catheter and BP??? what?

Nurses General Nursing

Published

This pt hadn't been voiding, bladder scanned 800ccs, doc ordered foley. simple enough. but then the nurse told her orientee to go and clamp the foley cuz if it drains too fast the pt could go into shock. Now, mind you i don't have anyone here to discuss it with, and i am not going to argue with her. she's been a nurse forever and i don't want her to think i'm being difficult. but isn't the only thing that could really happen is the pt would get bladder spasms? Urine already in the bladder has nothing to do with BP, right? (I feel like I am having a debate with myself!!)

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.

There seems to be a lot of opinions about draining bladders. I've had one doc say clamp after 1000 cc's if the bladder isn't empty to prevent spams. I've had another urologist say just let it drain no matter how many cc's are drained.

There doesn't seem to be any literature supporting one way or the other. I've drained over 1000 cc's at a time without any problem.

I've seem more bladder spasms with foley's in a patient and the bladder was completely empty than spasms during draining a newly cathed patient. But I'm sure it happens otherwise it wouldn't be the policy of so many people. :)

Up Vote Up Vote ×
Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.

There seems to be a lot of opinions about draining bladders. I've had one doc say clamp after 1000 cc's if the bladder isn't empty to prevent spams. I've had another urologist say just let it drain no matter how many cc's are drained.

There doesn't seem to be any literature supporting one way or the other. I've drained over 1000 cc's at a time without any problem.

I've seem more bladder spasms with foley's in a patient and the bladder was completely empty than spasms during draining a newly cathed patient. But I'm sure it happens otherwise it wouldn't be the policy of so many people. :)

Up Vote Up Vote ×
There seems to be a lot of opinions about draining bladders. I've had one doc say clamp after 1000 cc's if the bladder isn't empty to prevent spams. I've had another urologist say just let it drain no matter how many cc's are drained.

There doesn't seem to be any literature supporting one way or the other. I've drained over 1000 cc's at a time without any problem.

I've seem more bladder spasms with foley's in a patient and the bladder was completely empty than spasms during draining a newly cathed patient. But I'm sure it happens otherwise it wouldn't be the policy of so many people. :)

Neurogenic shock can occur with those patients with quadriplegia because of an overstimulation to the nerves. :)

Up Vote Up Vote ×
There seems to be a lot of opinions about draining bladders. I've had one doc say clamp after 1000 cc's if the bladder isn't empty to prevent spams. I've had another urologist say just let it drain no matter how many cc's are drained.

There doesn't seem to be any literature supporting one way or the other. I've drained over 1000 cc's at a time without any problem.

I've seem more bladder spasms with foley's in a patient and the bladder was completely empty than spasms during draining a newly cathed patient. But I'm sure it happens otherwise it wouldn't be the policy of so many people. :)

Neurogenic shock can occur with those patients with quadriplegia because of an overstimulation to the nerves. :)

Up Vote Up Vote ×

the liter limit was taught us in nursing school. It is like hypovolemic shock, too much too soon causes dire results. I would also consider the age and size of the patient, as older and smaller people may get shocky before a liter has been drained.

Up Vote Up Vote ×

the liter limit was taught us in nursing school. It is like hypovolemic shock, too much too soon causes dire results. I would also consider the age and size of the patient, as older and smaller people may get shocky before a liter has been drained.

Up Vote Up Vote ×
Specializes in Education, Acute, Med/Surg, Tele, etc.

I tend to recall a liter limit, but never had a foley drain that much in a short period of time so I haven't clamped anyones for this purpose. I do know that many of the times I had to clamp a foley for UA's to test for the probelm of a UTI causing the retention so maybe that is a make shift way of achieving this.

But I will say bladder scanners are aweome! I don't have one at my facility (heck we don't have a defib, or a pulse ox either..uhggggg) and I sure miss them! They were so diagnostic and you knew what to expect once that foley went in! I try not to rely on machines, but rather looking at my patient to find clues..but that bladder scanner to me was such a nice asset! LOL, maybe I should find one on E-Bay...maybe then my facility will get one at discounted price..LOL! (I doubt it but LOL!!!!!!).

Up Vote Up Vote ×
Specializes in Education, Acute, Med/Surg, Tele, etc.

I tend to recall a liter limit, but never had a foley drain that much in a short period of time so I haven't clamped anyones for this purpose. I do know that many of the times I had to clamp a foley for UA's to test for the probelm of a UTI causing the retention so maybe that is a make shift way of achieving this.

But I will say bladder scanners are aweome! I don't have one at my facility (heck we don't have a defib, or a pulse ox either..uhggggg) and I sure miss them! They were so diagnostic and you knew what to expect once that foley went in! I try not to rely on machines, but rather looking at my patient to find clues..but that bladder scanner to me was such a nice asset! LOL, maybe I should find one on E-Bay...maybe then my facility will get one at discounted price..LOL! (I doubt it but LOL!!!!!!).

Up Vote Up Vote ×

Not just quadriplegics, paraplegics can crash on you if you empty a very full bladder too fast.

Up Vote Up Vote ×

Not just quadriplegics, paraplegics can crash on you if you empty a very full bladder too fast.

Up Vote Up Vote ×
Specializes in Med/Surg, Ortho.

I hadnt heard anything about shock, but we were taught that a quick drarin of over 800-1000ml would damage the receptors on the posterior lining of the bladder and cause the patient to not be able to determine when the bladder was full causing overflow incontinence.

But isnt a bladder scan a pretty expensive way to determine if the bladder is full? Was the bladder palpated to see if it was distended? Why wouldnt you just do a straight cath for residual? Had an attempt been made to insert a foley and was not successful? Seems a lot of expense and time, not to mention potential discomfort for the patient with a full bladder to have to be moved and wait so someone can put pressure over the bladder during the scan to find out if its full. I dont know the whole situation but doing a scan for a non urinating patient before other options were unsuccessful could almost be called medicare/insurance fraud couldnt it?

Up Vote Up Vote ×
Specializes in Med/Surg, Ortho.

I hadnt heard anything about shock, but we were taught that a quick drarin of over 800-1000ml would damage the receptors on the posterior lining of the bladder and cause the patient to not be able to determine when the bladder was full causing overflow incontinence.

But isnt a bladder scan a pretty expensive way to determine if the bladder is full? Was the bladder palpated to see if it was distended? Why wouldnt you just do a straight cath for residual? Had an attempt been made to insert a foley and was not successful? Seems a lot of expense and time, not to mention potential discomfort for the patient with a full bladder to have to be moved and wait so someone can put pressure over the bladder during the scan to find out if its full. I dont know the whole situation but doing a scan for a non urinating patient before other options were unsuccessful could almost be called medicare/insurance fraud couldnt it?

Up Vote Up Vote ×
+ Add a Comment