Is it possible.....

ShayRN · Jun 10, 2012

Had a patient come to me from a world renowned hospital. They reported extreme agitation & restlessness. He fell asleep for me that night after I drained 1500ml from his bladder. This is the new side effect of Medicare clamping down on cath infections, even people who really need them don't get them.

applewhitern, BSN, RN · Jun 10, 2012

Yes, it is possible; have seen it many times. (I was taught in nursing school, many years ago, to stop for a bit if you reach 1000cc immediately upon inserting the catheter, don't know if that is still taught or not, tho.)

applewhitern, BSN, RN · Jun 10, 2012

After a 14-16 hour shift without getting a minute to go pee, lots of nurses can put out 2 liters at once!

amoLucia · Jun 10, 2012

Oh yeah - and just watch the volume go up after some lasix if they can't get to pee frequently. It's a major deluge after a zaroxylyn/lasix cocktail!!!

notpuurfctbtgdenghns · Jun 10, 2012

Let us just say that a litter or L is 1000cc; 10,000 is 10 litter or 10L. A gallon is a little more than 3.78L; so, 10,000 a little less 3 or 2.6 gallon to be exact.

This is a reply of posting #4/Zumalong

Cat_RN, ASN, BSN, RN · Jun 11, 2012

The first foley I ever did returned 2500mL of urine. It was a LOL who was admitted for AMS who was hardly rousable to painful stimuli. Not 30 mins later the woman is alert, talking and asking for water!

allnurses Guide · Jun 11, 2012

I've also seen it before, they come in saying they haven't been able to pee. Almost always male, usually prostate related.

Last time, I got 1600 out, dark cloudy urine, and then it turned to thick brown pus draining out. He had only been passing the overflow for so long it literally grew pus inside the bladder at the bottom level. Can we say, IV antibiotics stat?

rn/writer, RN · Jun 11, 2012

post-op C section
5,000 cc

Just over 3,000 cc. Also a post-op c-section.

It used to be thought that no more than 1,000 cc should be drained off at a time for fear that the patient's hemodynamic status would experience a drastic (possibly life-threatening) shift. Evidence-based practice showed this to be a falsehood. In most cases, the fluid is sitting in the bladder and has already been taken out of circulation, so to speak. Making the patient wait an hour or more for another straight cath does nothing but continue the discomfort and raise the chances for infection with each subsequent cath insertion.

Altra, BSN, RN · Jun 11, 2012

I once had a patient who drained 2,200 mL within about 5 minutes.

tothepointeLVN, LVN · Jun 29, 2012

I think that might have been me. I had idiopathic urinary retention that lasted about 1 week before going away (no I didn't hold it in for a week LOL) It started one night could not void so I thought more fluids. Chug chug chug. I tried to make it to morning so I coud just go to the clinic. Finally gave in at 3am as my Dr is yelling at me through the phone. Went down to the ER the put a foley in. About 2.5L came out. My nurse was like "you weren't joking around." Unfortunately my NP accidentally d/c'ed the FC trying to get a sample out of the port. Sent me home with instructions to return to the ER if it happened again. It did. Repeat the ER process.

So yes it's possible to drain 2L+ and to do it more than once. Of course the upside is holding my bladder through a 12hr shift is no problem now.

Rhody34 · Jun 29, 2012

Just curious... I'm a recent grad awaiting my NCLEX date... I answered a practice question incorrectly and part of the rationale was- you should clamp an cath after 400mL of urine because rapid decompression of the bladder can cause it to tear, or rupture. Any one ever hear or experience this? This post made me think of that!

Been there,done that, ASN, RN · Jun 29, 2012

Certainly possible. I have seen it several times. There is even a policy in some facilities to clamp after the first 1000 cc's .. so a fluid shift cannot occur. The bladder is smooth muscle.. it can stretch to accommodate a huge volume.