Catheter_Care

Basic information for caring for patient with indwelling urethral and suprapubic catheter. What is a catheter' A catheter is a tube that can be inserted into the body’s cavity, duct, or vessel. Catheters are used for drainage or administration of fluids, medication. The process of inserting a catheter is called catheterisation, a catheter can be left inserted either temporarily or permanently, this is often refer to as indwelling catheter. REASONS FOR CATHETERISATION: TO empty the bladder before certain investigations. To accurately measure urine output. To carry out bladder irrigation. To relieve urine obstruction. To administer cytotoxic drugs. There are different types of ureteral catheter: Long-term catheter that stays in for 3 months. Short term stays in for 7 -17 days then it would need to be changed to a long-term catheter, if necessary. Intermittent self-catheterisation is used only as needed and not left insitu. Supra pubic catheter is inserted through the abdomen directly into the bladder. A catheter comes in different sizes and is made with different materials. Irrigation catheter has three lumen instead of the standard two, with sizes ranging from 18-24. Catheter material: catheter is made from different materials, PVC, latex, Teflon, all silicone, hydrogel coating, and conformable catheter. All silicone is more widely used in clinical settings. ALWAYS CHECK IF PATIENT’S HAS AN ALLERGY ESPECIALLY TO LATEX. There are three lengths currently available. Paediatric 30cm. Female 23-26cm Standard 40-44cm. All catheters are held the bladder by a balloon that is inflated after the catheter has been inserted. Only sterile water should be used to inflated balloons and the correct amount should be used depending on the size of the catheter. Most standard size catheter comes with a prefilled syringe, for balloon inflation. Drainage systems: There are different types of drainage systems available, always chose a drainage bags according to patient clinical needs. Different types of drainage bags: 2litre bags commonly known as night bags, these are mostly used for patient who is bedbound. Leg bags hold approximately 370-750 mls. These are strapped to legs and allow greater mobility for patient, and more discreet. Legs bags also come in different length, long Medium and short. Patient should be given the opportunity to choose which catheter bags they prefer. Uro-meter bags are used for measurement when close monitoring of urine output is required. Catheter Valves are mostly used in bladder training, this allows the bladder to fill and be emptied as required. All bags/valves must be changed every 5-7days. Always take into consideration patient manual dexterity Catheter bags should always be positioned below the bladder and emptied as required. Bags positioned above the level of the bladder and full of urine causes reflux, which is associated with infection. Catheter Hygiene. Patient with urinary catheter have a high risk of developing urinary tract infection. Therefore, catheter hygiene is of utmost importance. Daily meatal cleaning is important to prevent infection. Uncircumcised male should be shown how to pull back their fore skin and clean around the meatus. They should also be shown how to clean away from the tip of the penis down the catheter tube. Female should be also being encouraged to maintain good personal hygiene. Encourage patient to drink2-2.5 litre of water a day as this increases urine production. Patient with suprapubic catheter should be shown how to clean around entry site and observe for signs of infection. The following should be taken into consideration when discharging a patient home with catheter. Catheter care should be taught and teaching should be offered to family, carers who would be supporting patient when discharged. Allow patient sufficient time to familiarise themselves with empting their leg bag and attaching night bags, or managing catheter valves. All patients must be referred to district nurse/ urology nurse if needed. Give information leaflet. Always encourage patient and their relative to express any concerns they might have.