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NF 2 - Midterm 1 > Module 5 - Urinary Elimination - Catheter/Bowel Irrigation > Flashcards

Module 5 - Urinary Elimination - Catheter/Bowel Irrigation Flashcards

1
Q

Kidneys (Upper urinary tract)

A
  • Filtration of blood occurs in glomerulus (capillary network)
  • Waste is metabolized and urine is produced in the nephron’s
  • Plays a role in electrolyte balance
  • Production of Renin (hormone to regulate BP) by regulating renal blood flow - renin-angiotension aldosterone system
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2
Q

Ureters (Upper urinary tract)

A
  • Urine enters ureters from renal pelvis via collecting ducts
  • Ureters connect to bladder
    Urine > Renal Pelvis > Collecting Ducts > Ureters > Bladder
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3
Q

Bladder (Lower urinary tract)

A
  • Muscular organ
  • Stores urine
  • Expands and contracts
  • Contraction expels urine
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4
Q

Urethra (Lower urinary tract)

A
  • Urine travels from the bladder through the urethra
  • Fibromuscular tube
  • Sphincter muscle in urethra contributing to closure between voids
  • Women urethra = 3-4 cm
  • Men urethra = 18-20 cm
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5
Q

Oliguria

A

Production of low amounts of urine

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6
Q

Anuria

A

No urine production

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7
Q

Polyuria

A

Excessive amount of urine production

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8
Q

Dysuria

A

Painful/difficult urination

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9
Q

Hematuria

A

Blood in urine

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10
Q

Nocturia

A

Urination at night during sleep cycle

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11
Q

Cystitis

A

Urinary tract infection (UTI) affecting the lower urinary tract

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12
Q

Normal output of urine for adult?

A

1-2 L or 30 mL/hour

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13
Q

Factors affecting urine output?

A
  • Age
  • Medications
  • Infections
  • Urine retention
  • Low fluid intake
  • Urinary incontinence
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14
Q

Types/Reasons of Catheter: Straight (Intermittent) Catherization

A
  • Single lumen
  • “in and out” (Single use)
  • Used for 5-10 min to drain the bladder
  • Urine drains from tip through lumen into a receptacle
  • Can be performed by patient or nurse
  • Can reduce HCAI’s
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15
Q

Coude Catheter

A
  • Type of in-dwelling catheter
  • Curved and rigid tip
  • Used on male patients with enlarged prostates
  • Stiff and easier to control
  • Requires special education
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16
Q

In-dwelling (Foley) Catheter

A
  • Continuous catheter
  • Double lumen (most common) > one lumen inflates/deflates balloon with sterile water and other drains urine
  • Triple lumen > same as double but also allows for irrigation
  • Small balloon is attached that anchors to bladder neck
  • Can be used long-term but daily review is required
17
Q

Subrapubic Catheter

A

Surgical placement of catheter through abdominal wall above pubis into the bladder

18
Q

Surgical urinary diversions:

Nephrostomy tube, Ileal conduit and Neobladder

A

Nephrostomy tube - opening between kidney and skin which allows for urinary diversions, placed into the nephron where urine is produced
Ileal conduit - bladder cannot function so abdominal surgery of the ileum (small intestine) is required, insertion of urinary drainage to the ileum
Neobladder - Surgical procedure to reconstruct a new bladder

19
Q

Reasons for Catherization

A
  • Surgical reasons
  • Kidney/Bladder stones
  • Urinary retention
  • Cancer
  • Injury/Trauma
  • Nerve damage
  • Enlarged prostates
20
Q

Define when urometer drainage system is required

A
  • Special receptacles that are attached between in-dwelling catheters and drainage bags
  • Measures urine volume
  • Used when precise hourly measurements of urine are needed
  • Can hold 100-200 mL of urine
21
Q

Precautions that must be taken when performing Cathertization

A
  • Prevention of infection
  • Principles of sterility
  • Perineal irritation or discomfort
  • Fever/odour
  • Burning sensations
22
Q

Urinary Tract Infections and symptoms

A

Cystitis of lower urinary tract causing inflammation of the urethra

  • Delirium
  • Pain
  • Fever
  • Chills
  • Tenderness
23
Q

Why are UTI’s one of the leading HCAI?

A
  • Most common in in-dwelling catheter patients
  • Long hospital admissions
  • Bacteria in catheter tube caused bacteria to grow in bladder
  • Improper hand hygiene
  • Improper sterility
24
Q

Key points for client education on catheter care

A
  • Promotion of regular micturition
  • Increase intake of fluid
  • Perineal hygiene
  • Prevention of infection
  • Observation of any pain/discomfort urinating
  • Ensuring proper mobility with catheter (below the waist)
  • Empty drainage bag regularly
25
Q

Interdisciplinary resources for patient care/management of catheters

A
  • Urology specialist
  • Nurse with urology experience
  • History of client
  • Medical chart
  • Lab results
  • Assessment of client
  • Documentation
26
Q

Urinary retention

A

Accumulation of urine in the bladder as the bladder is unable to empty

  • Severe cases can hold 2-3 L of urine
  • Treatments are surgery and catheterization
27
Q

What are you going to assess prior to catherization?

A
  • Client’s last void
  • Intake/output
  • Bladder distention
  • When the client bathed
  • Pain/discomfort
  • Perineum area - REEDA
  • Mobility/physical limitations
28
Q

Purpose of bladder irrigation

A

Bladder irrigation is using sterile fluid to flush out the bladder in order to remove/prevent blood clots as well as the growth of bacteria

29
Q

Open irrigation

A
  • Sterile technique
  • Requires MD order
  • Intermittent (no port on drainage bag) - closed for irrigation
  • Catheter tip has a bulb - use of syringe
  • greater risk for infection
30
Q

Closed irrigation

A
  • Sterile technique
  • Requires MD order
  • Intermittent (no port on drainage bag)
  • Continuous - three way irrigation system, triple lumen
  • Collection bag is clamped prior to irrigation and then unclamped when finished
31
Q

Indications for closed bladder irrigation (Continuous)

A
  • Hematuria
  • Bladder cancer
  • Bladder surgery
  • Kidney surgery
  • Benign prostatic hypertrophy
32
Q

Indications for intermittent bladder irrigation (Open)

A
  • Client is in discomfort/pain
  • Bladder distention
  • Hematuria
  • Removal of bacteria
33
Q

Indications for manual bladder irrigation

A
  • Hematuria
  • Pain/discomfort
  • Bladder/prostate surgery
34
Q

Solutions used for bladder irrigation

A
  • Normal saline

- 0.25% acetic acid

35
Q

Unexpected outcomes during bladder irrigation

A
  • Irrigation solution does not return
  • Bright red bleeding
  • Increased cloudiness of urine
  • Fever
  • Pain
36
Q

Bladder irrigation education

A

Observation of urine color, clarity, consistency, odour, amount and signs of obstruction
- UTI indications (delirium, fever, chills, pain, tenderness)

NF 2 - Midterm 1 (7 decks)

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