Foley cath

In my experience, no cath. There will be scant urinary output. We kept them clean and comfortable. Also we gave frequent oral care.

I never cath unless there are signs of discomfort or agitation.

In my facility we never cath without a doctor's order. I assume by your question that you facility has a protocol in place that allows nurses to decide when to cath based on urine output. If your protocol does not specifically account for a hospice patient then I'm thinking you should contact the doctor for guidance in the individual circumstance. What you are saying makes a lot of sense, but its important to stick to stick to the orders and/or protocols.

i would do a bladder scan in addition to other assessments of the pt´s physical condition just to feel comfortable with the situation...

We have to bladder scan and notify the doctor after two shifts without any urine output. It is then up to the doctors discretion. Most of the time the doctor says it is expected and to only cath if resident appears uncomfortable or is over a certain amount in bladder.

If you don't have the equipment to perform a scan at least palpate the bladder to check for distension. Morphine can cause urinary retention and should be ruled out in a restless actively dying patient.

We don't have bladder scans. Bladder was not distended. I did talk the family into inserting one. No urine for 3 days. Got over 1000 out. Day two I tried talking them into it but they wished for no foley because she pulls and messes with any tubing attached to her.

A st. cath. PRN would be appropriate for comfort. I think it's amazing that you couldn't palpate the bladder and still got that much urine. I'm pretty sure mine holds about 90 cc-especially when I'm traveling.

Foley catheters can be as much or more uncomfortable than a fullish (not overly full) bladder. I'd prefer straight catheterizing prn any time, prn.

Palpate, scan if possible, and monitor for signs of discomfort and get an order when necessary.