Urinary Retention & Catheters

What can cause URINARY RETENTION?

• Obstruction: enlarged prostate, stone, stricture, clot, tumor • Weak detrusor: diabetes, neurologic disease, spinal injury

• Post-op: anesthesia, pain, spasm, immobility

• Meds: opioids, anticholinergics, antihistamines, decongestants

What findings occur with URINARY RETENTION?

• Small frequent voids or none

• Suprapubic fullness, firm/dull to percussion

• Restlessness/discomfort

• Sometimes elevated BP

• Older adults: confusion/agitation without explanation

What should the nurse DO for urinary retention?

• Bladder scan → anticipate straight cath → notify provider → review meds → reassess

What should you know about a STRAIGHT CATHETER?

• Intermittent

• One lumen

• Relieves acute retention

• Sterile technique

• Measure residual

• In and out

• Preferred if needed one/few times

• LOWEST infection risk

What should you know about an INDWELLING FOLEY?

• Two lumens: drainage + balloon

• Ongoing drainage when genuinely indicated

• Ask daily whether it can come out

• HIGHER infection risk the longer it stays

What should you know about a COUDÉ-TIP catheter?

• Two lumens

• Male patient with enlarged prostate

• Used if straight tip cannot pass

• Curved tip inserted pointing up

• NEVER force catheter

What should you know about a TRIPLE-LUMEN catheter?

• Three lumens: drainage, balloon, irrigation

• Used for continuous bladder irrigation after prostate/bladder surgery

• Only catheter that can run CBI

What are the main CATHETER SAFETY rules?

• Sterile technique

• Keep bag below bladder level

• Advocate for removal when indication is gone