Blocked urinary catheters
Blocked urinary catheters
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Flush catheter with 50mls normal saline or sterile water
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Monitor urine output for 30 mins
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If no drainage, change catheter
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Urinary catheters get blocked due to debris and crystallization within the urine. This can be prevented by increased fluid intake. Advise patients to consume 2 litres of fluid per day composed mainly of water (unless symptomatic heart failure is the limiting factor, if it is, discuss with GP)
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Bypassing urinary catheters
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Not always due to catheter blockages, most are due to bladder spasms
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Flush catheter with 50mls normal saline or sterile water
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If catheter patent on flushing, bypassing is not due to blockage
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Advise patient to ensure 2 litres per day fluid intake composed mainly of water (unless symptomatic heart failure is the limiting factor)
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Prescribe anticholinergic medication for bladder spasms e.g. solifenacin
Blocked nephrostomy
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Small drainage tube usually 6-10F
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Inserted via the flank directly into the renal pelvis, performed by interventional radiology
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Allows drainage of urine directly from the kidney bypassing the ureter and bladder
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Used in patients with complete ureteric obstruction
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Often get blocked with debris due to small size of tube
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Blocked nephrostomies present with
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No urine output in the collection bag
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Leaking of urine around the nephrostomy insertion site
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Flank pain or pain around the nephrostomy insertion site
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Detach drainage bag from nephrostomy tubing, flush nephrostomy tubing with 20mls of normal saline or sterile water, it is usual for this to cause the patient mild discomfort.
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Monitor for 30 mins for urine drainage
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Repeat flushing of tube with another 20 mls of normal saline or sterile water if no output
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If no urine output despite two flushes, contact interventional radiology department to arrange nephrostomy exchange (nephrostomy patients are usually provided with a direct contact number for interventional radiology nurses in the event of such situations)