Catheterization Flashcards
is the introduction of a catheter (tube) through the urethra into the bladder for the purpose of withdrawing urine.
Catheterization
What is catheterization
is the introduction of a catheter (tube) through the urethra into the bladder for the purpose of withdrawing urine.
lack or absence of urine production
Anuria
Define Anuria
lack or absence of urine production
low urine production
Oliguria
Define Oliguria
low urine production
production of abnormally large amounts of urine by the kidneys, often several litters more than the client’s usual daily output.
Polyuria
What is Polyuria
production of abnormally large amounts of urine by the kidneys, often several litters more than the client’s usual daily output.
voiding two or more times at night.
Nocturia
what is nocturia
voiding two or more times at night.
sudden strong desire to void
Urgency
Voiding that is either painful or difficult.
Dysuria
what does the patient feel when they have dysuria
Voiding that is either painful or difficult.
Involuntary urination in children beyond the age when voluntary bladder control is normally acquired, usually 4 0r 5 years of age.
Enuresis
what is enuresis
Involuntary urination in children beyond the age when voluntary bladder control is normally acquired, usually 4 0r 5 years of age.
When emptying of the bladder is impaired, urine accumulates and the bladder becomes overdistended.
Urinary retention
what is urinary retention
When emptying of the bladder is impaired, urine accumulates and the bladder becomes overdistended.
Meaning of BUN
Blood urea nitrogen
Blood levels of two metabolically produced substances. Urea, the end product of protein metabolism. Creatinine is produced relatively constant quantities by the muscles.
BUN
Position of patient when in catheterization
dorsal recumbent
Factors affecting voiding
- developmental factors
- psychosocial factors
- fluid and food intake
- medications
- muscle tone
- pathologic conditions
- surgical and diagnostic procedures
TRUE OR FALSE: Urine output of an infant varies according to fluid intake but gradually increases to 500 to 1000 ml a day during the first year.
FALSE: 250 - 500 ml
TRUE OR FALSE: An infant may urinate as often as 20 times a day
TRUE
TRUE OR FALSE: Pre-schoolers are able to take responsibility for independent toileting.
TRUE
TRUE OR FALSE: Parents should punish their children when accidents happen
FALSE: Parents need to realize that accidents do occur and the child should never be punished or classified for this.
TRUE OR FALSE: The school-age child’s elimination system reaches maturity during this period.
TRUE
TRUE OR FALSE: The kidney double in size between ages 7 and 10 years.
FALSE: 5 and 10 years old
TRUE OR FALSE: The kidney’s excretory function diminishes with age, but usually not significantly below normal levels unless a disease process intervenes.
TRUE: Elders
the reflex responsible for the process of urination
micturition reflex
a set of conditions helps stimulate the micturition reflex. give examples
Privacy, normal position, sufficient time, running water.
TRUE OR FALSE: The healthy body maintains balance the amount of fluid ingested and the amount fluid eliminated.
TRUE
TRUE OR FALSE: Fluid such as alcohol, increase fluid output by inhibiting the production of antidiuretic hormone
TRUE
TRUE OR FALSE: Many medications, particularly those affecting the autonomic nervous system, interfere with the normal urination process and may cause retention.
TRUE
TRUE OR FALSE: Diuretics. decrease urine formation by preventing the reabsorption of water and electrolytes from the tubules of the kidney into the blood stream.
FALSE: increases
TRUE OR FALSE: Good muscle tone is important to maintain the stretch and contractility of the detrusor muscle so the bladder can fill adequately and empty completely.
TRUE
is a smooth muscle that forms the wall of the bladder and helps in urination.
Detrusor muscle
What happens when patient has diseases that causes voiding?
It can affect the formation and excretion of urine.
What happens when patient had some surgical and diagnostic procedures
It can affect the passage of urine and the urine itself.
ex. The urethra may swell following a cystoscopy, and surgical procedures in any part of the urinary tract.
1 to 2 days
15-60ml
3 to 10 days
100-300ml
10 days to 2 mos
250-450ml
2 mos to 1 yr
400-500ml
1 to 3 years
500-600ml
3 to 5 years
600-700ml
5 to 8 years
700-1,000ml
8 to 14 years
800-1,400ml
14 years through Adulthood
1,500ml
Older adulthood
1,500 or less ml
What are intermittent catheters
catheters or straight catheters , are used to drain the bladder for shorter periods (5-10mins).
catheters or straight catheters , are used to drain the bladder for shorter periods (5-10mins).
intermittent
catheters- if the catheter is to remain in place for continuous drainage. Also called Retention catheters or Foley catheters.
