Fully drain distended bladder?

[haunani]

I'm wondering if I did the right thing...

I was helping a newer nurse with a patient that had a distended bladder, on whom she had obtained an order for a straight cath. She was approximately 22 hours postpartum, vag delivery. Bladder scan showed 999+ mL of retained urine. Pt's uterus remained firm and lochia was WNL.

Straight cath netted 3075 mL of urine. Upon hearing this, one of the older, more experienced nurses said that we should not have drained the urine all at once. I don't remember being taught that or hearing it.

Did I mess up?

[dmw2010]

I was taught in school that draining more than 1000ml at once might cause fluid shifts. Some hospitals (hopefully) have it stated in their facility policy.

Now, if she was actively hemorrhaging and had a boggy uterus, that might be a different story....... Because if you only drained 1000ml at a time, you would have 2075ml left and she might continue to bleed because the uterus still won't clamp down.....

[pearlsrwisdom]

Yes..i too was taught in school to not drain more than 1000cc at a time due to bladder spasms.

[JoannaK]

I work in ICU as a Nurse Practitioner. I spoke to one of the intensivists about it one time and he told me the bladder shouldn't be drained all at once to prevent hemorrhagic cystitis. The reason why I spoke to him specifically about it is because back when I was a nurse I was taught not to drain a bladder to prevent hypotension. Obviously it is not true, the urine is not in the vascular compartment.

[brownbook]

On 7/2/2014 at 12:12 PM, LibraSunCNM said:

Not to seem judgmental, but may I ask why a patient was left 22 hours post-delivery without voiding before someone straight-cathed her? She could have ruptured her bladder with that much urine retained.

This whole discussion is clear as mud......as usual with technical questions. I suppose it depends on the patients underlying health, why the bladder is full, etc.

Once I had a full bladder on a slow bus ride to my hotel after an all night flight. A more memorable part of a not so great vacation. The last few miles of the bus ride I kept thinking....now I will find out if a bladder can really burst!

The bus stopped in front of the luxury hotel. I ran off the bus dragging my suitcase into the lobby, asked where the bathroom was, of course it was down a flight of stairs. I ran down the stairs banging, my suitcase behind me. It was an open marble staircase, made a heck of a lot of noise. I made it to the bathroom with several (many) people staring at me! A lady from reception even came by and asked if I was okay. My bladder didn't burst and I didn't have hypotension or hemorrhagic cystitis. Unfortunately I didn't have any way to measure the amount of urine ? to do a scientific study.

[Skips, MSN, RN]

I was taught to stop draining at 800ml d/t hypotension and bladder spasm. I think you should consult your hospital's specific policy on this, as the exact numbers vary facility to facility. Let us know what you find! ?