Catheters

[jyoung1950]

I'm a CNA at a nursing home. Something here doesn't seem right to me although I may be completely off base.

About a year ago one of the ladies on my unit wasn't voiding very well during the day; however, the aid on night shift said she was voiding ok on her shift.

Within a day or so this lady had a catheter inserted. It's a year later and she still lives with a catheter in her. We record input and output every day. Some days she comes close to overflowing the urinal when we empty the bag.

Is it common to keep a person on a catheter month after month, now going on year after year?

Or is this wierd medical care?

[julieK]

All I can say is that the catheter must be cared for very well if she hasn't gotten an infection yet!

-Julie

[Darlene K.]

When you say, "she wasn't voiding very well", what do you mean? Could she amubulate to the toilet?

[BHolliRNMS]

Unless a medical condition was discovered that validates the need of the catheter indefinitely, an attempt should be made to discontinue it. We discontinue many catheters and monitor the resident's output closely. We may also do a post voided residual urine check to determine if the resident is emptying their bladder sufficiently. In order to get rid of unnecessary catheters, you need a nurse that will ask the doctor for orders to attempt it. Sounds like the resident is very well hydrated...which is a great thing in her favor.

[leslie :-D]

you want to keep it in if there's a coccygeal ulcer that needs to heal and the pt. is incontinent or non-ambulatory. other than a handful of other etiologies i don't know why it would be for long term use.

[jyoung1950]

No, this woman was unable to walk, was incontinent. I don't know if she has Alzheimer's or some other kind of neurological disorder as she can't communicate her needs.

The day staff said they noticed that her diapers were still dry when they changed her in the afternoon care.

When you say, "she wasn't voiding very well", what do you mean? Could she amubulate to the toilet?

[CCU NRS]

Most policies state that indwelling catheters must be changed every 14 days and suprabubic catheters changed monthly. If she has a medical necessity for a catheter her physician should investigate and if the Pt is paraplegic or quadriplegic depending on where the spinal injury is this could cause loss of feeling to promote urination, this would be cause for long-term intervention such as a suprapubic cath.

Also older females can have prolapsed uterus which can block the bladder, and like someone else said any number of other causes are possible.

Of course all of this is speculation because we have no history on the Pt.

[RNwendy]

residents also have to have a diagnosis that supports the catheter. incontinence is not one of them. maybe she was straight cath'd and had a large amount of residual resulting in a dx of urinary retention that supported the cath. catheters are monitored closely in ltc. i am going to "assume" that bladder tone training has not been successful and she continues to require the cath to void?