Urine return???

[Debbie_LPN]

In LTC nursing, when changing a catheter, do you ALWAYS get urine return??? In school, we are always told that u will get a return if u are in the right spot.

I'm asking b/c the other day, I changed a catheter and got no return. So I got the other nurse, and as it turns out, I was in the right place but there wasn't a return right away. So he tells me if you are unsure, inflate the balloon and if you tug and it comes out you're wrong. I did that on another catheter, and it stayed in there so I left it go. The dayturn nurse then had to change it cause 2 shifts had no output.

Thanks in advance!!!

Debbie

[CoffeeRTC, BSN, RN]

Most LTC don't have a scanner. How about a little bladder massage? or position change...running water sound?

[Faby]

In LTC nursing, when changing a catheter, do you ALWAYS get urine return??? In school, we are always told that u will get a return if u are in the right spot.

I'm asking b/c the other day, I changed a catheter and got no return. So I got the other nurse, and as it turns out, I was in the right place but there wasn't a return right away. So he tells me if you are unsure, inflate the balloon and if you tug and it comes out you're wrong. I did that on another catheter, and it stayed in there so I left it go. The dayturn nurse then had to change it cause 2 shifts had no output.

Thanks in advance!!!

Debbie

Hi: I can telll from my experience that the first step is choosing the right orifice. If talking about elder females,or obese females, it could be a little inlady partsted into the lady partsl entrance. If so, you'd better find the orifice first.

Then introduce the catheter into it about 5 cm. You'll reach the bladder.

After tesi it should be urine return, depending on the patient's input and hydration assesment. If no return is obtained, I would rather check the inputs, and increase input( I/V, oral) for a while. If the patient's hydration status in OK, you should have a urine return in about 20 min or so. You could inflate the baloon if you'd introduced the catheter more than 5 cm, you're in place without doubt.

If talking about male insertion, it would take more than 12 cm, in addition to a careful procedure, to be sure that you're in place. But if we're speaking of a change, generally the urethra would be opened enough so that it would allow you not to make a fake route, which is the gratest risk.

I would advice you to check you're facility's procedure mannual on this, and stick to the procedure in order to succeed.