ch46: urinary elimination -- interventions

Question 1

(midstream urine sample): after pt initiates urine stream –> pass specimen container into stream + collect 90-120mL urine

Answer 1

initial urine flushes out organisms that normally accumulate at urinary meatus and prevents transfer into specimen

Question 2

(sample from indwelling catheter): clamp drainage tubing for 15min

Answer 2

permits collection of fresh sterile urine in catheter tubing rather than draining into bag

Question 3

(sample from indwelling catheter): withdraw 3mL for culture or 20mL for urinalysis

Answer 3

allows collection of urine without contamination; proper vol needed for tests

Question 4

(inserting catheter): help female pt into dorsal recumbent position (on back with knees flexed)

Answer 4

exposes perineum and allows hip joints to be externally rotated

Question 5

(inserting catheter): position male patient supine with legs slightly extended and thighs slightly abducted

Answer 5

comfortable position for pt and aids in visualization of the penis

Question 6

drape female for catheter insertion

Answer 6

opening in drape creates sterile field around labia

Question 7

holding forceps in dominant hand, pick up one moistened cotton ball or pick up one swab stick at a time

Answer 7

front to back cleaning of the vagina moves area of least contaminated to highly contaminated

Question 8

using uncontaminated dominant hand, clean penis meatus with cotton

Answer 8

circular cleaning pattern follows principles of medical asepsis

Question 9

ask female patient to bear down gently

Answer 9

bearing down = help visualize urinary meatus and promotes relaxation of external urinary sphincter, aiding in catheter insertion

Question 10

position drainage bag below level of bladder by attaching to bedframe with no kinks

Answer 10

keeping bag below level of bladder prevents back flow which can cause risk of CAUTI

keeping the catheter and collecting tube free from kinging may reduce risk of CAUTI

Question 11

palpate bladder for distention or use bladder scan as per agency protocol

Answer 11

determines whether distention is relieved

Question 12

observe urinary output and urine characteristics

Answer 12

sudden decrease in urine output may indicate occlusion of catheter
- cloudy, foul smelling urine associated with other systemic symptoms = CAUTI

Question 13

(catheter removal): allow balloon fluid to drain into syringe (what you put in is what you should get out); syringe should fill, examine syringe to ensure that it is whole

Answer 13

pulling out partially inflated balloon can traumatize urethral wall during removal

non whole catheter - pieces may still be stuck in bladder = NOTIFY HEALTH PROVIDER

Question 14

explain that many pts experience mild burning, discomfort, or small volume voiding with first voiding which soon subsides

Answer 14

burning results from urethral irritation