Catheter Care

Question 1

When should indwelling urinary catheters be used according to NICE guidelines?

Answer 1

Should only be used when alternative methods of managing urinary problems have been considered

Question 2

What catheter value should patients be given with a continuous bladder sensation?

Answer 2

Should be offered a catheter valve rather than a continuous drainage bag

Patient can then release the balance when they fell the bladder is full

Best used with patients that have bladder sensations, stable bladders and more likely to be TWOCed

Question 3

How often should catheter values be changed?

Answer 3

Should be changed every 5-7 days

Question 4

What features of a leg bag must be considered?

Answer 4

The length of the drainage tube (short, medium or long)

Volume of urine to be contained (350, 500 or 750)

Outlet tap

Question 5

How should drainage bags be worn?

Answer 5

Should be worn below the level of the bladder to allow efficient urine damage

Question 6

What supporting accessories are available for catheters?

Answer 6

Open weave net sleeves to fit the thigh or calf

Leg traps

Garments

Question 7

List contraindications for catheter valves.

Answer 7

Reduced bladder capacity, absent bladder sensation, cognitive impairment, or poor manual dexterity.

Question 8

How should you clean around the catheter site?

Answer 8

Daily with mild soap and water, using a single-use cloth; clean away from the urethral opening.

Question 9

Key hygiene instruction for patients with a catheter?

Answer 9

Wash hands before touching the catheter; daily bathing/showering is allowed.

Question 10

What is the recommended fluid intake for catheterised patients?

Answer 10

1.5–2 litres per day unless contraindicated.

Question 11

What should be documented regarding catheter care?

Answer 11

All care given, date of catheter change/removal, and proposed review date.

Question 12

What should always be done before any catheter-related procedure?

Answer 12

Explain the procedure to the patient and obtain their consent.

Question 13

How should urine be disposed of to maintain dignity?

Answer 13

Cover the jug when transporting it to the toilet or sluice.

Question 14

How should the outlet port of a drainage bag be cleaned?

Answer 14

With a 70% alcohol-impregnated swab, then allow it to dry.

Question 15

What types of outlet taps are available for leg bags?

Answer 15

Safety-lock tap, lever tap, and push/pull tap.

Question 16

What should be done if a patient has poor vision when using a tap?

Answer 16

Choose a tap with a textured surface for tactile guidance.

Question 17

Why should the outlet tap not touch the container during emptying?

Answer 17

To prevent contamination and reduce infection risk.

Question 18

What is the importance of daily hygiene for catheterised patients?

Answer 18

Promotes independence and reduces risk of cross-contamination.

Question 19

What is the preferred cleaning method for the catheter area?

Answer 19

Use mild soap and water with a single-use cloth, cleaning away from the urethra.

Question 20

What is the purpose of anti-reflux valves in some drainage bags?

Answer 20

To prevent urine from flowing back into the bladder.

Question 21

What is the preferred alternative to an indwelling catheter?

Answer 21

Intermittent catheterisation or urinary sheath, where appropriate.

Question 22

When should a patient be offered a trial without catheter?

Answer 22

As soon as appropriate after initial catheterisation.

Question 23

What type of drainage system is most common in acute settings?

Answer 23

Valve-less catheter on continuous drainage into a large-capacity bag.

Question 24

How should a catheter valve be managed overnight?

Answer 24

Attach a continuous drainage bag to the valve to allow overnight drainage.

Question 25

What factors contraindicate the use of a catheter valve?

Answer 25

Reduced bladder capacity, absence of sensation, cognitive impairment, and poor manual dexterity.

Question 26

What percentage of body weight is water in men and women?

Answer 26

Men ~60%; Women ~52%.

Question 27

What is the normal daily fluid gain/loss for adults?

Answer 27

Around 2550 mL gained and lost.

Question 28

What are the main compartments of body fluid?

Answer 28

Intracellular (2/3) and extracellular (1/3) – the latter includes interstitial and plasma.

Question 29

Minimum urine output threshold indicating concern?

Answer 29

Less than 0.5 mL/kg/hr may indicate AKI.

Question 30

Signs of dehydration on physical exam?

Answer 30

Thirst, dry mucosa, poor skin turgor, decreased mental state, low BP, increased HR.

Question 31

Signs of hypervolaemia?

Answer 31

Oedema, raised JVP, dyspnoea, weight gain, orthopnoea.

Question 32

Key signs of hypovolaemia?

Answer 32

Low BP, tachycardia, prolonged cap refill, cool peripheries, dry mucosa, dizziness.

Question 33

What is a fluid balance chart and why is it important?

Answer 33

A legal record documenting fluid intake/output; used to detect imbalances and guide care.

Question 34

What fluids are counted as inputs?

Answer 34

Oral, enteral, IV fluids, meds, supplements, rectal/NG infusions.

Question 35

Common causes of hypovolaemia?

Answer 35

Diarrhoea, vomiting, reduced intake, diuretics, sepsis, burns, trauma.

Question 36

What are “insensible losses”?

Answer 36

Losses that cannot be measured directly (e.g., water loss via skin and lungs, ~1200 mL/day).

Question 37

What proportion of total body water is intracellular vs. extracellular?

Answer 37

Intracellular = two-thirds (≈25 L); Extracellular = one-third (≈15 L, including plasma and interstitial).

Question 38

Name three transcellular fluid compartments.

Answer 38

Pleural space, peritoneal cavity, gastrointestinal secretions.

Question 39

What early lab sign suggests hypovolaemia before creatinine rises?

Answer 39

Rising blood urea with normal creatinine.

Question 40

List the AKI diagnostic criteria (NICE 2019).

Answer 40

Urea rise ≥26 µmol/L in 48 h; or ≥50% rise in 7 days; or urine output <0.5 mL/kg/h for >6 h; or ≥25% fall in eGFR in children. Urea rise ≥26 µmol/L in 48 h; or ≥50% rise in 7 days; or urine output <0.5 mL/kg/h for >6 h; or ≥25% fall in eGFR in children.

Question 41

Why is body-weight monitoring useful in fluid balance?

Answer 41

Rapid weight change (>8% loss in elderly) indicates severe dehydration or overload.

Question 42

Describe how to assess skin turgor.

Answer 42

Gently pinch skin (sternum/inner thigh); <3 s return suggests dehydration (may be unreliable in elderly).

Question 43

Why include IV fluids on a fluid balance chart?

Answer 43

They contribute to input volume and influence clinical decisions on fluid management.

Question 44

How do you measure fluid loss from incontinence pads?

Answer 44

Weigh pads; assume 1 g weight gain ≈1 mL fluid loss.

Question 45

When can you discontinue a fluid balance chart?

Answer 45

Patient eating/drinking normally and urine output ≥1 mL/kg/h with chart “in balance.”

Question 46

What legal status does a fluid balance chart have?

Answer 46

It is a legal record—must be accurate, legible, timely, and any anomalies reported immediately.

Question 47

What are the clinical signs of fluid overload on examination?

Answer 47

Peripheral oedema, raised JVP, crackles on lung auscultation, orthopnoea.

Question 48

What are the clinical signs of hypovolaemia on examination?

Answer 48

Tachycardia, hypotension (esp. postural), prolonged cap refill, cool extremities, dry mucosa.

Question 49

What outputs besides urine must be charted?

Answer 49

Vomit, diarrhoea, NG drainage, wound/stoma/drain output (per local policy).