Question

Ken Washington, a 61-year-old male patient, arrived today for a follow-up visit from a recent hospitalization for a stroke. Up until his hospitalization, he has had hypertension but no other major health issues. He now has weakness in his left arm and leg, and his speech is difficult to understand. His wife tells you that she has noticed some blood in the toilet after he urinates. She also tells you that he has had some pain when he urinates and often only urinates a small amount. While he was in the hospital, Ken had a urinary catheter in place for 6 days.

Discussion Questions:

1. Is it significant that Ken had a urinary catheter in place for 6 days while he was in the hospital? Why?
2. Dr. Buckwalter plans to send Ken home with a urinary catheter in place. What information can you give him to help him prevent infection?
3. You note on the chart that Dr. Buckwalter wants to see Ken again in 2 days. You ask Ken to schedule an appointment for that time. Ken’s wife states that they are going out of town for a week and will not be able to return until after that time. What should you tell Ken about making an appointment for more than a week?

Answer 1

¤ A patient after an attack of stroke will loss the bladder functioning resulting in incontinence . The reason behind this is the injury caused to the nerves of bladder. In order to manage incontinence, urinary retention and infection out of it ,urinary catheterisation is recommended .

¤ Someone of the ways to prevent infection in a patient with urinary catheter are

• Ensure that daily cleaning of the catheter is done either with Betadine solution or atheist with soap and water around the catheter site to prevent invasion of microorganisms
• Secure the urinary catheter in the thigh with a microtape to prevent accidental dislodgement
• Cather should be below the hip level this can help to prevent contamination from the bag to bladder
• Empty the bag when full or as required and clean the tip of the noze with antimicrobial solution and recap it
• Encourage to drink plenty of water to keep urine clear and non concentrated
• Take medication as directed
• Observe the urine for color change ,deposits ,odour to rule out infection.
• Teach clamp and release technique to improve bladder sensation for micturation

¤The following information has to be provided to Ken

• Aseptic techniques to handle the catheter
• Take the prescribed antibiotics if suspected for risk of infection
• Delay in appointment can increase the risk for infection and other complications so try to make follow up at the earliest for better and faster recovery.