Exam 3: Urinary and Kidney Flashcards
1
Q
Structures of the Renal System
A
Kidneys and Nephrons x2
Ureters x2
Bladder
Urethra
Male Prostate
2
Q
Nephrons ____
A
filter
3
Q
Are the left and right kidneys perfectly symmetrical?
A
No, the left kidney is higher than the right one because of the location of the liver
4
Q
Functions of the Kidney
A
- Urine Formation:
Glomerular Filtration
Tubular Reabs and Secretion
- Regulation Functions:
Osmolarity and water excretion
Lyte and AcideBase Balance
BP (RAA System)
RBC Production (Erythropoietin)
Vitamin D Synthesis
Secretion of Prostaglandins
- Waste Excretion
End products of metabolism, bacterial toxins, water soluble drugs, and drug metabolites
Urine storage (bladder) and emptying
5
Q
As a risk factor, childhood diseases can lead to what possible renal/urologic disorder
A
chronic kidney disease
6
Q
As a risk factor, advanced age can lead to what possible renal/urologic disorder
A
incomplete bladder emptying, etc
7
Q
As a risk factor, cystoscopy or catheterization can lead to what possible renal/urologic disorder
A
UTI or incontinence
8
Q
As a risk factor, immobilization can lead to what possible renal/kidney disorder
A
kidney stone formation
9
Q
As a risk factor, diabetes can lead to what possible renal/urologic disorder
A
Chronic Kidney Disease (CKD)
Neurogenic Bladder
10
Q
As a risk factor, HTN can lead to what possible renal/urologic disorder
A
renal insufficiency
CRF
11
Q
As a risk factor, multiple sclerosis can lead to what renal/urologic disorder
A
incontinence
neruogenic bladder
12
Q
As a risk factor, Parkinsons Disease can lead to what renal/urologic disorder
A
incontinence
13
Q
As a risk factor, Gout, Chrohns, and Hyperparathyroidism can lead to what renal/urologic disorder
A
Kidney stones
14
Q
As a risk factor, BPH can lead to what renal/urologic disorder
A
obstruction
15
Q
What information should be taken upon reanl/urologic assessment in the health history
A
Chief Complaint
Pain (Reason, pattern, intensity, what makes it worse or better etc)
Past health history (hx of UTi, tests, renal angiograms, caths, STDs, etc)
Family Hx
Social Hx (Habits and behaviors)
Voiding Patterns (when is normal, how much, smell, at night a lot?)
Medications (What is taken, what may affect UO/micturation/renal toxicity)
16
Q
What is an important bit of information to teach elderly patients about their renal function
A
to drink plenty of water everyday even if they are not thirsty as it is good for their renal function
17
Q
What information should we gather about renal system pain patterns
A
Is the pain from distention, obstruction, or inflammation of renal tissue?
Are we discovering these diagnoses when they seek care for other symptoms?
Are they experiencing any pain even?
18
Q
Is absence of pain or symptoms for issues lik STIs common
A
yes 50% of people wont even report pain or symptoms
19
Q
When is a lot of renal/urologic issues and diagnoses found
A
they tend to be found when clients are seeking care for other symptoms like for a cold
20
Q
Urinary Frequency
A
voiding more than every 3 hours
21
Q
Urinary Urgency
A
Having a strong desire to void
22
Q
Dysuria
A
Painful urination
23
Q
Urinary Hesitancy
A
delay in initiation
24
Q
Nocturia
A
excessive urination at nightr
25
Incontinence
Involuntary loss of urine
26
Enuresis
Bed wetting
27
Polyuria
increased volume of urine
28
Oliguria
UO less than 500 mL a day
29
Anuria
Less than 50 mL of UO a day
30
When are oliguria and anuria most common
chronic renal failure
31
Hematuria
RBC in urine
32
Proteinuria
Protein in urine (should not be there)
33
The most accurate indicator of fluid loss or gain in patients who are acutely ill is ___
weight
34
Areas of Emphasis for the Renal/Urologic Physical Exam
Abdomen
Suprapubic Region
Genitalia
Lower Back
Lower Extremities
KIDNEYS - Not always palpable
Bladder percussion
Areas of Edema
Checking DTRs and Gait
35
Renal dysfunction may produce tenderness...
