Module 5 - Urinary Elimination - Catheter/Bowel Irrigation Flashcards
Kidneys (Upper urinary tract)
- 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
Ureters (Upper urinary tract)
- Urine enters ureters from renal pelvis via collecting ducts
- Ureters connect to bladder
Urine > Renal Pelvis > Collecting Ducts > Ureters > Bladder
Bladder (Lower urinary tract)
- Muscular organ
- Stores urine
- Expands and contracts
- Contraction expels urine
Urethra (Lower urinary tract)
- 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
Oliguria
Production of low amounts of urine
Anuria
No urine production
Polyuria
Excessive amount of urine production
Dysuria
Painful/difficult urination
Hematuria
Blood in urine
Nocturia
Urination at night during sleep cycle
Cystitis
Urinary tract infection (UTI) affecting the lower urinary tract
Normal output of urine for adult?
1-2 L or 30 mL/hour
Factors affecting urine output?
- Age
- Medications
- Infections
- Urine retention
- Low fluid intake
- Urinary incontinence
Types/Reasons of Catheter: Straight (Intermittent) Catherization
- 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
Coude Catheter
- Type of in-dwelling catheter
- Curved and rigid tip
- Used on male patients with enlarged prostates
- Stiff and easier to control
- Requires special education
In-dwelling (Foley) Catheter
- 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
Subrapubic Catheter
Surgical placement of catheter through abdominal wall above pubis into the bladder
Surgical urinary diversions:
Nephrostomy tube, Ileal conduit and Neobladder
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
Reasons for Catherization
- Surgical reasons
- Kidney/Bladder stones
- Urinary retention
- Cancer
- Injury/Trauma
- Nerve damage
- Enlarged prostates
Define when urometer drainage system is required
- 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
Precautions that must be taken when performing Cathertization
- Prevention of infection
- Principles of sterility
- Perineal irritation or discomfort
- Fever/odour
- Burning sensations
Urinary Tract Infections and symptoms
Cystitis of lower urinary tract causing inflammation of the urethra
- Delirium
- Pain
- Fever
- Chills
- Tenderness
Why are UTI’s one of the leading HCAI?
- 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
Key points for client education on catheter care
- 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
