Fully drain distended bladder?

Undone · Jul 2, 2014

I do not have any experience with this but I came across an nclex question days ago that stated that fully draing a distended bladder could result in damage to the bladder and I am pretty sure it said you should not drain more than 500mL at once.

Elle23 · Jul 2, 2014

I do not have any experience with this but I came across an nclex question days ago that stated that fully draing a distended bladder could result in damage to the bladder and I am pretty sure it said you should not drain more than 500mL at once.

How, exactly would the bladder get damaged? (I am asking this as a general question to anyone...)

I have heard the same admonition, but where are the examples of people this actually happened to? Studies? Research? Anything concrete we can go on other than "it can damage the bladder"?

iPink, BSN, RN · Jul 2, 2014

I have drained more than 1000mLs of urine on a patient. The only thing that happened was the patient felt relief and his vitals were normal.

Undone · Jul 2, 2014

How, exactly would the bladder get damaged? (I am asking this as a general question to anyone...)
I have heard the same admonition, but where are the examples of people this actually happened to? Studies? Research? Anything concrete we can go on other than "it can damage the bladder"?

I really don't know what damage can be caused. I suppose that is why I got that question wrong

There are several threads here on AN about it, with different reasons as to why the bladder should not be fully emptied, none that I read made a great amount of sense to me.

Zara, RN · Jul 2, 2014

From my experience and understanding draining more than 1000cc of urine will cause the bladder to spasm and cause hypotension.

For my own reasons I always clamp at 1000.

RunBabyRN · Jul 2, 2014

I believe the risk is hypotension, but I've heard it more related to ascites and other fluid balance issues. If the uterus is midline and lochia light, I don't see a need to drain 3000+ ml at one time, but I think as long as the pt responded well (which is what it sounds like), I wouldn't stress too much.

**LibraSunCNM, BSN, MSN, CNM** · Jul 2, 2014

Not to seem judgmental, but may I ask why a patient was left 22 hours post-delivery without voiding before someone straight-cathed her? She could have ruptured her bladder with that much urine retained.

sandytoes · Jul 2, 2014

Following with interest. I've never straight cathed for more than about 1000 and I had huge wide eyes when I did. That poor woman w/3000+!!!

idialyze, BSN, RN · Jul 2, 2014

I was taught years ago, that draining that much urine at once would cause hypotension due to the rapid refill of the capillary bed in the abdomen.

loriangel14, RN · Jul 2, 2014

Where I work we clamp the catheter after 500mls and then open it up again after 30 minutes or so and drain a bit more.Draining than a few hundred at a time can cause painful bladder spasms and hypotension.

Why on earth would they leave a patient that long with no void?

haunani, BSN, RN · Jul 3, 2014

Let me reiterate that this wasn't my patient. The patient was non-English speaking and it appears the day shift nurse wasn't very thorough in her questioning of the patient during her assessments. When I went in with the new(er) nurse at her request, I immediately noticed her fundus was grossly displaced (though still firm), and asked her if when she went to the bathroom if she "peed a lot or a little". She responded very little, so I told the nurse to bladder scan her.

Our straight caths drain fairly slowly, and it took well over 30 minutes to fully drain her bladder. She expressed a relief from most of the pain after the first 1000mL and we were both shocked that it kept draining...

and kept draining. By the time it was done, her abdoment was visually noticeably less distended.

She ended up being straight cathed again later in last night's shift, then started voiding very small amounts today, and a foley was finally inserted this evening to give her bladder a chance to rest and recover.