
An abnormal PVR (post-void residual) could indicate a blockage in the urinary tract, an enlarged _____, or possible side effects from medications.
An abnormal PVR (post-void residual) could indicate a blockage in the urinary tract, an enlarged _____, or possible side effects from medications.
What is the recommended placement of the bladder scanner on the patient's abdomen?
What is the recommended placement of the bladder scanner on the patient's abdomen?
An indwelling catheter is designed for single-use and is removed immediately after draining the bladder.
An indwelling catheter is designed for single-use and is removed immediately after draining the bladder.
What does CAUTI stand for?
What does CAUTI stand for?
Which of the following is a risk associated with the use of indwelling catheters?
Which of the following is a risk associated with the use of indwelling catheters?
Which condition might indicate the need for an indwelling catheter due to the necessity for strict monitoring of intake and output?
Which condition might indicate the need for an indwelling catheter due to the necessity for strict monitoring of intake and output?
It is acceptable to lay a urinary catheter bag on the floor as long as it is kept clean.
It is acceptable to lay a urinary catheter bag on the floor as long as it is kept clean.
To avoid obstruction, frequently check the tubing for kinks and _______ loops, which can impede urine flow.
To avoid obstruction, frequently check the tubing for kinks and _______ loops, which can impede urine flow.
What action should be taken if leakage or disconnection occurs in a urinary catheter system?
What action should be taken if leakage or disconnection occurs in a urinary catheter system?
Straight or intermittent catheters remain in the bladder to provide continuous drainage.
Straight or intermittent catheters remain in the bladder to provide continuous drainage.
In what situation is a straight or intermittent catheter typically used?
In what situation is a straight or intermittent catheter typically used?
What is a neurogenic bladder?
What is a neurogenic bladder?
A suprapubic catheter is inserted surgically into the bladder through an incision above the _______.
A suprapubic catheter is inserted surgically into the bladder through an incision above the _______.
Suprapubic catheters are typically used for short-term bladder drainage after surgery.
Suprapubic catheters are typically used for short-term bladder drainage after surgery.
Which condition is a common indication for the use of a suprapubic catheter?
Which condition is a common indication for the use of a suprapubic catheter?
Give one example of an external urine collection device.
Give one example of an external urine collection device.
External urine collection devices are effective for managing urinary obstruction and retention.
External urine collection devices are effective for managing urinary obstruction and retention.
What is a potential risk associated with the use of external urine collection devices like condom catheters?
What is a potential risk associated with the use of external urine collection devices like condom catheters?
Why is it important to point the bladder scanner toward the bladder when scanning?
Why is it important to point the bladder scanner toward the bladder when scanning?
Cleaning around the meatus should be done only when there is visible discharge to prevent irritation.
Cleaning around the meatus should be done only when there is visible discharge to prevent irritation.
When administering an indwelling catheter, it is important to use _____ technique and equipment to prevent infection.
When administering an indwelling catheter, it is important to use _____ technique and equipment to prevent infection.
What is the primary reason for using a wicking device for females?
What is the primary reason for using a wicking device for females?
What does 'PVR' stand for in the context of bladder scanning?
What does 'PVR' stand for in the context of bladder scanning?
Match the following catheter types with their primary characteristic:
Match the following catheter types with their primary characteristic:
What is the potential consequence of dependent loops in urinary catheter tubing?
What is the potential consequence of dependent loops in urinary catheter tubing?
Which of the following is the most accurate way to measure urine output from a catheter?
Which of the following is the most accurate way to measure urine output from a catheter?
An indwelling catheter is inserted into the _____ to allow for continuous drainage of urine from the bladder.
An indwelling catheter is inserted into the _____ to allow for continuous drainage of urine from the bladder.
It is best practice to check the tubing for kinks and dependent loops once a day.
It is best practice to check the tubing for kinks and dependent loops once a day.
Which of the following statements best reflects the primary role of a nurse regarding indwelling catheters?
