Understanding Bladder Scans

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Questions and Answers

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.

True (A)

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 ___________.

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

Match the following conditions with their potential impact on urinary function:

<p>Enlarged Prostate = Can compress the urethra, hindering urine flow. Urethral Stricture = Narrows the urethral pathway, obstructing urine exit. Neurogenic Bladder = Impairs bladder function due to damaged neural pathways. Spinal Cord Injuries = Causes urinary retention due to edema or nerve damage.</p> Signup and view all the answers

What is the recommended maximum postvoid residual (PVR) volume that a bladder scan should ideally indicate?

<p>100 mL (B)</p> Signup and view all the answers

A bladder scan typically consists of three components: an ultrasound monitor, a handheld scanner, and a printer.

<p>False (B)</p> Signup and view all the answers

What type of waves does the transducer in the handheld scanner send out to bounce off the bladder?

<p>Ultrasound waves</p> Signup and view all the answers

Before performing a bladder scan, ensure the patient does not have abdominal _______ over the midline lower abdominal area.

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

Match each condition with its potential effect on a patient's ability to void:

<p>Stroke = May experience impaired ability to void due to neurologic injuries. Impaired Cognitive Ability = May struggle to connect the sensation of needing to void with the action of voiding. Renal Calculi/Renal Mass = Can physically block the outflow of urine. Urinary Incontinence = Can result in incomplete emptying of the bladder.</p> Signup and view all the answers

Why might edema in the abdomen, resulting from post-operative intervention, lead to urinary retention?

<p>It may compress the urethra, causing partial or complete occlusion. (A)</p> Signup and view all the answers

Bladder scans are primarily used to diagnose the presence of kidney stones or renal masses.

<p>False (B)</p> Signup and view all the answers

What landmark on the lower abdomen is used as a guide when positioning the bladder scanner?

<p>Symphysis pubis</p> Signup and view all the answers

Patients with ____________ may not have the sensation or urge to void, which can lead to urinary retention.

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

Match the following medications with their potential to cause urinary retention:

<p>Anticholinergics = Reduce bladder contractions, potentially leading to retention. Tricyclic Antidepressants = Possess anticholinergic effects that may inhibit bladder emptying. Antispasmodics = Relax bladder muscles, which can lead to incomplete voiding. Opioids = Can decrease bladder contractility and increase urinary sphincter tone.</p> Signup and view all the answers

Which condition might result in impaired bladder emptying due to anomalies of the renal structures, infection, or neurologic conditions?

<p>Urinary incontinence (B)</p> Signup and view all the answers

If a female patient has undergone a hysterectomy, the 'female' setting should still be used on the bladder scanner.

<p>False (B)</p> Signup and view all the answers

What specific type of solution should be used to decontaminate the bladder scanner after each use?

<p>Antibacterial solution</p> Signup and view all the answers

An airtight seal between the bladder scanner and the skin is created by the application of _______ ______.

<p>conductive ultrasound gel</p> Signup and view all the answers

Match each patient scenario with the appropriate adjustment to bladder scanning technique:

<p>Patient with Hysterectomy = Use male setting on scanner. Patient with Loose Skin = Pull extra tissue aside for accurate scanning. Patient Who Is Obese = Pull extra tissue aside for accurate scanning. Patient Has Just Voided = Perform scan 10 minutes after voiding.</p> Signup and view all the answers

Why is it important to avoid moving the transducer scanning tip once the bladder is visualized during a scan?

<p>To ensure an accurate reading of the bladder volume. (D)</p> Signup and view all the answers

Documenting how the patient tolerated the procedure is an optional, but recommended, step after completing a bladder scan.

<p>False (B)</p> Signup and view all the answers

What should the healthcare provider be notified of after scanning if the bladder scan results indicate?

<p>Urinary retention</p> Signup and view all the answers

Placing the scanner one inch above the ______ _______ helps ensure correct placement for an accurate bladder scan.

