Urinary Catheter Care Instruction F t septicemia

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					                               Pingtung Christian Hospital                                           No:ND(ipd)-024
                                                                                                     2003.7 issue
                             Urinary Catheter Care Instruction                                       2004.10 modify

● Definition
  A urinary catheter is any tube system placed in the body to drain and collect urine from the bladder.
● Information
  A Foley catheter is a soft plastic or rubber tube that is inserted into the bladder to drain the urine. Urinary catheters are
  sometimes recommended as way to manage urinary incontinence and urinary retention in both men and women. There are
  several different types of catheters which may be used for a variety of different reasons.
  Urinary catheters may be used to drain the bladder. This is often a last resort because of the possible complications associated
  with continuous catheter usage. Complications of catheter use may include:urinary tract and /or kidney infections, blood
  infections(septicemia), urethral injury, skin breakdown, bladder stones, and blood in the urine(hematuria). After many years
  of catheter use, bladder cancer may also develop.

    Patient’s doctor may recommend use of a catheter for short term use or long term use(indwelling). The catheter may be left in
    place during this time, or patient’s may be instructed on a procedure for placing a catheter just long enough to empty the
    bladder and then remove it(clean intermittent self catheterization).

  Catheters come in a large variety of sizes(12 Fr., 14Fr.,…30Fr.),materials(latex,silicone,Teflon) and types(Foley catheter,
  straight catheter, coude tip catheter). It is recommended that you see the smallest size of catheter, if possible. Commonly, a
  size 14Fr. Or size 16Fr. Catheter is used. Some people may require larger catheters to control leakage of urine around the
  catheter or if the urine is thick and bloody or contains large amounts of sediment. Be aware that larger catheters are more
  likely to cause damage to the urethra. Some people have developed allergies or sensitivity to latex after long term latex
  catheter use; these people should use the silicone or Teflon catheters
  A catheter that is left in place for a period of time may be attached to a drainage bag to collect the urine. There are two types
  of drainage bags. One type is a leg bag, which is a smaller drainage device that attaches by elastic bands to the leg. A leg bag
  is usually worn during the day since it fits discreetly under pants or skirts, and is easily emptied into the toilet. The other type
  of drainage bag is a larger drainage device(down drain) that may be used during the night. This device is usually hung on the
  bed or palced on the floor.
  Most experts advise against routine changing(replacing) of the catheters. If the catheter is clogged(obstructed), painful, or
  infected it may require immediate replacement. Routine care of the indwelling catheter MUST include daily cleansing of the
  urethral area(where the catheter exits the body) and the catheter itself with soap and water. The area should also be
  thoroughly cleansed after all bowel movements to prevent infection. Experts no longer recommend using antimicrobial
  ointments around the catheter as they have not been shown to actually reduce infections.

  The drainage bag must always stay lower than the bladder to prevent a back flow of urine back up into the bladder. The
  drainage device should be emptied at least every eight hours, or when the device is full. Care must be taken to keep the outlet
  valve from becoming infected. Wash your hands before and after handling the drainage device. Do not allow the outlet valve
  to touch anything. If the outlet becomes obviously dirty, it should be cleaned with soap and water.
  Some people have occasional leakage of urine around the catheter. This may be caused by a catheter that is too small,
  improper balloon size, or bladder spasms. If bladder spasms occur, you should check to see that the catheter is draining
  properly. If there is no urine in the drainage bag, the catheter may be obstructed by blood or thick sediment, or kinking of the
  catheter or drainage tubing. If you have been instructed on irrigation(flushing the catheter) procedure, try to irrigate the
  catheter and see if this help. If you have not been instructed on irrigation and urine is not flowing into collection device,
  please call nurse immediately. Other causes of urine leakage around the catheter include constipation or impacted stool, or
  urinary tract infections
 Notify patient’s nurse if you develop any of the following:
 1. the urine has a strong smell or becomes thick and/or cloudy.
 2. fever, chills
 3. urethral swelling around the catheter.
 4. bleeding into or around the catheter.
 5. catheter draining little or no urine despite adequate fluid intake.
 6. leakage of large amounts of urine around the catheter.
  A suprapublic catheter is basically an indwelling catheter that is placed directly into the bladder through the abdomen. The
  catheter is inserted above the public bone. This catheter must be placed by a urologist during an outpatient surgery or office
  procedure. The insertion site(opening on the abdomen) and the tube must be cleansed daily with soap and water and covered
  with a dry gauze.

   These catheters usually are changed by qualified medical personnel. The catheter may be attached to the standard drainage
   bags described above. A suprapublic catheter may b recommended in people who require long term catheterization, after
   some gynecological surgeries, and in people with urethral injury or obstruction.

   Complications of suprapublic catheter use may include: urinary tract and/or kidney infections, blood infections(septicemia),
   urine leakage around the catheter, skin breakdown, bladder stones, and blood in the urine(hematuria). After many years of
   catheter use, bladder cancer may also develop.
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                                                       Urinary Catheter Care Instruction

          Patient __________________family member or myself has read carefully and accept medical staff given Urinary Catheter
          Care Instruction slip and explain the related topics.
                TO                                         Pingtung Christian Hospital Foundation
          Family member signature: _____________ relationship with patient: ___________ Medical Staff:____________________
          Republic     of     China                     Year                   Month                   Day