at the CVA (can very rarely palpate the kidney here too)
36
Why are DTRs and Gait checked with renal physical exams
Because the peripheral nerve innervating the bladder also innervates the lower extremities
37
What are some possible urine colors to find in patients and what do they mean
Colorless/Pale Yellow - Dilute Urine, Alcohol, Lots of Fluid Intake
Yellow/Milky White - pyuria, vaginal cream
Bright Yellow - mult vitamin preparations
Pink/Red - Hgb breakdown, RBCs, blood, certain drugs
Blue/Blue Green - dyes and certain pseudomonas species
Orange/Amber - concentrated urine, dehydration, fever, bile, meds
Brown/Black - old blood, very concentrated urine, iron, certain compounds
38
It is important to document ____ and ____ of urine
color and amount
39
What are some urinary diagnostic tests commonly seen
Urinalysis and Urine Culture
Renal Fxn Tests: Specific Gravity and 24 hour Urine Test
Serum Tests: Creatinine, BUN, BUN:Creatinine
Biopsy
40
Another name for 24 hour urine test is...
creatinine clearance test
41
What is normal urine specific gravity
1.010 - 1.025
42
Urine C&S is often used for suspected ___
UTIs
43
Some of the most common urologic nursing diagnosese are...
1. Knowledge Deficits
2. Pain r/t infection, edema, obstruction, bleeding along tract, etc
3. Fear for potential alteration in renal function and embarassment s/t urinary function
44
Normal BUN:Creatinien ratio
10:1
45
What is the process of urine collection/clean catch (midstream)
1. Nurse has pt wash genitals and perineal area prior w/ soap and water
2. Males: Void directly into container; Females - Hold container between legs
3. Begin voiding, then place specimen container in stream of urine and collect 30-60 mL
46
How should males clean their genitals prior to a clean catch
clean the meatus and head of penis with a circular motion
Use each towelette (3 total) once
47
How should females clean their genitals prior to a clean catch
front to back
use each towelette (3 total) once
48
What is the gold standard of urine collection for determining renal fxn
24 hour urine collection
49
How does a 24 hour urine collection work
A special orange speciment container with a preservative is obtained from the lab in order to collect urine (unless the pt has an indwelling catheter)
Signs are posted in the client room, chat, and bathroom regarding all urine needing to be collected in the next 24 hours
Client will void and discard the first urination at the start of the 24 hour period and then begin collecting everything after that
Once 24 hours is up container is put on ice and the client should void one last time to collect that urine before being sent to the lab
50
What are some diagnostic imaging tests for urinary function / renal function
KUB (Kidney Ureter Bladder Radiograph) - Likea kidney x ray
US - high frequency waves through the body - non invasive
CT - 3D image
Bladder Scan 0- INjectible scan
MRI
IVP - intravenous polygraphy - injectnle dye and X rays of the kidney/urinary tract
Nuclear Scans
Cystography - small cystoscope goes in and looks
Renal Angiography - injectible medium looks at renal blood flow
51
What is needed before any diagnostic test
consent form signed
52
What is needed before urologic testing using contract sgents
1. have emergency equipment ready for anaphylactic shock and double check for allergies to things like iodine and shellfish
2. Informed consent
3. Know kidney baseline function because some dyes can cause more injury
*If a renal angiograph, catheter may need to be inserted first
53
What are 3 common renal nursing dx
1. Knowledge deficit r/t lack of understanding about procedures and diagnostic tests AEB ___
2. Chronic pain r/t ____ AEB ___ (Infection, edema, obstruction, bleeding along urinary tract)
3. Fear (Anxiety) r/t potential alteration in renal fxn AEB ___
54
What are some examples of Renal Nursing Goals
1. Pt demonstrates increased understanding of tests and procedures by ___
2. Patient reports a pain level of <3 by ___
3. Patient reports decreased anxiety by ___
4. Patient experiences improved elimination patterns by ___
55
Urinary Retention
Inadequate bladder emptying disorder
Residual urine stays in the bladder after voiding and can result in overflow incontinence
56
Results of Urinary Retention
Overflow Incontinence
Urinary Stasis --> Bacterial Growth --> Infection/Stones
57
If urinary retention is left untreated what will happen
A UTI will begin or possible stone formation
58
Etiology of Urinary Retention
Detrusor fxn deficit
Calculi
Fecal Impaction
Obstruction at or below the bladder outlet
BPH
Prostate Carcinoma
Urethral stricture or distortion
Medications
59
Things to assess with Urinary Retention
Nursing Hx
Q-A: S/S / Accurate Health History and Assessment
Inspection Percussion Palpation
60
Nursing Dx for Urinary Retention
THINK OBSTRUCTION:
Risk for INfection ...