<p>symphysis pubis</p> Signup and view all the answers

Match conditions with why bladder scanning may be considered:

<p>Post-op urinary retention = Monitor recovery of bladder function after surgery Stroke = Assess bladder control issues due to neurological damage Spinal cord injuries = Evaluate urinary retention Renal Calculi = Assess possible obstruction affecting urinary output</p> Signup and view all the answers

What benefit does using a bladder scanner offer compared to urinary catheterization?

<p>It reduces discomfort, pain, and risk of infection. (C)</p> Signup and view all the answers

The primary goal of using ultrasound gel during a bladder scan is to lubricate the skin for easier movement of the scanner.

<p>False (B)</p> Signup and view all the answers

What action should be taken to ensure correct scanner placement in a patient with a large amount of loose skin?

<p>Pull extra tissue to the side</p> Signup and view all the answers

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.

<p>never</p> Signup and view all the answers

Match each medication with the specific mechanism by which it can cause urinary retention:

<p>Antipsychotics = Can have anticholinergic side effects, reducing bladder muscle contractions. Antiparkinsonian drugs = Can impair nerve signals that control bladder function. Anesthetics = Can temporarily interfere with bladder muscle function and sensation. Antispasmodics = Relax bladder walls, preventing full bladder emptying</p> Signup and view all the answers

What is the MOST IMPORTANT step to perform immediately after completing a bladder scan to prevent potential spread of pathogens?

<p>Cleansing the transducer gel from the patient's abdomen and decontaminating the bladder scanner. (D)</p> Signup and view all the answers

Bladder scanners should be stored uncovered, to allow the machine to air out.

<p>False (B)</p> Signup and view all the answers

If a bladder scan is indicated and your patient has just voided, about how long should you wait before you perform the scan?

<p>10 minutes</p> Signup and view all the answers

When placing the scanner, tilt it (upward/downward) ______________ towards the bladder to ensure correct placement.

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

Match the following conditions with their relevance to bladder scanning:

<p>Pregnancy = Bladder scanning may be contraindicated in pregnant patients Abdominal wounds = Avoid scanning over wounds on the midline lower abdomen Obesity = More tissue needs to be pulled aside Paralysis = May cause impaired ability to void</p> Signup and view all the answers

Which of the following actions is MOST important when preparing a patient for a bladder scan?

<p>Ensuring privacy, explaining the procedure, and assisting the patient into a supine position. (B)</p> Signup and view all the answers

After completing a bladder scan, the digital image should be immediately deleted to protect patient privacy.

<p>False (B)</p> Signup and view all the answers

Name the author of the article.

<p>Charlotte Davis</p> Signup and view all the answers

Retained urine leads to urethral damage, pain, and ___________

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

Match bladder scanning contraindications with special considerations

<p>Wounds = Do not perform bladder scan over wounds. Pregnancy = Generally avoided as other methods are preferred. Ascites = May have interference with the accuracy of bladder scans. Implants = May have interference with the accuracy of bladder scans.</p> Signup and view all the answers

What is the primary function of a bladder scanner?

<p>To measure the volume of urine within the bladder. (C)</p> Signup and view all the answers

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.

<p>True (A)</p> Signup and view all the answers

An abnormal PVR (post-void residual) could indicate a blockage in the urinary tract, an enlarged _____, or possible side effects from medications.

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

What is the recommended placement of the bladder scanner on the patient's abdomen?

<p>1-inch above the symphysis pubis. (A)</p> Signup and view all the answers

An indwelling catheter is designed for single-use and is removed immediately after draining the bladder.

<p>False (B)</p> Signup and view all the answers

What does CAUTI stand for?

<p>Catheter-associated urinary tract infection</p> Signup and view all the answers

Which of the following is a risk associated with the use of indwelling catheters?

<p>Increased risk of CAUTI. (B)</p> Signup and view all the answers

Which condition might indicate the need for an indwelling catheter due to the necessity for strict monitoring of intake and output?