Indwelling
is designed so that it does not slip out of the bladder.
indwelling
is inflated to ensure that the catheter remains in the bladder once it is inserted
Balloon for indwelling catheter
ASSESSMENTS for catheterization
*assess the patient’s normal elimination habits
*assess the patients degree of limitations and ability to help with activity
*assess for the presence of any conditions that may interfere with passage of the catheter or contraindicate insertion of the catheter, such as urethral strictures or bladder cancer.
* check for the presence of drains, dressings, intravenous fluid infusion sites, tractions or any other devices
* assess bladder fullness before performing procedures (palpation or bladder utz device) * ask patient about any allergies, especially to latex and iodine
* ask patient if she has ever been catheterized, if she had an indwelling catheter previously, ask why and for how long it was used.
Appropriate nursing diagnoses may include
- Impaired Urinary Elimination
- Urinary Retention
- Total Urinary Incontinence
- Risk for Infection
- Risk for Impaired Skin Integrity
- Risk for Injury
What outcome identification and planning must be done?
- The patient urinary elimination will be maintained ( with a urine output at least 30 ml/hr, and the patients bladder will not be distended)
- The patients skin remains clean, dry and intact without evidenced of irritation or breakdown
- The patient verbalizes an understanding of the purpose for and care of the catheter, as appropriate.
Equipment to prepare for female catheterization: indwelling
Catheterization tray with :
▪ A. Foley catheter with a 5 ml balloon (Fr16-18 for adults; F10-14 for children
▪ B. Sterile gloves
▪ C. Sterile cotton balls with an antiseptic solution
▪ D. Water soluble lubricant
▪ E. Syringe with sterile water
▪ F. Disposable urine bag
▪ G. Specimen container
▪ H. Waterproof pad
What do we do first: placing waterproof pad or positioning the patient to dorsal recumbent position?
Place a waterproof pad or rubber sheet first then place the client in dorsal recumbent position with knees flexed to drape the client
How do we drape the client?
Place the client in dorsal recumbent position with knees flexed. Drape the client.
▪ Positioning allows adequate visualization of the urinary meatus
▪ a. Spread the blanket diagonally over the bed. Have the client hold the top part.
* b. Wrap one corner of the blanket on the right side around the client right legs.
* c. Wrap the other corner to the left leg, leaving the genital area exposed.
Where do we place the catheterization tray?
Place the tray on the bed, between the legs of the client. Position the light to give the clearest view of the genitals. Good lighting is necessary to see the meatus clearly.
How do we separate the labia of the female?
With the thumb and forefinger of the left hand, separate the labia and pull the hand slightly upward to make the urinary meatus visible. Smoothing the area immediately surrounding the meatus helps to make it visible
How do we cleanse the genitalia of the female
Cleanse from above the urinary meatus downward with one stroke. Drop used cotton balls in the receptacle for soiled cotton balls. Cleanse the labial folds from above downwards to the anus. Make sure that the cotton balls are discarder after each stroke.
Why do we clean the area before inserting the catheter?
Cleaning the meatus last helps prevent reduce then possibility of introducing microorganisms into the bladder.
TRUE OR FALSE: Pick up the catheter and lubricate the catheter about 1-2 inches from the tip to reduce trauma
TRUE
How long is the female urethra
about 1.5-2.5 inches long
How long should we insert the catheter?
Insert the tip of the catheter (about 2 inches) very gently and slowly or until urine starts to flow.
How do we check if the indwelling catheter is functional before cleaning the are and inserting the foley?
Inflate the balloon with the pre-filled syringe to check if defective. Aspirate fluid back and into the syringe
TRUE OR FALSE: Pull the catheter after injecting sterile water just simply because to pull it.
FALSE: When we use foley catheter for patients we must pull the catheter gently after to feel the resistance.
Where should we secure the catheter?
Secure the catheter with a tape on the upper thigh.
What should we document?
- type and size of catheter and balloon inserted
- amount of fluid used to inflate the balloon.
- patients tolerance of the activity
- amount of urine obtained
- unusual urine characteristics
- urine amount on intake and output record
