Team urology

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Don’t hate urinate – urethral catheterisation: Urinary catheters can be placed for a variety of reasons from stranguria to spinal surgery. It is a useful skill for a nurse to master and utilise in practice. There are multiple different techniques to follow depending on the sex and species of the patient. Learn about the different types of catheters, how to successfully place, measure and monitor in practice.Urine for a treat – nursing the blocked bladder: Urinary tract obstruction is a common, potentially life threatening emergency which requires immediate attention. Over-filling of the bladder causes an increase in pressure within the bladder, ureters and kidneys resulting in decreased glomerular filtration rate (GFR). The reduced GFR leads to reduction of urine production and excretion of potassium and acids. Without prompt recognition of the condition and immediate treatment, this can give rise to azotaemia, hyperkalaemia, metabolic acidosis and hypovolaemia. Many of these patients present cardiovascularly unstable secondary to these fluid deficits and metabolic derangements. After confirmation of obstruction, the patient is likely to need a period of stabilisation prior to sedation or general anaesthesia to allow for the obstruction to be relieved. Intravenous fluid therapy (IVFT) plays a vital role in the stabilisation of these patients. Bolus therapy with a balanced electrolyte solution should not be withheld in order to correct hypovolaemia, hyperkalaemia and metabolic acidosis. Severe hyperkalaemia can be life-threatening and the cardiotoxic effects of hyperkalaemia can greatly increase anaesthetic risks. IVFT will not only to help improve tissue perfusion but will also dilute the potassium lowering its serum concentration. Other stabilisation methods in severely hyperkalaemic patients may include the use of calcium gluconate, and insulin and dextrose.

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