straight cath on anuric pt

Nurses Safety

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Last night I was taking report on an anuric pt who was receiving dialysis every other day. There was an order to straight cath qday. The past few days the pt had been straight cathed at 6 am for 0 urine( Dialysis at 8am every other day). When I asked the outgoing RN why straight cath was necessary, she retorted, " to see if there is urine" and looked at me as if I was a clueless child. Isn't Straight cath uneccessary at this point since it has been established that this pt is anuric? Any thoughts?

Thankyou.

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Specializes in LTC, assisted living, med-surg, psych.

Depends on what is meant by "anuric". In my experience, many pts. who are considered anuric actually do produce small amounts of urine from time to time, but it's usually less than 50cc (not to mention VERY concentrated) and they may go many hours, or even days, without producing any at all.

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I can understand the need to find out if the pt is producing urine, but, instead of the invasive cath (and possibility of infection), why don't you guys use a bladder scan to see if there is any urine? Then if there is urine, go to the cath.

bob

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I agree with you on questioning the order... that seems cruel almost...even if there is 50 cc or so of urine, what does it matter,you are not going to get a substantial amount and the better way to assess the patients status would be their weight, amount dialysis was able to take off, current BUN/creat, lung sounds, etc...

If I were that patient, I would be refusing the straight cath !!!!!!

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Specializes in LTC, assisted living, med-surg, psych.

Me too. I agree with Bob, there are much more humane ways of checking bladder volume than doing a straight cath. Not only that, but many so-called anuric patients who produce urine are perfectly able to pass it on their own, without invasive and uncomfortable interventions! Somebody should clue the ordering physician in on this, as well as that nurse who is following the order on auto-pilot instead of using her brain......

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Ditto on the bladder scan!

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Specializes in MS Home Health.

I can tell you I would not let people cath me if I was on dialysis.

renerian

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We had a pt who was anuric and the order was to straight cath QOD. This was not to check volume; the pt had been anuric for several years, dialysized MWF. It was to get the yucky, crappy foul smelling "urine" out of the bladder!

The amount we would get was ~100 cc. The "urine" was thick (sometimes so thick it was difficult to get out), whiteish/gray, foul smelling - almost pusy looking. Typical dialysis pt urine.

So, I would ask the reason for the cath.

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