<p>Cardiac problems. (C)</p> Signup and view all the answers

It is acceptable to lay a urinary catheter bag on the floor as long as it is kept clean.

<p>False (B)</p> Signup and view all the answers

To avoid obstruction, frequently check the tubing for kinks and _______ loops, which can impede urine flow.

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

What action should be taken if leakage or disconnection occurs in a urinary catheter system?

<p>Replace both the catheter and collection system. (A)</p> Signup and view all the answers

Straight or intermittent catheters remain in the bladder to provide continuous drainage.

<p>False (B)</p> Signup and view all the answers

In what situation is a straight or intermittent catheter typically used?

<p>To drain the bladder a single time or intermittently. (B)</p> Signup and view all the answers

What is a neurogenic bladder?

<p>A bladder where the nerves connecting it to the spinal cord and brain are not functioning properly</p> Signup and view all the answers

A suprapubic catheter is inserted surgically into the bladder through an incision above the _______.

<p>symphysis pubis</p> Signup and view all the answers

Suprapubic catheters are typically used for short-term bladder drainage after surgery.

<p>False (B)</p> Signup and view all the answers

Which condition is a common indication for the use of a suprapubic catheter?

<p>Urethral stricture or injury. (D)</p> Signup and view all the answers

Give one example of an external urine collection device.

<p>Condom catheter or wicking device</p> Signup and view all the answers

External urine collection devices are effective for managing urinary obstruction and retention.

<p>False (B)</p> Signup and view all the answers

What is a potential risk associated with the use of external urine collection devices like condom catheters?

<p>Increased risk of skin breakdown. (C)</p> Signup and view all the answers

Why is it important to point the bladder scanner toward the bladder when scanning?

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

Cleaning around the meatus should be done only when there is visible discharge to prevent irritation.

<p>False (B)</p> Signup and view all the answers

When administering an indwelling catheter, it is important to use _____ technique and equipment to prevent infection.

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

What is the primary reason for using a wicking device for females?

<p>To actively remove urine as it is expelled from the body (A)</p> Signup and view all the answers

What does 'PVR' stand for in the context of bladder scanning?

<p>Post-void residual</p> Signup and view all the answers

Match the following catheter types with their primary characteristic:

<p>Indwelling Catheter = Remains in place for continuous drainage Straight Catheter = Used for single-time drainage and then removed Suprapubic Catheter = Inserted surgically through the abdomen Condom Catheter = External device for males</p> Signup and view all the answers

What is the potential consequence of dependent loops in urinary catheter tubing?

<p>Backflow of urine into the patient (D)</p> Signup and view all the answers

Which of the following is the most accurate way to measure urine output from a catheter?

<p>Emptying the bag into a graduated container (C)</p> Signup and view all the answers

An indwelling catheter is inserted into the _____ to allow for continuous drainage of urine from the bladder.

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

It is best practice to check the tubing for kinks and dependent loops once a day.

<p>False (B)</p> Signup and view all the answers

Which of the following statements best reflects the primary role of a nurse regarding indwelling catheters?

<p>To advocate for the removal of indwelling catheters as soon as appropriate (D)</p> Signup and view all the answers

Other than cardiac problems and heart failure, what is another condition that would indicate the use of an indwelling catheter?

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

What key factor distinguishes a condom catheter from other types of urinary catheters??

<p>It is an external device that doesn't enter the body. (A)</p> Signup and view all the answers

Cleaning around the meatus should be done daily and after each bowel movement and you should clean from the meatus _____.

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

If a bladder scanner shows an incomplete bladder emptying, the immediate next step is always to insert a catheter for complete drainage.

<p>False (B)</p> Signup and view all the answers

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?

<p>To minimize the patient's risk of acquiring a catheter-associated urinary tract infection (CAUTI). (A)</p> Signup and view all the answers

In what specific anatomical location should a suprapubic catheter be inserted?