Risk for Renal Calculi...
Urinary retention r/t detrusor fxn deficit ...
61
Goals for urinary retneiton are based on ...
the nursing diagnoses
thinking obstructions you want to address risk for infection and calculi but also work on that retention itself
62
Interventions for Urinary Retention
Privacy
Warm Sitz Bath
Normal Standing or Sitting Position to Void
Faucets and Warm Water
Bedside Commode or Toilet
Analgesia after surgical interventions
Catheterizations
Establish normal voiding and evaluate outcomes
63
Urinary Incontinence
Involuntary loss of urine caused by functional issues, neurogenic issues, etc
64
What are the 5 main types of incontinence
Stress
Urge
Functional
Iatrogenic
Mixed
65
Stress Incontinence
Involutnary loss of urine through an intact urethra as a result of sneezing, coughing or CofP
66
Urge Incontinence
involuntary loss of urine alongside a strong urge to void that cannot be suppressed
Need to void but cannot reach the toilet in time
67
Functional Incontinence
Instances in which lower Urinary tract fxn is intact but other factors like cognition make it difficult
68
Iatrogenic Incontinence
involuntary loss of urine d/t extrinsic factors and medical factors - primarily medications like alpha adrenergic agents
69
Mixed Incontinence
Empasses several types of urinary incontinence, is involuntary leakage associated with urgency and also exertion, sneeze, or cough
70
How can treatment for incontinence vary
Could be as simple as behavioral treatment or as complex as neuromodulation
71
Risk Factors for Urinary Incontinence
Age related changes
caregiver or toilet unavailable
cognitive disturbances like dementia or Parkinsons
Diabetes
genitourinary surgery
high impact exercise
immobility
incompetent urethra due to trauma or sphincter relaxation
medications like diuretics sedatives hypnotics and opioid agents
menopause
morbid obesity
pelvic muscle weakness
pregnancy - vaginal delivery, episiotomy
stroke
72
Common Nursing Dx with urinary Incontinence
Anxiety
Impaired Skin Integrity
73
Goals for Urinary incontinence should be...
measurable and derviced from the nursing dx like anxiety reduction or maintenance of skin intgegrity
74
Interventions for Urinary Incontinence
Treat underlying cause
Behavioral therapy - kegal exercise, voiding diary, prompted voiding, habit retraining, bladder retraining
Administer meds as ordered
educate about surgical options appropriate
75
Are anticholinergic drugs good for urinary incontinence
yes because they lead to urinary retention by inhibiting the bladder contractions adn blocking involuntary movement of smooth muscles
76
Strategies for Promoting Continence to educate the pt on
avoid bladder irritants - caffeine, alcohol, aspartame
avoid diuretic agents after 4 pm
increase awareness of amount and timing of fluid intake
perform pelvic floor muscle exercises x2 pid
stop smoking - coughing causes incontinence
avoid constipation - drink adequate fluid, a good high fiber diet, exercise, and stool softeners if recommended
void 5-8 times a day every 2-3 hours - first in morning, before a meal, before bed, once during night if needed
77
Urinary Tract Infections
Infections of the urinary tract that can be acute, chronic, uncomplicated, complicated, lower or upper
78
Examples of lower UTIs
Cystitis
Urethritis
Prostatitis
79
Examples of Upper UTIs
pyelonephritis
interstitial nephritis
renal abscesses
80
Cystitis
lower UTI of the bladder
81
Urethritis
lower UTI of the urethra
82
Prostatitis
lower UTI of the prostate gland
83
Pyelonephritis
inflammation of the renal pelvis
Upper UTI
84
Interstitial Nephritis
inflamamtion of the kidney
upper UTI
85
Clinical Manifestatiosn of Uncomplicated UTIs
Burning on urination
Frequency, urgency, nocturia, incontinence
Suprapubic or pelvic pain
Hematuria and back pain
86
Clinical manifestations of complicated UTIs
can range from asymptomatic to Gram Negative sepsis with chock (aka urosepsis)
have a lower response rate to treatment
tend to reoccur
87
UTI Nursing Dx
Acute paint r/t infection within the urinary tract
Deficient knowedge about factors predisposing the patient ot infection and recurrence, detection and prevention of recurrence and pharmacologic therapy
88
Major Goal for UTIs
Controlling Pain
Teach and educate patients and make sure they know when to come to the hospital
89
What are some potential complications from UTIs
Urosepsis
Acute kidney injury and/or chronic kidney disease
90
Risk Factors for UTIs
Female Gender
Diabetes
Pregnancy
Neurologic Disorders
Gout
Altered States caused by incomplete emptying of the bladder and urinary stasis
Decreased natural host defenses or immunosuppression
Inability or failure to empty the bladder completely
Inflammation or abrasion of the urethral mucosa
Instrumentation of the urinary tract (cath, cytoscopic, procedure)
Obstructed Urinary flow from:
congenital abnormalities, urethral strictures, contractures of bladder neck, bladder tumors, calculi, and compression of ureters
