Advanced Elimination

Question 1

Reasons for Urinary Catheterization

Answer 1

• monitor output
• keep bladder empty
• monitor critically ill
• mechanical obstruction: swelling, childbirth, prostatitis, prolapsed uterus
• relieve urinary retention
• epidural anesthesia
• obtain specimen

Question 2

normal bladder function

Answer 2

• frequently empties

- acidic environment (antibacterial advantages): defense mechanism

Question 3

how are indwelling catheters designed

Answer 3

with a ballon that inflate after insertion to keep it from coming out

Question 4

2 types of drainage bags

Answer 4

-

Question 5

considerations about lower urinary tract

Answer 5

• bladder is sterile
• bladder infection can ascend to kidneys
• external opening to the urethra can never be sterilized
• kidney infection(pyelonephritis) can be serious

Question 6

Catheter associated urinary tract infactions

Answer 6

• catheterization should be avoided
• catheters should be removes asap
• duration of catheter is biggest risk for UTI

Question 7

types of catheter

Answer 7

• intermittent/ straight catheter
• self cauterization
• indwelling catheters/ foley
• indwelling with irrigation
• suprapubic catheters

Question 8

male and female positions for catheterization

Answer 8

• female: dorsal recumbent
• male: supine
• side lying/sim/later: for patient with limited hip/knee movement

Question 9

factors to consider for urinary catheterization

Answer 9

• patient positions
• privacy and comfort
• catheter graded on French scale according to lumen size: range for adults 14Fr- 20Fr

Question 10

Catheter size

Answer 10

• 14-20Fr for adults
• 16Fr most common
• 18Fr can increase erosion of the bladder neck and urethral mucosa and cause formation fo strictures

Question 11

whenshould you seek help during urinary catheterization

Answer 11

-if patient is experiencing pain with Foley catheter

Question 12

bacteriuria

Answer 12

bacteria in the urine, asymptomatic condition

Question 13

irrigating a close system: procedure

Answer 13

• irrigate through part
• solution: room temp, 18G needle, instill 30-60 slowly
• subtract irritant from U/O

Question 14

2 types of irrigation

Answer 14

• intermittent

- continuous

Question 15

urinary diversion: ileal conduit

Answer 15

Type fo incontinent cutaneous urinary diversion. that involves a surgical resection of the small intestine which transplantation of the ureter to an isolated segment for the small bowel.-ureters are attached to a section of ileum

• ileum is separated for small bowel and Brought to abdominal wall
• incontient
• stoma

Question 16

cutaneous ureterostomy

Answer 16

-second type of incontinent cutaneous diversion where the ureters are directed though the abdominal wall and attached to a n opening in the skin

Question 17

continent urinary reservoir

Answer 17

ureters are diverted into a segment of ileum and cecum in an Indiana pouch
-this s a surgical alternative that uses a section of the intestines to create an internal reserves that hold urine, with the creation of a ctheterizatiobale stoma. The external stoma must be catharized at regular intervals to drain urine

Question 18

continent urinary reservoir

Answer 18

ureters are diverted into a segment of ileum and cecum in an Indiana pouch
-this s a surgical alternative that uses a section of the intestines to create an internal reserves that hold urine, with the creation of a ctheterizatiobale stoma. The external stoma must be catharized at regular intervals to drain urine

Question 19

ostomy

Answer 19

surgically formed opening from inside an organ to the outside

Question 20

stoma

Answer 20

the part of the stony that is attached to the skin and is formed by suturing the muscosa to the skin

Question 21

ileostomy

Answer 21

allows fecal content from the ileum of the small intestine to be eliminate through the stoma
-can be temporary

Question 22

colostomy

Answer 22

permits formed stool in the colon to exit though the stoma

Question 23

Colostomy and Ileostomy care:

Answer 23

• stoma assessment: inspect regularly, color, moisture, size
• peristomal skin
• general assessment: monitor peristalsis and I&O
• patient teaching

Question 24

Changing ostomy bag

Answer 24

-keep skin around peristomal area clean and dry: avoid candida or yeast infection

Question 25

critical points

Answer 25

• applicate should fit snugly around the stoma, with only 1/8th inch skin visible around opening
• inspect and assess the stoma and surrounding skin
• patient teaching