question

777RNThatsMe · Aug 27, 2006

What is the procedure for collecting post void residual? Do you let the pt. urinate and wait about 15 min. and then straight cath for residual?

I've seen this done and, where it was done..the person tried to urinate (self in the toilet) twice..then the machine like an ultra sound machine was brought in...and the bladder is scanned for residual (what is left in the bladder after the person had self-voided or attempted to). If there is more than X amount left (may be 300cc etc depending on what doc writes in orders) then per orders, foley or straight cath may be done. This is what happened in the case I witnessed. Same procedure. Straight cath done... and then not measured again w/bladder scanner -- probably repeat the process later again before straight cathing again...checking to see if bladder can void enough on it's own.

777RNThatsMe · Aug 27, 2006

And no....the void was attempted (self void).... and then immediately the bladder scanner was used. Then immediate cath at that time.

Different places may have different orders and/or procedures though.

Noryn · Aug 28, 2006

It for the most part depends on the patient and the exact circumstance. Most of the time the reason you dont want a large post void residual (usually over 150 or 200) is that this creates a growing medium for bacteria in the bladder and can also reflux back into the kidneys.

99 percent of the time, if you have a pvr > what the doctor has ordered then you should go ahead and cath and check the results against the bladder scan machine. These machines can be wrong, so if you are cathing for more or less than the machine is telling you then there is a problem somewhere--the machine isnt working, needs calibrated or there is a user error.

This is usually applicable to those with neurogenic bladders. If I have a 85 year old male with an enlarged prostate, with a residual of 175 or so (and probably has for 10 years) I think you can do more harm than good especially since intermittent catheterization can cause so much pain. Younger people though such as those with spinal cord injuries do need to be much more aware of their post void residual.

weirdRN, RN · Aug 28, 2006

What is the procedure for collecting post void residual? Do you let the pt. urinate and wait about 15 min. and then straight cath for residual?

It depends on where you are facility wise and why you are measuirng post void residual.

Typically at my facility, we encourage the patient to urinate in the BR first then straight cath immediately after and measure the amount. Typically this is done for men who have an enlarged prostate, and women who have a prolapsed bladder. This is used to help guide treatment. It is sometimes also used in cases of chronic UTI.