catheter and BP??? what?

[djsrn]

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!!)

[djsrn]

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?

Using a bladder scanner uses less pressure (or at least the same amt) as palpating. The patient doesn't have to be moved, he stays right in his bed. And no, its not expensive to use the scanner. (I work at a Veterans Hospital). We can also do a bladder scan for a pvr, which is non-invasive.

I don't think when you cath someone the bladder empties so fast that it would damage anything. I can understand someone with neurogenic bladder might have issues. That makes sense....anyone else have any ideas?

[djsrn]

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?

Using a bladder scanner uses less pressure (or at least the same amt) as palpating. The patient doesn't have to be moved, he stays right in his bed. And no, its not expensive to use the scanner. (I work at a Veterans Hospital). We can also do a bladder scan for a pvr, which is non-invasive.

I don't think when you cath someone the bladder empties so fast that it would damage anything. I can understand someone with neurogenic bladder might have issues. That makes sense....anyone else have any ideas?

[txspadequeenRN, BSN, RN]

How many times have you gone into shock while going tee tee?:rotfl:

[txspadequeenRN, BSN, RN]

How many times have you gone into shock while going tee tee?:rotfl:

[HappyNurse2005, RN]

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?

time? bladder scanning doesn't take much time at all. less than 5 minutes, less time than it would take to do a in and out cath. and its not much pressure at all, i never had a patient complain that the bladder scan was uncomfortable. i would think it would prevent an unnecessary cath-if they dont have as much urine in bladder as expected, you wouldn't have to cath them. i would much rather be scanned than cath'd

rose

[HappyNurse2005, RN]

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?

time? bladder scanning doesn't take much time at all. less than 5 minutes, less time than it would take to do a in and out cath. and its not much pressure at all, i never had a patient complain that the bladder scan was uncomfortable. i would think it would prevent an unnecessary cath-if they dont have as much urine in bladder as expected, you wouldn't have to cath them. i would much rather be scanned than cath'd

rose

[alanpe]

I know that if the bladder is evacuated very quickly the patient can suffer an hemorrhage; take a look to the color of urine one time you have installed a cath, perhaps it is yellow but yellow urine maybe has got leucocites (hemorrhage).

It is posible that some people do not reaction in the same way, but a quickly and full bladder evacuation can end with hemorrhage.

The volume and pressure of bladder change after a cath, this change can be affect and end with hemorrhage; a speedly evacuation can affect these parametres.

Bladder preasure, volume pressure that affect receivers, hemorrhage and some people tendency can possible result in shock.

But I beleive is very difficult or imposible to say what is exactly producing a shock after a bladder cath.

Alanpe

[alanpe]

I know that if the bladder is evacuated very quickly the patient can suffer an hemorrhage; take a look to the color of urine one time you have installed a cath, perhaps it is yellow but yellow urine maybe has got leucocites (hemorrhage).

It is posible that some people do not reaction in the same way, but a quickly and full bladder evacuation can end with hemorrhage.

The volume and pressure of bladder change after a cath, this change can be affect and end with hemorrhage; a speedly evacuation can affect these parametres.

Bladder preasure, volume pressure that affect receivers, hemorrhage and some people tendency can possible result in shock.

But I beleive is very difficult or imposible to say what is exactly producing a shock after a bladder cath.

Alanpe

[redshiloh]

bladder scanning is preferred because it is noninvasive. Inserting a cath always carries a risk of infection.

Bladder scans are easy and, if your facilty already has one(that works), cost effective.

[redshiloh]

bladder scanning is preferred because it is noninvasive. Inserting a cath always carries a risk of infection.

Bladder scans are easy and, if your facilty already has one(that works), cost effective.

[TracyB,RN, RN]

When I worked on the inpatient rehab unit, we used a bladder scanner at least every shift, depending on our census. Our unit had the only machine in the hospital (cost.... 13,000). No charge to pt to scan the bladder, it is just as quick as taking a temp. No discomfort, the scanner works very similar to ultrasound, & if your aim is proper, takes about 10 seconds for a result. I would much rather use the scanner than straight cath.....unless, the pt has been diagnosed with neurogenic bladder. In that case, I would scan first, then straight cath if warranted. Most of our docs would order straight cath if scan greater than 400cc, or no output in 6 hrs.

[TracyB,RN, RN]

When I worked on the inpatient rehab unit, we used a bladder scanner at least every shift, depending on our census. Our unit had the only machine in the hospital (cost.... 13,000). No charge to pt to scan the bladder, it is just as quick as taking a temp. No discomfort, the scanner works very similar to ultrasound, & if your aim is proper, takes about 10 seconds for a result. I would much rather use the scanner than straight cath.....unless, the pt has been diagnosed with neurogenic bladder. In that case, I would scan first, then straight cath if warranted. Most of our docs would order straight cath if scan greater than 400cc, or no output in 6 hrs.