catheter and BP??? what?

merricat · Oct 28, 2004

oops! i am sorry-- i looked at my post and decided the others were much better and more informative. but i do not think there is any way to erase entire post. (sigh). sometimes i post too soon. sorry!

merricat · Oct 28, 2004

oops! i am sorry-- i looked at my post and decided the others were much better and more informative. but i do not think there is any way to erase entire post. (sigh). sometimes i post too soon. sorry!

alanpe · Nov 7, 2004

It said "This can affect" and it is very important:

1. :)The removal of more than 1 litre can cause important changes in pressure levels.

2. :)Not say anything about other pathologies or aspects that can suposse it.

The best is to drain 1/4 litre, wait 10 minutes and so forth; but this can not exclude that a shock may be caused by other pathologies even idiopatics.

:)

alanpe · Nov 7, 2004

I wan to add that said it "can". OTOH a nurse can drain a bladder slow enough and patient think it was enough slow.

:)

Jetman · Nov 7, 2004

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!!)

Draining more than 1000cc at a time can cause a drop in BP due to the vessels in the pelvic floor being compressed by the oversized bladder. When the bladder is emptied quickly, those vessels can become engorged causing a systemic drop in BP. Hope this helps.

Jetman

URO-RN · Nov 7, 2004

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

Off the subject...

I love your avatar pic. Is that your hubby?.

Jo Anne.

Jetman · Nov 7, 2004

Draining more than 1000cc at a time can cause a drop in BP due to the vessels in the pelvic floor being compressed by the oversized bladder. When the bladder is emptied quickly, those vessels can become engorged causing a systemic drop in BP. Hope this helps.
Jetman

OOPS!, just saw someone else already explained it, sorry for the repeat.

gwenith, BSN, RN · Nov 7, 2004

Hmmmm I was always told it was only the chronic retention patients that this was a problem with. The rare patient that has been underdraining the bladder and end up with very large 2000+ capacities. They are also the ones who will have hypertrophied the bladder. Interesting that this subject is still has so much contention surrounding it. I do agree with Jan about the Autonomic Dysreflexia though - very scarey.

alanpe · Nov 8, 2004

It is really a problem this chronic retention; the hypertrophy do more difficult follow the insertion of a cath; one time the cath is inside, 2 litres of urine require a slow draining, even when we must follow with a lot of other tasks, it never justifies a quickly drainig and a shock.

:):)

mediatix8 · Nov 8, 2004

I wasn't the best patho student but I do remember this topic. According to my teacher, a patient's blood pressure could drop if their bladder is very full and you insert a catheter. It had something to do with the fact that when the bladder is very full and big, all the blood vessels are overly stretched and when the bladder suddenly resumes it's normal size, a lot of blood rushes to the bladder whose blood vessels can now accomodate for more blood.

NYCRN16 · Nov 8, 2004

I have had several ER docs tell me that there has been recent research done on this, and they all stated that there is no real correlation between the two, and that this is sort of an "old wives tale". I have had patients drain over 1000 cc's from the catheter very quickly, and I have never seen anything bad come of it.

jgillyrn · Nov 9, 2004

We clamp at 1000cc due to bladder spasm's and hx of HTN. I've seen a BP go sky high due to spasm's.