Which of the following statements best reflects the primary role of a nurse regarding indwelling catheters?
Other than cardiac problems and heart failure, what is another condition that would indicate the use of an indwelling catheter?
Other than cardiac problems and heart failure, what is another condition that would indicate the use of an indwelling catheter?
What key factor distinguishes a condom catheter from other types of urinary catheters??
What key factor distinguishes a condom catheter from other types of urinary catheters??
Cleaning around the meatus should be done daily and after each bowel movement and you should clean from the meatus _____.
Cleaning around the meatus should be done daily and after each bowel movement and you should clean from the meatus _____.
If a bladder scanner shows an incomplete bladder emptying, the immediate next step is always to insert a catheter for complete drainage.
If a bladder scanner shows an incomplete bladder emptying, the immediate next step is always to insert a catheter for complete drainage.
In the context of urinary catheterization, what is the MOST critical reason behind prioritizing the removal of an indwelling catheter at the earliest appropriate time?
In the context of urinary catheterization, what is the MOST critical reason behind prioritizing the removal of an indwelling catheter at the earliest appropriate time?
In what specific anatomical location should a suprapubic catheter be inserted?
In what specific anatomical location should a suprapubic catheter be inserted?
The joint consisting of the fibrocartilaginous disc sandwiched between the articular surfaces of the pubic bones is a unique joint called the _____ _____.
The joint consisting of the fibrocartilaginous disc sandwiched between the articular surfaces of the pubic bones is a unique joint called the _____ _____.
Which approach exemplifies the BEST practice for managing a patient with urinary retention following surgery, considering the potential risks and benefits?
Which approach exemplifies the BEST practice for managing a patient with urinary retention following surgery, considering the potential risks and benefits?
Using warm tap water is an acceptable substitute for sterile saline when cleaning around the meatus of a patient with an indwelling catheter.
Using warm tap water is an acceptable substitute for sterile saline when cleaning around the meatus of a patient with an indwelling catheter.
Flashcards
Bladder Scan
Bladder Scan
A noninvasive ultrasound device providing a virtual 3D image of the bladder and urine volume.
Retained Urine
Retained Urine
A reservoir for bacteria in the bladder, leading to infections and potential damage.
Purpose of a bladder scan
Purpose of a bladder scan
Assesses postvoid residual (PVR) volume as an alternative to bladder palpation.
Components of bladder scan
Components of bladder scan
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Pre- Bladder Scan Assessment
Pre- Bladder Scan Assessment
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Post-op decreased urinary output
Post-op decreased urinary output
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Enlarged Prostate
Enlarged Prostate
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Urethral Stricture
Urethral Stricture
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Neurogenic Bladder
Neurogenic Bladder
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Spinal Cord Injuries
Spinal Cord Injuries
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Stroke
Stroke
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Impaired Cognitive Ability
Impaired Cognitive Ability
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Renal Calculi or Renal Mass
Renal Calculi or Renal Mass
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Urinary Incontinence
Urinary Incontinence
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Diabetes
Diabetes
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Ultrasound Gel
Ultrasound Gel
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Advantage of Bladder Scan
Advantage of Bladder Scan
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Bladder scanner
Bladder scanner
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Post-void residual (PVR)
Post-void residual (PVR)
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First step for using a bladder scanner
First step for using a bladder scanner
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Symphysis pubis
Symphysis pubis
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Indwelling catheter
Indwelling catheter
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Indications for indwelling catheter
Indications for indwelling catheter
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Meatus cleaning
Meatus cleaning
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Straight/intermittent catheter use
Straight/intermittent catheter use
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Suprapubic catheter
Suprapubic catheter
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Indications for suprapubic catheters
Indications for suprapubic catheters
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Wicking device for females
Wicking device for females
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Indications for external urine collection
Indications for external urine collection
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Risks Using An Indwelling Catheter
Risks Using An Indwelling Catheter
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Study Notes
Bladder Scanners
- Bladder scanners are portable ultrasound devices that measure urinary retention, specifically the volume of urine in the bladder.
