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Coming from the Urethra, insertion site. Again doesn't start til about 2 weeks after it has been changed
she has had sediment on and off since insertion. It is thick, stringy, which makes us needing to irrigate, thinking this is causing blockage. Urine odor strong, When she was running low grade fever in past did UA, culture and round of antibiotics. But fever now, so not done. Doctor is reluctant to order antibiotics due to "resistance", developing due to long term. We can request tho...
our biggest concern is the leakage after 2 weeks in, and seems to have more more sediment causing us to irrigate. The bags have to be changed weekly...
We cannot take her in for any studies. She is basically Palliative Care so work directly with the Doctor. No need to do ultrasound or KUB, Yes her albumin is high.....we just need some tips on palliative care, control of the leakage? She can certainly have chronic cystitis we have given her azogantrisin otc, would Diprovan be helpful?
Hi there and thank you for the question. I am also a Registered Nurse and will be happy to help you today. I felt the need to chime in on this one regarding the leakage. 99% of the time, the cause of leakage is due to the extended use of a catheter and the urethra loses tone because of this (and also her age). First intervention would be to remove the foley she has now and reinsert a larger Fr catheter. Also, limit the irrigation as this continues to reintroduce bacteria into her bladder (which is otherwise a sterile organ). Threads, mucus and sediment are most likely due to bacteria that is currently in her bladder (urinary tract) and I would certainly push for antibiotics to clear this up asap. But most of all, increase your foley size and make sure the balloon is properly inflated. The '2 week' point could mean that gravity is letting the saline leak from the balloon over time combined with the foley size being too small. Hold off on requesting the Ditropan until all of the other issues have been resolved (improper cath size and infection). Don't forget to check your balloon prior to insertion (to make sure there are no leaks prior to insertion) and also advance the catheter in enough so that the balloon is not on the sphincter...and make sure the tubing is never kinked and causing it to leak. If all else fails, I would have a Urologist take a look at her anatomy to make sure she doesn't have a fistula so that she is able to urinate from both her vagina and urethra (urine leaks from her urethra into her vagina).