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NURS 270 > Chapter 34 - Urinary Elimination > Flashcards

Chapter 34 - Urinary Elimination Flashcards

1
Q

What is the average urinary output for an adult?

A

2200 to 2700 mL in 24 hours

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2
Q

An hourly output of less than ___mL/hr for 2 hours identifies need for further evaluation.

A

30mL/hr

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3
Q

When should you measure I&O?

A

When there is an actual or anticipated change in fluid balance

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4
Q

What do serum electrolyte measurement tell us?

A

about alterations in fluid balance

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5
Q

You should use the ___________ catheter possible

A

smallest

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6
Q

You should __________ the catheter as soon as possible

A

remove

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7
Q

Patients taking what medication should have access to a toilet or urinal close by?

A

diuretics

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8
Q

What extra measures are necessary when dealing with bodily wastes of patients receiving hazardous oncology drugs?

A

-double chemotherapy gloves
-protective chemotherapy gown
-eye/face protection
-respiratory protection

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9
Q

Insertion of a urinary catheter requires what?

A

a doctors order

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10
Q

What does CAUTI stand for?

A

catheter associated urinary tract infection

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11
Q

How long is short term catheterization?

A

less than or equal to 2 weeks

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12
Q

How long is long term catheterization?

A

more than 14 days

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13
Q

What is intermittent urinary catheterization?

A

insertion of a flexible single-use catheter used for retention or specimen collection

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14
Q

What is the difference between intermittent catheter and indwelling catheter?

A

indwelling uses an inflated balloon

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15
Q

Intermittent catheter = ________ lumen

A

single

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16
Q

What are the two lumens of indwelling catheters used for?

A
  1. urinary drainage
  2. balloon inflation
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17
Q

What is the third lumen (if needed) for?

A

irrigation solution

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18
Q

What is an ideal urine output after catheterization?

A

30mL/hr

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19
Q

What is the most common catheter size for adults?

A

14Fr to 16Fr

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20
Q

What is the most common catheter size for older adults?

A

12Fr to 14Fr

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21
Q

Larger catheter sizes increase the risk of…

A

urethral trauma

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22
Q

How should a female patient be positioned for catheter placement?

A

dorsal recumbent position (on back with knees flexed) or laying on side (Sims) with upper leg flexed at the knee

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23
Q

How do you position a male patient for catheterization?

A

supine with legs extended and thighs abducted

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24
Q

Is it recommended to pretest a balloon?

A

no

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25
Q

Closure of the labia during the procedure means…

A

the area is contaminated and needs cleaning to proceed

26
Q

What order do you clean the labial folds?

A

far, near, over centre of urethral meatus

27
Q

How far do you insert a catheter in a female patient?

A

-5 to 7.5cm or until urine flows
-stop if straight catheter, or continue another 2.5 to 5cm for indwelling catheter

28
Q

Should you use force to insert a catheter?

A

no.

29
Q

Why should you ask patient to bear down as if needing to void when inserting catheter?

A

relaxes external sphincter

30
Q

How far do you advance a catheter into a male patient?

A

-17 to 22.5cm or until urine flows out
-stop with straight catheter, advance indwelling until bifurcation

31
Q

What do you document after inserting a urinary catheter?

A

-reason for catheterization
-type and size of catheter
-amount of fluid used to inflate balloon
-specimen collection
-characteristics and amount of urine
-patient response and learning

32
Q

What should you teach patients and family about catheters?

A

-monitor for UTI symptoms
-how to prevent UTI
-signs of skin irritation
-how to empty (if necessary)

33
Q

What lubricant should be used for pediatric catheterization?

A

containing 2% lidocaine

34
Q

What should be recorded after a catheter removal?

A

I&O 24-48 hours after removal

35
Q

What urine output indicates return of voluntary bladder function?

A

at least 150mL with each void no more than 6-8 hrs post removal

36
Q

How do you allow balloon fluid to drain during catheter removal?

A

gravity

37
Q

What do you record after removing a catheter?

A

-when it was removed
-teaching related to increasing fluid intake, S&S of UTI
-time, amount, characteristics of first void
-intake and voiding times
-patient symptoms during and after catheter removal

38
Q

How much fluid should one drink with a catheter?

A

at least 2200mL of fluid per day

39
Q

What does PVR?

A

postvoid residual

40
Q

How long after voiding do you measure PVR?

A

postvoid residual

41
Q

What is a concerning PVR measurement?

A

2+ measurements greater than 100mL

42
Q

What do you record after irrigating a catheter?

A

-method
-amount and type of solution
-amount returned as drainage
-characteristics of output

43
Q

Never use ______ to secure a condom catheter

A

tape

44
Q

When are suprapubic catheters used?

A

when there is a blockage of the urethra or when long-term urethral catheter interferes with sexual functioning

45
Q

What is a symptom of UTI in older adults that may not be obvious at first?

A

change in mental status that may be confused as delirium

46
Q

What are the two things involved in catheter maintenance?

A
  1. cleaning
  2. monitoring for UTI symptoms
47
Q

When should the drainage bag be emptied?

A

when 1/2 full

48
Q

What should you do if a patient is unable to void 6-8 hours after catheter removal?

A

-assess for bladder distension
-perform bladder scan
-notify provider

49
Q

What is the purpose of catheter irrigation?

A

to keep the bladder clear and free of blood clots or sediment

50
Q

What is continuous bladder irrigation (CBI)?

A

continuous infusion of a sterile solution into the bladder using a three-way irrigation closed system

51
Q

Does catheter irrigation require an order?

A

yes!

52
Q

With CBI the amount of fluid draining from the bladder should be (more/less) than the fluid inserted

A

more than

53
Q

What does closed continuous irrigation involve?

A

-use of an IV drop system, aseptic technique

54
Q

What does closed intermittent irrigation involve?

A

-use of a sterile syringe, aseptic technique

55
Q

How much space should be between the tip of the penis and the end of the condom catheter?

A

2.5 to 5cm

56
Q

What should you document after applying a condom/hydrocolloid catheter?

A

-which device you applied
-condition of penis, skin, scrotum
-urinary output
-voiding pattern
-patient response

57
Q

What is important to be aware of with condom catheters?

A

skin breakdown

58
Q

Condom catheters are not recommended with ___________ obstruction

A

prostatic

59
Q

What is a risk of patients who can’t feel pain and have a condom catheter?

A

possible pressure injury

60
Q

Where is a suprapubic catheter inserted?

A

through a small incision in the abdominal wall

61
Q

What do you record after cleaning a suprapubic catheter?

A

-condition of insertion site
-type of dressing change
-patients comfort

NURS 270 (14 decks)

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