catheter

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Catheter question. there is a question in my study guide and i dont understand.

Question:pt has become aggitated and accidently disconnects the urinary catheter from the drainage system. What would the best course of action for the practical nurse to take?

1. irrigate the cath. and reattach the cath. to the drainage system

2. attach a new drainage system to the catheterr, and moniter urine output.

3. tape the cath. securely to his leg, and moniter urine output

4.insert new catheter and attach a drainage system.

appartently the correct awnser is 2. i dont understand the ratioale?

if it is a closed sterile system, why woulnt you change everything, since the cath is now contaminated.

if it was a condom catheter i can see it being diffrent. but it says urinary. ive tried looking this up, and cant find any info about this, if anyone has some insight id really appreaciate it. thank you.

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Specializes in Gerontology.

My logic is by removing the cath and reinserting a new one you are actually increasing the risk of infection. Plus, the part the catheter outside the body is not sterile anyway.I would however, clean the catheter end with alcohol before reattaching the new drainage system.

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Specializes in cardiac/critical care/ informatics.

well maybe the rationale is that the risk of infection is greater or the same inserting a new catheter. Every time you insert a catheter you have a risk of infection. I personally would have thought change it all out as well.

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Specializes in ICU, PACU, Cath Lab.

I think that inserting a new cath would have a higher risk of infection than cleaning the end and attaching a new drainage canister. I would bet that Cath's are one sterile procedure that is not done correctly the majority of the time...I mean really how many times have you seen or heard of someone putting it in the lady parts and pulling it out and trying again....ewwww.

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Specializes in ED/trauma.
My logic is by removing the cath and reinserting a new one you are actually increasing the risk of infection. Plus, the part the catheter outside the body is not sterile anyway.I would however, clean the catheter end with alcohol before reattaching the new drainage system.

That was my thinking. Also, although it seems logical just to reinsert a new one (like you would with an IV, for example), you would actually need an order to reinsert a new one. I'm not sure what the reasoning for needing a new order is (anyone else?), but I do know that it's true.

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Specializes in Gerontology.
That was my thinking. Also, although it seems logical just to reinsert a new one (like you would with an IV, for example), you would actually need an order to reinsert a new one. I'm not sure what the reasoning for needing a new order is (anyone else?), but I do know that it's true.

I don't think you would need an order. After all, if a pt pulls out an IV or you lose the site, you just put a new one in. I would think the same logic would apply to a catheter. I have had pts pull out catheters - ballon intact! (ouch) and we've just re-inserted.

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1. irrigate the cath. and reattach the cath. to the drainage system

2. attach a new drainage system to the catheterr, and moniter urine output.

3. tape the cath. securely to his leg, and moniter urine output

4.insert new catheter and attach a drainage system.

I would have answered #2. 1 - wrong, b/c by irrigating (which at least at our hospital requires a dr's order) you are likely contaminating the bladder with germs that came into the catheter when it was detached. 3 - obviously is not right b/c it says nothing about reattaching the catheter. Why would I pick 2? B/c we deal with quite a few post op TURPs and TURBs, and they go home on leg bags. Which means, they detach the large foley catheter bag and attach a small bag. Then they switch bags at night. They'll do this for several weeks, possibly. You wash your hands, you teach them to use alcohol wipes on the end of the catheter that goes into the rubber port. No need to reinsert an entire new system, it would increase risk of infection.

Hope that helps a little.

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Specializes in OPERATING ROOM, ICU.

Do not d'c an existing foley without doctor's order. You would attach a new collection device and monitor for urinary output, allowing you to ensure catheter is still patent (without the invasive procedure of putting a new catheter in) and to check color (any blood visible, which may indicate trauma).

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Specializes in Acute Care, Rehab, Palliative.

I would agree with #2. Where I work many pts change to the small leg bag when they are up during the day and back to the larger collection bag at HS. We don't, obviously reinsert the cath each time.

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Specializes in ED/trauma.
I don't think you would need an order. After all, if a pt pulls out an IV or you lose the site, you just put a new one in. I would think the same logic would apply to a catheter. I have had pts pull out catheters - ballon intact! (ouch) and we've just re-inserted.

I'm not sure what the logic is, but I know at my hospital, we need a new order if a foley comes out. I think it might have something to do with reassessing whether or not the pt still needs it / can tolerate it. Most docs will just say, "Yeah, sure!" Some are more thorough and want to reassess first, though. I'm all about CYA when it comes to orders!

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thank you very much for everyone replying to my question.

I was studying for my LPN national exam. I had been using the study guide, and came to this question. I completly get it now, and i wrote the exam, and this question was my last question on the exam, nearly word for word.

I m so thankful i asked, and thank ful you all toke the time to explain it. :yeah:

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