We have always been taught when cathing a patient to plug off the flow if it gets to be more than 500 or 600 cc at the beginning, i can't find this in print and have been told by urologist that that is not true. Can anybody enlighten me?
Learned this in nursing school, too. Trying to remember, and I think it had to do with too much fluid loss so quickly? Or maybe, bladder spasms brought on by too rapid emptying of the bladder after it has been stretched so far? Don't know if it is a legitimate concern, tho. Sorry.
Mar 8, '03
I think it was something that was taught a long time ago...I graduated 10 years ago and we were told then it was an old theory that has since been disproven...
Mar 9, '03
I also was taught this but read that it makes no difference. But I do see people still doing it. Pain of bladder spasms (maybe) vrs the pain of a full bladder (for sure)- I'd go with the maybe.
Apr 3, '03
Not practised at all in my hospital.... I havent actually heard of it myself....we practise keeping the ucath in if its more than 700-100mls
Often times the patient rarely complains but feels very much relieved after RU has been darined out....
Apr 3, '03
It was to prevent "bladder shock" and it only applied to chronic urinary retention where you have a slowly inflating bladder from chronic prostate problems. The bladder shock was supposed to be a variant of autonomic dysreflexia I think but it has been some years and I would have to dig out(literally) some old notes
Apr 3, '03
I was taught this
Apr 18, '03
Originally posted by gwenith It was to prevent "bladder shock" and it only applied to chronic urinary retention where you have a slowly inflating bladder from chronic prostate problems. The bladder shock was supposed to be a variant of autonomic dysreflexia I think but it has been some years and I would have to dig out(literally) some old notes
I completely agree with gwenith...
We don't practice it as a rule, but you are always aware of the drainage amount as it is draining so as to not allow the bladder to go into shock.
The pain of retention versus the pain of bladder spams is certainly a valid argument but if a patient is in acute retention then the drainage off of 500 to 700 mls is usually enough to relieve most of the pressure.
Keep up the good work everyone!
Aug 7, '03
When the bladder is FULL (2000cc), it hurts. A catheter does not drain very fast,so I don't usually pause for any reason. The two times I found over 2,000ccs in a bladder, the patient's look of relief told me I was doing OK. Follow the facial expressions for clues.
Aug 7, '03
I once straight-cathed a new mom for 2100 cc of urine after she had gone some 14 hrs. after delivery without voiding. (Never did find out why no one had picked up on that on earlier shifts.) Although I'm very good at cathing people, I had a hard time convincing her that this was the best course of action; once I had her talked into it, it didn't take long for her to agree as the urine began to flow. The poor girl started out with this expression of pure agony on her face, then she visibly relaxed, then became more animated as things progressed, and was even laughing by the time the deed was done. She was so relieved she actually hugged me when it was over!
Now, I wouldn't have wanted to take that much urine from a frail elderly pt. weighing 90# wringing wet, but since this one was young and healthy with a more than adequate blood volume, I didn't worry too much. I think this is something you just learn over time, like most nursing skills---you develop judgment that enables you to take things on a case-by-case basis, rather than adhere to some arbitrary number (that was probably decided by someone who never had half a gallon of urine sitting in his bladder!!).