- They aid in diagnosing urinary retention, especially large post-void residuals (PVR), which is the amount of urine remaining after urination.
- An abnormal PVR may indicate a urinary tract blockage, an enlarged prostate, or medication side effects.
Instructions for Using a Bladder Scanner
- Encourage the patient to void, if possible, to assess PVR amount.
- Turn on the scanner and choose the appropriate setting (male or female).
- Selecting the correct sex is crucial, as the machine recalibrates accordingly, especially to account for the presence or absence of a uterus.
- Apply ultrasound gel to the patient's abdomen.
- Place the scanner 1 inch above the symphysis pubis, which is a unique joint comprised of a fibrocartilaginous disc between the pubic bones' articular surfaces.
- Ensure the scanner is pointed towards the bladder, not the bone mass.
- Press the "SCAN" button and adjust the probe to center the bladder image on the screen's crosshairs.
- Press "DONE" when satisfied, and print the results.
Urinary Catheters
- Urinary catheters facilitate urine drainage from the bladder.
- Types include indwelling, straight or intermittent, and suprapubic catheters, plus external collection devices.
Indwelling Catheters
- An indwelling catheter is a tube inserted into the urethra for continuous urine drainage from the bladder.
- Also known as a Foley catheter, though "indwelling" is preferred in nursing school.
Indications for Use of an Indwelling Catheter
- Indwelling catheters are indicated for patients requiring strict intake and output monitoring due to cardiac problems, heart failure, or being comatose.
- They also address urinary retention, obstruction, bladder irrigation, and severe perineal or sacral wounds.
Risks When Using an Indwelling Catheter
- Indwelling catheters increase the risk of catheter-associated urinary tract infections (CAUTI), causing pain or urethral injury.
- The longer the catheter remains, the greater the infection risk, as it bridges the outside and inside of the body.
Indwelling Urinary Catheter Care
- Insert indwelling catheters using sterile technique and equipment.
- Hang the bag below bladder level, on the bed frame, and avoid placing it on the floor.
- Regularly check the tubing for kinks and dependent loops, which obstruct urine flow due to gravity.
- Dependent loops can cause urine backflow and infection. Avoid the patient lying on the tubing.
- Clean around the meatus (urethra's exit point) daily and after bowel movements, cleaning outward.
- Replace both the catheter and collection system upon leakage or disconnection.
- Empty the bag into a graduated container for accurate measurement.
- Remove the indwelling catheter as soon as appropriate, advocating for its removal to decrease infection risk.
Straight or Intermittent Urinary Catheters
- Straight or intermittent catheters drain the bladder once or intermittently for chronic retention.
- They use a narrower tube and are removed immediately after use, unlike indwelling catheters.
Indications for Use of Straight or Intermittent Catheters
- Straight or intermittent catheters help with chronic retention, such as in neurogenic bladder.
- Neurogenic bladder is where the nerves connecting the bladder, spinal cord and brain are not functioning properly.
- They can also be used for urine sampling if unobtainable otherwise, with the goal of natural voiding after single use.
Risks When Using Straight or Intermittent Catheters
- Like indwelling catheters, these catheters increase CAUTI risk.
Suprapubic Catheters
- A suprapubic catheter is surgically inserted into the bladder through a small incision above the symphysis pubis for long-term continuous drainage.
- Indications include urethral stricture or injury and severe BPH (benign prostatic hyperplasia/prostate gland enlargement).
- The placement procedure can increase the risk for infection.
External Urine Collection Devices
- External urine collection devices include:
- Condom catheters for males: a rubber sheath rolled down the penis connected to a drainage bag.
- Wicking devices for females: a tube with wicking material placed between the labia attached to suction to remove urine.
- These devices reduce infection risk but are ineffective for obstruction or retention; they are used for incontinence.
- Skin breakdown risk is increased due to prolonged skin moisture, especially with condom catheters.
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