91
Why are females more likely to get a UTI
they have a shorter urethra/anatomy
92
What are some area of education to provide the patient to prevent recurrent UTI
hygiene - showering rather than bathing, cleaning area front to back each bowel movement
Fluid intake - flush the system and bacteria
Voiding habits - every 2-3 hours to prevent bacteria buildup
Absorbic acid or other treatments as prescribed like probiotics
93
Urosepsis
gram engative becteremia originating in urinary tract
it is an infection from the urinary tract spreading into the blood leading to systemic infection
94
The most common organism cause of Urosepsis is ___
E. Coli
95
the most common cause of urosepsis is
presence of indwelling catheter or untreated UTI in medically compromised patients
96
What is the 2 major problems regarding urosepsis
1. Bacterium ability to develop resistant straints
2. Urosepsis can lead to septic shock if not treated aggressively
97
The most common s/s of urosepsis are
FEVER - most common and earliest
Perfuse/Sweat more than normal
Different Vitals
C&S Results from Urine
98
Interventions for urosepsis are done...
after the culture and sensitivity
99
Interventions for Urosepsis
adminsiter IV antibiotics as prescribed - usually until afebrile for 3-5 days
use of oral antibiotics
secure, smallest, and aseptic catheterization only when needed
great perineal care
100
Bacteriuria increases with ___ and ___
age and disability
101
What is the most common cause of bacterial sepsis in those 65+
UTIs
102
What is the mortality rate like for older patients with UTIs
>50%
103
S/S of UTI in Older Populations
Fatigue (most common and subjective complaint in this gorup)
Altered confusion, cognition
104
Factors that contribute to UTIs in older adults
cognitive impairment
frequent use of antimicrobial agents
high incidence of multiple chronic medical conditions
immunocompromise
immobility and incomplete bladder emptying
obstructed flow of urine
indwelling catheters
105
Clinical Manifestations of Cystitis
*R/t actual inflammatory response*
Frequency, urgency, and voiding in small amounts
Burning upon urination and inability to void
incomplete bladder emptying and spasm
lower abdominal or back discomfort
cloudy, dark foul smelling urine
hematuria
malaise, chills, fever, n/v
nocturia
incontinence
suprapubic, pelvic, or back pain
confudion in older populations
106
What does hematuria indicate in cystitis
infection and inflammation spreading up toward the kidneys (also cloudy dark foul smelling urine)
107
Important Nursing Dx for Cystitits
Pain
Infection
108
Education for Cystitis Patient
Pharmacological Therapy
Prevent recurrence
Deficient knowledge gaps
109
Interventions for Cystitits
Collect urine for C&S - ID bacteria
Instruct to force fluids - especially if taking a sulfonamide
Use strict aseptic technique when inserting a urinary catheter and provide meticulous perineal care
Maintain closed urinary drainage systems for clients with indwelling catheters
administer prescribed meds
education
110
How many fluids should be forced a day for cystitis
300 mL/day or 10 oz/hr x 10 hour
111
Why is it particularly important to force fluids if a patient is on a sulfonamide
because they can form crystals in concentrated urine
112
Education Points for Cystitis
acid ash diet - discourage caffeine products and avoid alcohol
heat to abdomen or sitz bath for c/o discomfort
avoid bubble baths and perfumed hygiene products
avoid tight fitting clothing and nylon undergarments
follow up urine culture following treatment
Medications (Analgesic, antiseptic, antispasmodic, antibiotic, antimicrobial)
113
What is the msot frequent cause of Urethritis in men
gonorrhea and chlamydia
114
What is the most frequent cause of Urethritis in women
feminine hygiene sprays
perfumed toilet paper and sanitary napkins
spermicidal jellies
UTIs and change in vaginal mucosa lining
115
What are the s/s on assessment of urethritis in men
Frequency
Uregncy
Nocturia
Difficulty Voiding
Burning on urination
Penile discharge
116
What are the s/s of on assessment of urethritis in women
Frequency
Urgency
Nocturia
Difficulty Voiding
Painful urination
lower abdominal discomfort
117
How do the s/s of urethritis differ in men and women
men have burning in urination and penile discharge
meanwhile women have more painful urination and lower abdominal discomfort
118
Interventions for Urethritis
encourage fluids
testing for STIs
administer antibiotics as prescribed
instruct client in SITZ Bath
if stricture occurs prepare for dilation of urethra and instillation of antiseptic solution
instruct to avoid intercourse until symptoms subside or STI treatment is complete
Instruct women to avoid using perfumed toilet paper, sanitary napkins, and feminine hygiene sprays
119
BPH - Benign Prostatic Hyperplasia
hyperplastic process - increased number of cells - of the prostate gland in men
a NON CANCEROUS enlargement
120
The most common disease or condition in aging men is...
