[cornelia]

I work in a LTC facility this is my first job and I'm still building confidence and growing skills. I have a resident who does intermittent straight cath. on himself during the night, he is 75 yrs old. His technique is acceptable, he has been doing it for a number of years. Sometimes he goes too far into the bladder and gets some bleeding at the tip of the cath. increasing his risk for infection. Is there a special technique I can teach him to ensure that he does it right every time? e.g. measuring the maximun length of the cath. he should insert... Any suggestions for some of you veterans?

[lpnandloveit1]

with a 75 year old man the problem could be vision or sensation.is he using a clear cath or a red one. make sure he stops as soon as he has urine also he could be getting blood from tissue near the prostate often a problem at his age. Does he reuse caths? If he does you could measure and mark them for him. If he doesn't reuse you could make him a measuring tool as a guide.something like umbilical tape.would do.

[cornelia]

Thanks for the advice. The resident uses a new cath. every time and they are the clear ones. I did manage to leave a measuring tape as a guide for him to use. The past few times seem to be more successful.

[lpnandloveit1]

you very welcome

[Charles S. Smith, RN, MS]

Originally posted by cvr:
<STRONG>Thanks for the advice. The resident uses a new cath. every time and they are the clear ones. I did manage to leave a measuring tape as a guide for him to use. The past few times seem to be more successful. </STRONG>

Another consideration is the material out of which the cath is made...is it a hard or soft material? There are new silicon caths that are very soft, pliable and do far less damage to the urethra. Another tip is to use xylocaine jelly instead of other lubricants. Xylocaine jelly not only temporarily anesthetizes the site, but it also relaxes the urethra for easier insertion and less friction. For really difficult male caths, take a 5 cc syringe and fill it with xylocaine jelly. Insert the syringe tip into the urethral meatus and inject the jelly directly into the urethra. Wait for 2-3 minutes then perform the cath. This techique results in much more effective caths with less resistance.

regards
chas

[lpnandloveit1]

before using xylocaine you need to check your facilities Policy and Procedure. You may need a Dr. order for this as Policies differ when you are in a LTC enviroment.

[Charles S. Smith, RN, MS]

Originally posted by lpnandloveit1:
<STRONG>before using xylocaine you need to check your facilities Policy and Procedure. You may need a Dr. order for this as Policies differ when you are in a LTC enviroment.</STRONG>

Thanx for the reminder! yes, always check your policies and procedures first. If using xylocaine is not covered in P&P, work toward getting it approved. It is a urology standard

chas