student question-clamping caths

I was wondering how long you can (safely) clamp a urinary catheter for?

Also, our teacher told us that if a pt is having bladder spasms, you should instruct them to a)increase fluid intake b)check patency and c)reposition balloon by maniupulating catheter. HOWEVER, I read somewhere that bladder spasms can cause frequent urinary leaks around the tube and reflux of infected urine into the renal pelvis, increasing the risk of pyselonephritis, renal failure, etc. So it seems like a much more serious problem than warrents more than just telling them to increase their fluid intake. When would you notify the MD? I know I've heard about alot of patients with newly inserted caths complaining of a feeling of urgency (need to go pee)...is this the same thing as a bladder spasm? I'm jumping all over the place, but for some reason I'm gettign hung up on all of this.

Any advice appreciated!:)

I'm not sure of the answer to all of your questions here, but I do know that one main reason that a lot of people with newly inserted catheters feel a sense of urgency is that the balloon in their bladder causes the sensation of a full bladder, since there is something in there. Because the bladder (especially in young people, or those with smaller bladders) contains the balloon, the patient then feels as though they have a full bladder and need to void. Hope someone else pops in with some more information to you in response to your questions!

4 hours, I recently applied neomycin around the eurethera opening of a patient. Also our hospital has a foley regimen of 500 mg Vitamin C and 8 oz of cranberry juice around the clock for patients with invasive urinary catheters.

What we are advised by our urologist is 2 hrs clamped for bladder retraining. The full sensation is most likely due to pressure on the inner urethral sphincter by the balloon, which will also cause the bladder to spasm and urine to leak around the catheter.

Check placement of the catheter making sure all kinks are out, that the UD bag is below the level of the bladder and if necissary, that the catheter is not being unduely pulled and tugged on when the patient moves, deflate the balloon and reposition the catheter and reinstill the saline to the balloon.

I wouldnt think there would be reflux of urine into the renal pelvis unless it had been kinked off or the catheter otherwise blocked for an extended period of time and the bladder is full. In that case you should have alreardy been questioning why there is such a decrease in urine output and be investigating it already preempting the reflux in the first place.

Remember 30ml or less of urine output per hour warrents investigation of a catheter placement and/or reporting to doctor.