Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Job Classification

In most duration tables, five job classifications are displayed. These job classifications are based on the amount of physical effort required to perform the work. The classifications correspond to the Strength Factor classifications described in the United States Department of Labor's Dictionary of Occupational Titles. The following definitions are quoted directly from that publication.

Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Urethral Catheterization


Related Terms

  • Foley Catheterization
  • Indwelling Catheterization
  • Intermittent Catheterization
  • Straight Catheterization

Specialists

  • Emergency Medicine Physician
  • General Surgeon
  • Urologist

Comorbid Conditions

  • Bleeding disorders
  • Immunosuppression
  • Kidney failure
  • Neurologic disorders (neurogenic bladder)

Factors Influencing Duration

The presence of complications may influence the length of disability.

Medical Codes

ICD-9-CM:
57.0 - Transurethral Clearance of Bladder; Drainage of Bladder without Incision; Removal of: Blood Clots from Bladder without Incision, Calculus From Bladder without Incision, Foreign Body From Bladder without Incision
57.94 - Insertion of Indwelling Urinary Catheter
57.95 - Replacement of Indwelling Urinary Catheter

Overview

Urethral catheterization is a procedure that involves introducing a flexible rubber (latex, silicone, or Teflon) tube through the urinary opening (urethra) into the bladder. The most commonly used catheter is one of several types of Foley catheter.

There are two types of urethral catheterization. In straight, or short-term, urethral catheterization, a catheter is inserted only long enough to drain the bladder of urine and is then removed. In indwelling catheterization, a specialized catheter is inserted into the bladder for an extended period (days to weeks) to allow continuous drainage of urine into a collection bag.

A straight catheterization may be performed to obtain a sample of urine for laboratory analysis in individuals in whom a urinary tract infection, urinary tract injury, or kidney dysfunction is suspected. Indwelling urinary catheterization is usually performed to monitor the urine output of severely ill individuals, individuals undergoing surgery, after trauma or obstruction (obstructive uropathy) of the urinary tract, or to drain the bladder in individuals finding it difficult to void. Urinary catheterization may be performed in individuals who have urinary incontinence or who cannot empty their bladder because of neurological damage.

Older adults may need catheterization if they are at high-risk for urinary tract infection (cystitis) due to incomplete emptying of the bladder associated with prostate enlargement (in men), a decreased level of consciousness, or immobility. Other risk factors for cystitis include bladder or urethral obstruction, sexual intercourse, insertion of medical instruments into the urinary tract (catheterization or cystoscopy), pregnancy, diabetes, or a history of urinary reflux (reflux nephropathy).

Kidney infection (pyelonephritis) most often occurs as a result of lower urinary tract infection (cystitis), particularly in those who have backflow of urine from the bladder into the ureter or kidney (urinary reflux). The risk of pyelonephritis is increased in those with a history of cystitis, kidney stones, urinary reflux, or urinary tract obstruction. Individuals who have chronic or recurrent urinary tract infections are also at increased risk and may in some cases benefit from indwelling catheterization. Crushing injuries to the pelvis, gunshot wounds, or stab wounds may result in urinary tract trauma and require catheterization.

Obstructive uropathy is a blockage of the normal flow of urine somewhere along the urinary tract. The obstruction causes reflux of urine through the ureters, and the urine puts pressure on the kidney (hydronephrosis), which can result in renal failure (obstructive nephropathy). Obstructive uropathy may be caused by kidney stones, narrowing of the urethra, adjacent tumors, scarring of the urethra from radiation therapy, urinary tract infections, and cancer. It is most common in individuals with neuromuscular disorders, diabetes mellitus, benign prostatic hypertrophy, or a history of kidney stones.

Urinary incontinence may occur in individuals with weakened pelvic muscles or malfunction of the bladder neck (vesicourethral junction) and urinary sphincter. Trauma to the urethral area, neurological injury, and some medications also may weaken the urinary sphincter muscle that normally prevents leakage of urine from the bladder.

Source: Medical Disability Advisor



Reason for Procedure

Common reasons for urethral catheterization include a need to drain the bladder in individuals who are unable to urinate or unable to control urination (urinary incontinence), to measure residual urine after urination, and to collect a urine specimen for culture and sensitivity testing. Urethral catheterization also allows for diagnostic studies of the lower urinary tract (voiding cystourethrogram and urodynamics). Catheterization can monitor urine output, which is important in intensive care medicine to control fluid balance and detect congestive heart failure, kidney failure, or other disorders affecting urinary output.

Source: Medical Disability Advisor



How Procedure is Performed

The procedure varies slightly in men and women because of anatomical differences.

In women, the external genital region is cleansed with a disinfectant solution; the external genitalia (labia and external meatus) are spread to allow direct access to the urethra; a sterile lubricant is placed on a catheter, which is slowly inserted into urethra (above the vagina) and advanced until a flow of urine exits the catheter.

In men, the penis is cleansed with a disinfectant solution; a lubricated catheter is inserted into the opening in the penis (urethra) and slowly advanced until a flow of urine exits the catheter.

If the catheter is designed to be left in place (indwelling), a small amount of fluid is inserted through a separate opening (port) in the catheter to inflate a balloon that anchors the catheter in the bladder.

Source: Medical Disability Advisor



Prognosis

Generally, either straight or indwelling urethral catheterization is effective for gathering samples of urine or draining urine from the bladder. Catheterization is a relatively simple procedure, but personnel should be trained in its technique to avoid complications. Long-term and serious complications are more common with indwelling catheters than with straight catheters.

Source: Medical Disability Advisor



Complications

Potential complications of the procedure include damage to the lining of the urethra; bleeding from the urethra, prostate, or bladder; urinary tract infection; chronic irritation of the bladder; and obstruction of the catheter. Some individuals may react to the latex material in the catheter. Individuals with known latex sensitivity should be provided with Teflon or silicon urethral catheters. Catheterization may rarely be complicated by release of urinary bacteria into the bloodstream (sepsis), which can result in an infection involving the heart (endocarditis) if the bacteria lodge on a damaged heart valve. For this reason, individuals with valve prolapse or other heart valve conditions should receive prophylactic antibiotics before catheterization.

Source: Medical Disability Advisor



Ability to Work (Return to Work Considerations)

Individuals with chronic bladder control problems may need easy access to bathroom facilities or more frequent restroom breaks to perform self-catheterization. No work restrictions or special accommodations are required once the catheter is removed, except for those conditions causing the initial catheterization itself.

Risk: There is no risk to the individual in performing work activities following urethral catheterization. Individuals who must engage in self-catheterization should be instructed in good hygiene practices to avoid introducing bacteria into the urinary tract.

Capacity: Individuals who have been catheterized with an indwelling catheter may be temporarily unable to perform very heavy physical work due to the presence of a collection bag during the catheterization period.

Tolerance: Tolerance is typically not an issue with intermittent urethral catheterization.

Source: Medical Disability Advisor



Maximum Medical Improvement

7 days.

Source: Medical Disability Advisor



References

General

Schneider, Robert E. "Urologic Procedures." Clinical Procedures in Emergency Medicine. Eds. J. R. Roberts and J. R. Hedges. 4th ed. Philadelphia: W.B. Saunders, 2004. 1086-1097.

Source: Medical Disability Advisor






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