Catheters, Kindey Disease, Delirum Flashcards
What is the anatomy of urine stuff?
Urine produced in kidneys get transported to bladder by ureters. Bladders stores urine and urethra expels urine.
What is intermittent catheter?
It’s straight, has 1 lumen which drains urine, used for in and out catheter.
What is in dwelling catheter (foley or retention)?
Left inside bladder to drain continuously. Has balloon. Has 2 ends- 1 to inflate balloon and the other to drain urine.
What is tiemans (coude) catheter?
Has rounded curve to it. Used for older male patients with enlarged prostate and it helps to push through the prostrate.
Care of catheters?
Keep drainage bag below level of bladder, no kink in tubing, don’t put bag on bed rails, regular perineal care, secure bag to leg, drain frequently.
Documentation for catheters?
Document on size of catheter, urine (colour, ordor, consistency, volume), type of catheter used, reason for catheter, urine specimen if collects, how patient tolerate, patient teaching.
Specimen collection of urine?
- HH, cleans gloves, supplies to bedside
- Expose catheter tubing and clamp it below ports
- Clean with swab for 15 seconds, open syringe and out onto port to withdraw urine
Intermittent or in dwelling catheter insertion/removal
- Doctors orders, assess patient (when they last voided, age, anatomy, 14 Fr girls and 12 Fr for boys)
- Inspect perineum for drainage/odour with clean gloves (if clean move on)
- Go on left side of bed and bad under thighs, position (female- supine with knees flexed, male-supine with things slightly abducted), drape appropriately
- Open drainage bag and tube and put on bed
- Open kit, apply sterile gloves (lubricate 12.5-17.5 for males, 2.5-5 cm for girls
- Clean (retract labia and 3 swipes-middle, right, left, grasp penis and clean in circular motion 3 swipes)
- Retract labia Insert 5-7.5 cm in females/until urine flows, then another 2.5-5 cm, release labia and hold catheter and blow up balloon if needed
- Lift penis perpendicular to body and Insert 17-22.5 cm in male/until urine flows, and advance 2.5-5 cm, inflate balloon if needed
- Allow bladder to empty or inflate balloon
- attach tube of drainage bag
- secure drainage tube to thigh with tape and put below bladder level, perineal care
- remove= clean gloves, blue pad under and expose genitalia, drainage bag on bed
- insert syringe into inflation valve and fluid drains from balloon to syringe by itself
- patient breathe out and pull out and wrap it in blue pad to get ride of
- perineal care
What’s catheter irrigation?
Maintain or restore patency of catheter, Helps with blockages in tubing. Closed catheter irrigation- push sterile water into bladder by using clamp
Continuous bladder irrigation- 3 lumens, continuous to create turbulent flow to decreased blockages
Open catheter irrigation-
What is delirium?
State of acute mental confusion. Medical emergency and frequent in older adults. It is disturbance of attention/awareness of environment. Change in cognition, disorganized thinking.
What are the types of delirium?
Hyperactive (person is restless, agitated)
Hypoactive (drowsy, usually under diagnosed)
Mixed (both hyper and hypoactive)
What are causes of delirium?
Combination of risk factors and some sort of event (surgery, drug therapy, trauma, infection, insomnia), fluid and electrolyte imbalances.
What is goal with delirium?
Treat underlying cause, inter professional approach, and attempt to prevent common complications.
What is confusion assessment method and 4 questions we need to ask?
Ask 4 questions. Is there acute change in mental status, is there inattention, is their disorganized thinking, is there altered LOC?
Supportive measures for delirium?
Mobility (allow and encourage it), safety (bed alarms, eliminate tripping hazards) communication (calm, use short/simple sentences), behaviour management (want to keep them clam), environment (call bell, lighting, music).
