Stroke Training and Awareness Resources (STARs)

Investigations

Investigations
1. Urinalysis UTI (nitrates, leucocytes, protein, blood, pH), dehydration (specific gravity), diabetes (glucose, ketones).
2. Post-void bladder scan/in-out catheter if scanner not available Identifies persistent post-void residual urine volume. It is important to ensure the person empties their bladder before making a judgement about retention of urine.

Scanning should only be undertaken by a trained and competent practitioner.

Common misdiagnosis:

  • Trying to pass urine when lying down
  • Inadequate time on toilet
  • Failure to empty bladder fully before scanning
  • Assuming single high PVRU means retention when it may not
3. Fluid balance chart and bladder diary All  should be recorded over 3 consecutive full 24 hour periods. Clear information is essential on: total voided volume, voiding frequency and timing, incontinence episodes and severity, functional bladder volume, episodes of nocturia/enuresis. Total fluid intake should be approximately 500mls more than output to allow for insensible loss. Types of fluid are important, especially the amount of caffeine containing drinks. Dehydration is common following stroke, especially if dysphagia present.
4. Abdominal X-ray Identifies constipation and faecal impaction

 

Page last reviewed: 31 Jan 2022