Exam 1 Material : Renal Urinary Diversion Devices Flashcards
What are the different types of Urinary Diversion Devices?
Suprapubic catheter
Urethral Catheter (most common route)
Nephrostomy tube
Ileal Conduit
What are the two different types of urethral catheterization?
Indwelling and intermittent
What is indwelling catheter used for?
For getting accurate urine output for critically ill patients
Patients with pressure ulcers
Surgical considerations
Urinary obstruction
What is intermittent catheter used for?
Urinary retention
Sterile urine sample collection (should not be first choice of method)
Checking for post-void residual
Testing/instillation of medications
What are the nursing management needed for those on urethral Catheterization?
Prevention of CAUTI = Catheter Associated UTI
Maintaining closed system
Keep drainage bag below level of bladder and empty often
Perineal Care
Assess color of urine, any breakdown on urethral meatus, and to be sure catheter is secured by a securement device.
Following HOUDINI
What is HOUDINI?
A list of indications for continuned catheter use. If a patient does not have any of the indications, catheter can be removed immediately usually without a doctor’s order.
Hematuria Obstruction Urology surgery Decubitus Ulcer Input and Output measurement Nursing end of life care Immobility
What are the nursing considerations and patient care for those with Suprapubic catheter?
Nursing considerations:
Temporary placement for bladder or urethral surgery
Can be used long term for patients with no bladder control like spinal cord injury patients
Bladder spasms may be present
Patient care includes:
Prevent kinking
Maintain gravity drainage
Daily skin care and dressing change
What are the nursing considerations and patient care for those with Nephrostomy tube?
Nursing considerations include:
Tube is placed directly into the kidney
High risk for infection
Can become permanent for palliative care
Can be used temporary for ureteral obstruction
Tube may need to be changed every month
Patient care includes:
Prevent kinking
DO NOT CLAMP
May need to irrigate with sterile saline/water (no more than 5 mL)
Dressing changes with sterile technique
What are the nursing considerations and patient care for those with Ileal Conduit?
Nursing considerations include:
Conduit is connected to mesentary for support. Does not drain into bowel.
Conduit produces external stoma and uses a urinary bag
6-8 inch segment of ileum is used as conduit. Ureters are attached to the piece of ileum.
Assess for stoma S&S to report.
Patient care includes:
Stoma care, S&S to report.
Opening of pouch should only be 1/8 inch larger than stoma.
Urinary bag can be connected to tubing and gravity bag during hospitalization or at night if desired.
What are the S&S of stoma that should be monitored and reported for?
Stoma should not be cyanotic or look necrotic. It should look red, round, and somewhat dry.