BPH (51% of men have it with no clear cause known)
121
S/S of BPH
frequency
urgency
nocturia
difficulty initiating
when they do have a stream feels like nothing empties fully - hard to fully empty
dribbling
person QOL decrease
sleep patterns change
122
Complications from BPH
Stasis
Retention
UTI
Obstruction
123
Treament for BPH is tailored toward...
improving patient QOL - we want to make sure we improve urine output, relieve obstruction, and prevent further progression of the disease
124
Treatments for BPH
encouraging fluids
catheterization in severe PH (or urology has to do it if its too large and needs a metal cath)
medications - PROSCAR + Hytrin/Cardua/Flomax (Proscar shrinks gland)
Surgery
125
Prostatitis
inflammation of the prostate gland cause dby infectious agents (Bacterial) or tissue hyperplasia (Abacterial)
126
Bacterial Prostatitis
organism reaches the prostate through the urethra or bloodstream to cause infection and inflammation
127
Abacterial Prostatitis
inflammation occurring following viral illness or decreases in sexual activity
128
S/S of Bacterial Prostatitis
fever and chills
dysuria and urethral discharge when prostate is palpated
boggy and tender prostate
WBCs found in prostatic secretions
129
S/S of Abacterial Prostatitis
backache
dysuria
perineal pain
frequency and hematuria may be present
irregularly enlarged, firm, and tender prostate!!
130
Interventions for Prostatitis
encourage fluid intake
instruct to use sitz baths for comfort
administer antibiotics, analgesics, anti spasmodics, stool softeners as prescribed
inform client of activities to drain prostate: intercourse, masturbation, and prostatic massage
education to avoid spicy foods, coffee, alcohol, prolonged auto rides, and sex during acute inflammation
131
Surgeries for Prostate Enlargement
TURP - Transurethral Resection
Suprapubic Prostatectomy
Transurethral Incision
Ablation
Perineal
Retropubic
132
Why is screening for DRE and PSA important
because if DRE is abnormal of PRE is high it could mean prostate cancer
however, diagnosis requires confirmation via biopsy
133
Which prostate surgical procedure requires no incisions
TURP - Transurethral resection
(Technically ablation too)
134
Suprapubic Prostatectomy
There is an incision in the ambdomen AND bladder to access the prostate
Longer recovery process and monitoring for blood/hemorrhaging is important
135
Perineal Prostate Surgery
incision between scrotum and anus to get to prostate gland
can lead to impotence, sexual dysfunction, or rectal damage
136
Retropubic Prostate Surgery
AVOIDS BLADDER INCISION
Incision in abdomen while avoiding the bladder
Increased infection risk
137
Important Prostate Surgery PreOp and PostOp Nursing Diagnoses
PreOp:
Anxiety
Acute Pain
Deficient Knowledge
Post Op:
Risk for imbalanced fluid volume
Acute pain
Deficient knowledge about post op care
138
Transurethral Incision
Similar results to TURP but has an incision made (1-2 to relieve pressure on the urethra itself)
139
Transurethral Resection (TURP)
Prostatic tissue is removed through the urethra by optical instruments
Used for glands of various sizes and ideal for those who are at surgical risk
140
Advantages of TURP
avoids abdominal incision
safer for surgical risk pateints
shorter length of stay in hospital and recovery periods
lower morbidity rates
causes less pain
can be used as a palliative approach with hx of radiation therapy
141
Disadvantages of TURP
requires a highly skilled surgeon
recurrent obstruction, urethral trauma, and strictures can develop
delayed bleeding can occur
142
Important Nursing Consideration Post Op with TURP
monitor for hemorrhage
observe for symptoms or urethral stricture such as dysuria, straining, weak urinary stream
CBI - cont. bladder irradiation
give antispasmodics
143
Nursing Dx for Prostate Cancer
Anxiety
Urinary Retention
Deficient Knowledge
Imbalanced Nutrition: Less than body requirements
Sexual dysfunction
Acute pain
Impaired physical mobility
Hemorrhage, infection, bladder neck obstruction
