Chapter 36: Urinary Elimination/CAUTI Flashcards
What is CAUTI?
catheter associated urinary tract infection
What are the types of catheters used?
Straight catheters and indwelling
What are the characteristics of normal urine?
pale yellow, straw colored, slightly aromatic, clear, acidic, specific gravity (1.015-1.025).
What are some ORGANIC constituents in urine?
urea, uric acid, creatinine, hippuric acid, urican, urene pigments, and undetermined nitrogen.
What are some INORGANIC constituents in urine?
ammonia, sodium, chloride, iron, phosphorus, sulfur, potassium, and calcium
What effect does aging have on the urinary process?
decreased muscle tone, increased nocturia, increased frequency, decreased bladder contractibility, increased urinary retention, and increased UTIs,
What is the normal urine output per hour: know the basic amount and the formula.
30mL/hour. 0.5ml/kg/hr is the actual formula
What are two reasons that urinary output is low?
Either patient is not making urine OR the patient is unable to excrete urine.
What amount of urine will produce the urge to void?
150-250mL of urine
When should a straight catheterization be performed?
When the bladder is retaining more than 150mL of urine. These are used for short term emptying of the bladder.
What are some appropriate reasons to catheterize a patient?
Appropriate reasons to catheterize include: acute urinary retention, bladder outlet obstruction, when there is a need for strict I/O, perioperative use for selected procedures, pts with sacral or perineal wounds in pts who are incontinent, prolonged immobilization, and end of life care/comfort.
What are some Inappropriate reasons to catheterize a patient?
As a substitute for nursing care when a pt is incontinent, as a means of collecting urine when a pt can void independently, prolonged use after surgery.
What are S/S of UTI
Burning or pain in lower abd, fever, bloody urine, burning during urination, increase in frequency. elderly patients may experience great confusion.
How can CAUTI be prevented?
Use catheters only when necessary, remove as soon as possible, only properly trained personnel insert catheters using sterile technique, providing perineal care prior to insertion of catheter, and use of external urinary collection devices. Attach catheter to leg, keep bag lower than bladder, and empty regularly.
How do you care for pts with an indwelling catheter to prevent CAUTI?
Wash hands before/after care, clean peri area daily, after BM, always wiping front to back. Use mild soap/water. Increase fluid intake, encourage pt. involvement, note color/characteristics of urine, report S/S of infection, limit time period of use, and encourage GHWT for patient.
How does a nurse address incontinence in pts.?
Offer regular toileting, pelvic floor exercises, biofeedback, electrical stimulation, timed voiding, drug RX, Mech. Rx., use of absorbent pads, briefs, and adequate liquid intake.
What are the different types of urinary incontinence?
Transient, stress, mixed, overflow, functional, reflex, and total
What is transient incontinence?
A type of incontinence that appears suddenly and lasts up to 6mos.
What is functional incontinence?
Urinary incontinence caused by an inability to reach the toilet on time due to environmental barriers, physical limitations, memory loss, or disorientation
What is Stress incontinence?
Stress incontinence is incontinence caused by an involuntary loss of urine related to an increase in intra-abdominal pressure
What is mixed incontinence?
Mixed incontinence is a type of incontinence in which there are 2+ types of incontinence occurring.
What is overflow incontinence?
Overflow incontinence is an overflow of urine resulting from overdistention and overflow of the bladder.
What is reflex incontinence?
Emptying of the bladder without the sensation to void
What is total incontinence?
Continuous and unpredictable loss of urine due to trauma, surgery, physical malformation.
What are some ways to promote normal urination?
Maintenance of normal voiding habits, promote fluid intake, strengthening of muscle tone, and assist with toileting. Promote adequate fluid intake.
How do you determine if the patient is not making urine or is not able to excrete it?
Use of a bladder scanner will reveal the amount of urine in the bladder.
What are some steps for developing the maintenance of normal voiding habits?
Develop a schedule, assist pt, when they express urge to void, allow for privacy, position to void comfortably, and assist with hygiene.
Why would a pt have an indwelling catheter?
Trauma, long periods of immobilization, strict I/O, sacral, perineal wounds that need to heal.
