Module 4- Genitourinary Assessment Flashcards
what are factors that commonly influence urinary elimination?
-Psychological factors:
▪Anxiety, emotional stress, lack of privacy and time
-Sociocultural factors:
▪Culture, gender, religious practice
-Fluid balance: coffee/alcohol inhibit ADH
-Diagnostic examination:
▪involving instrumentation may cause urethra trauma and hematuria, urinary catheterization increases risk of infection
what are factors that commonly influence urinary elimination cont’d?
-Surgical procedures:
▪Post-operative urinary retention (POUR, postoperative pain control
-Pathological conditions: conditions affecting CNS (stroke, parkinson’s, advanced dementia)
-Medications: diuretics, sedatives
list and describe common alterations in urinary elimination
- Urinary tract infection (UTI)
- Urinary incontinence and other lower urinary tract symptoms
- Nocturia
- Urinary retention (holding more urine in bladder than normal)
what are nursing measures to reduce UTI’s?
- hand hygiene
- encourage 2000-2500ml of fluid intake (if no restrictions)
- maintain a closed drainage system (catheters)
- assess tubing for obstruction, kinks, pooling
- ensure urine bag is below level of the bladder
- teach patients
List measures to prevent Catheter Associated Urinary Tract Infection (CAUTI)
➢Reduce inappropriate catheter use (is a catheter necessary?)
➢Remove catheter as soon as possible
➢Secure indwelling catheters to prevent movement and pulling (to maintain closed urinary drainage system)
➢Ensure no kinks or obstructions
➢Keep the urinary drainage bag below the level of the bladder
➢Use a separate measuring receptacle for each patient. Do not let the drainage spigot touch the receptacle
➢Perform routine perineal hygiene daily and after soiling
how can you help protect and preserve elimination?
- patient education: regular micturition (3-4hrs), don’t pee too often or wait too long, maintain adequate fluid intake, avoid alcohol etc, stimulate micturition (running water)
- promote complete bladder emptying
- hygiene
list infant/children factors relating to genitourinary health
-Reproductive organs developed and present at birth, evolve with age
•Circumcision
•Cannot concentrate urine effectively (light yellow and clear)
•Excrete large volumes of urine relative to body size
•Toilet training (requires patience)
•May not gain full control until 4 or 5 years of age
list preadolescent/adolescent factors relating to genitourinary health
-Puberty
•Hair growth
•Enlargement of sexual organs
•Menarche (first signs of menstruation
list younger adult factors relating to genitourinary health
- Sexual development continues
- Normally voids 1500/2200-2700mL daily
- Women: Pregnancies with menopause beginning at approximately 48-51 yrs•Men: no end to fertility (40 yrs sperm production decreases)
- Men: decreased testosterone -slower and less intense sexual response
list older adult factors relating to genitourinary health
- Ability to concentrate urine or reabsorb water and sodium may decline
- Dysuria, incontinence, nocturia
- Possible alteration in sexual function
- Thinning, greying body hair
- Testes and penis size decreases
- In males, prostate enlargement begin in 40s, (may cause urinary frequency and urinary retention)
- Vagina shortens, narrows, less elastic, epithelium thins, drier, may be itchy
List subjective data for GU
- Urinary frequency, urgency, and nocturia
- Dysuria (pain, burning during urination)
- Hesitancy and straining
- Urine color
- Urinary and sexual health history
- Pain, lesions, discharge, swelling, lumps, any changes in appearance/function
- Current sexual health status
when is the GU objective assessment usually performed?
usually done during bathing or peri-care, palpation when necessary
what is the other name for an in-dwelling catheter?
foley catheter
simply state how you use an in-dwelling catheter
•Placement of a tube through the urethra into the bladder
what are you assessing on a patient with an in-dwelling catheter
redness, swelling, discharge, discomfort; assess for symptoms of CAUTI (urgency, tenderness, pain, fever, bloody urine etc); no kinks; appropriate urine output (1500ml)