144
Important Nursing Considerations Post Op with Suprapubic Surgery
abdominal and bladder incision needs frequent dressing changes - 2 incisions were made
longer healing process
sterility needs and issues
145
Important nursing considerations post op with retropubic surgery
less bleeding than most others
drainage and bladder spasms occur - need to monitor
146
Collaborative Problems/Potential Complications from any prostate surgery
hemorrhage and shock
infection
VTE/DVT
catheter obstruction
complications with catheter removal
urinary incontinence
sexual dysfunction
147
Nursing Interventions Post TURP
Assess for bleeding
Assess and treat pain
Infection
DVT Prevention/prophylaxis - get them walking ASAP
Obstruction monitoring
Antispasmodics as prescribed
Teach exercises for sphincter control
Continuous Bladder Irrigation (CBI)
148
What bleeding may be normal at first following TURP
Bleeding should be red/pink for 24 hours after and then turn a more tea like color
but if color remains bright red or has clots in it, then it is abnormal bleeding and indicates arterial bleeding - contact the provider
149
Continuous Bladder Irrigation
a 3 way (lumen) irrigation system to decrease bleeding and keep the bladder free from clots
Its a bag putting fluid into the stomach and it continuously allows bladder irrigation to prevent clot buildup and keep things moving
150
What is one major potential complication that can occur from CBI
TURP Syndrome
151
TURP Syndrome
A syndrome caused by CBI caused by neurologic, lyte, and cardiac imbalance from too much absorption of the irrigated fluid
152
S/S of TURP Syndrome
HTN
NV
Confusion
Cardiac Issues
153
What should be done if you suspect TURP syndrome
stop CBI and let the provider know
154
What are the 3 lumens on CBI used for
1 is for inflating a balloon (30 mL) to hold it in place
1 is for outflow
and 1 is for instillation (inflow)
155
How much fluid should be given to Post Op TURP Patients
2400-3000 mL/d if possible
156
When can you begin ambulating a post op TURP patient
ASAP - so as soon as the urine is more clear (not when pink/red)
157
What does arterial bleeding appear like post TURP and what should be done if this occurs
bright red urine with numerous clots --> If this occurs increase CBI and notify physicial immediately
158
What does venous bleeding appear like Post TURP and what should be done if this occurs
burgundy colored UO --> If this occurs inform MD who may apply traction on catheter
159
Important rule to CBI
What is put in must come out - so what is instilled better be in bag outflow or else something is wrong like tube kinking, urinary retention etc which can cause overdistention leading to secondary hemorrhage
160
Catheter Traction
Maintaining tautness to the catheter (straight leg not bent) taped to the abd/thigh which is done by the MD
Never released without MD order - usually after bright red/burgundy colored drainage diminished
Important to Post TURP Care
161
What should be run through the CBI
Normal Saline (or glycine) to prevent water intoxication
162
At what rate should CBI be run
at a rate to keep the urine pink
If bright red or has clots than run it faster (40 gtt/minute once bright red clears)
163
What should be done if the CBI catheter is obstructed
Turn off CBI, irrigate catheter with 30-50 mL NS and notify MD if obstruction is unresolved
164
What two things are important to watch for when using CBI / post TURP
Turp Syndrome
Severe Hyponatremia (Water intoxication)
(Both caused by excessive CBI absorption)
165
Important TURP Post Op Care Considerations
Expect red-light pink urine 24 hours - then amber for 3 days
Continuous feelings of urge to void is normal
Avoid attempts to void around catheter - causes bladder spasms
Antibitoics, Analgesics, Stool Softeners, and AntiSpasmodics as prescriped
Monitor 3 way foley cath: 30-45 mL retention balloon
Maintain CBI with NS
Educate on post op diet, s/s to watch for
Control pain
Stress importance of doctor follow up