<p>Above the symphysis pubis</p> Signup and view all the answers

The joint consisting of the fibrocartilaginous disc sandwiched between the articular surfaces of the pubic bones is a unique joint called the _____ _____.

<p>symphysis pubis</p> Signup and view all the answers

Which approach exemplifies the BEST practice for managing a patient with urinary retention following surgery, considering the potential risks and benefits?

<p>Encourage the patient to attempt voiding, use a bladder scanner to assess post-void residual (PVR), and consider intermittent catheterization if needed. (D)</p> Signup and view all the answers

Using warm tap water is an acceptable substitute for sterile saline when cleaning around the meatus of a patient with an indwelling catheter.

<p>False (B)</p> Signup and view all the answers

Flashcards

Bladder Scan

A noninvasive ultrasound device providing a virtual 3D image of the bladder and urine volume.

Retained Urine

A reservoir for bacteria in the bladder, leading to infections and potential damage.

Purpose of a bladder scan

Assesses postvoid residual (PVR) volume as an alternative to bladder palpation.

Components of bladder scan

An ultrasound monitor & a handheld scanner.

Signup and view all the flashcards

Pre- Bladder Scan Assessment

Ensure no abdominal wounds are present and the patient is not pregnant.

Signup and view all the flashcards

Post-op decreased urinary output

Surgery causing swelling that impairs urination.

Signup and view all the flashcards

Enlarged Prostate

Enlargement that partially compresses the urethra.

Signup and view all the flashcards

Urethral Stricture

Narrowing that obstructs the urinary pathway.

Signup and view all the flashcards

Neurogenic Bladder

Damaged neural pathways disrupting bladder control

Signup and view all the flashcards

Spinal Cord Injuries

Edema resulting from the trauma or injury.

Signup and view all the flashcards

Stroke

Neurologic injuries impairing the ability to void.

Signup and view all the flashcards

Impaired Cognitive Ability

Diminished ability to correlate the sensation of needing to void.

Signup and view all the flashcards

Renal Calculi or Renal Mass

Stones or masses physically blocking the outflow of urine.

Signup and view all the flashcards

Urinary Incontinence

Incomplete emptying due to infection, neurologic conditions, or anomalies.

Signup and view all the flashcards

Diabetes

Lack of sensation or urge to void.

Signup and view all the flashcards

Ultrasound Gel

Ensure acoustic pathway. Apply gel to the skin.

Signup and view all the flashcards

Advantage of Bladder Scan

Reduces need for catheterization.

Signup and view all the flashcards

Bladder scanner

A portable ultrasound device used to measure the volume of urine within the bladder.

Signup and view all the flashcards

Post-void residual (PVR)

The volume of urine remaining in the bladder after urination.

Signup and view all the flashcards

First step for using a bladder scanner

Encourage voiding to assess PVR amount.

Signup and view all the flashcards

Symphysis pubis

A unique joint consisting of a fibrocartilaginous disc sandwiched between the articular surfaces of the pubic bones.

Signup and view all the flashcards

Indwelling catheter

A tube inserted into the urethra for continuous drainage of urine from the bladder.

Signup and view all the flashcards

Indications for indwelling catheter

Monitoring intake/output, cardiac issues, urinary retention, bladder obstruction, severe wounds.

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Meatus cleaning

The point where urine exits the urethra.

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Straight/intermittent catheter use

Drain the bladder a single time or intermittently for chronic urinary retention.

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Suprapubic catheter

Placement surgically into the bladder through a small incision above the symphysis pubis.

Signup and view all the flashcards

Indications for suprapubic catheters

Urethral stricture/injury, or severe BPH

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Wicking device for females

A tube placed between the labia, actively removing urine ejected from the body

Signup and view all the flashcards

Indications for external urine collection

Used for incontinence but not obstruction or retention.

Signup and view all the flashcards

Risks Using An Indwelling Catheter

A CAUTI can cause pain or even urethral injury.

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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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