Urination elimination Flashcards
Suprapubic Urinary Catheter
Used for long-term continuous drainage
Surgically inserted through a small incision above the pubic area
Diverts urine from the urethra
Associated with decreased risk of contamination
Care includes skin care around the insertion site; care of the drainage tubing and drainage bag
Nursing Care of a Patient With an External Urinary Sheath (Condom Catheter)
External catheters (condom catheters)
Allow 1-2 inches between tip of penis and catheter (or it might fall off)
Vigilant skin care to prevent excoriation
Removing the urinary sheath daily
Washing the penis with soap and water and drying carefully
Inspecting the skin for irritation
DO NOT RETRACT the foreskin, it could cause necrosis
Alternatives to catheterization: Suprapubic catheters
Used with people with structural issues of the pelvis or blockages/ strictures of the urethra
catheter associated infection (CAUTI)
occurs while an indwelling catheter is in place or up to 48 hours after discontinuing
to prevent this, you would need to maintain a closed urinary drainage system
Reasons for Catheterization
Relieving urinary retention (<100cc)
Prolonged patient immobilization
Obtaining a sterile urine specimen when patient is unable to void voluntarily
Accurate measurement of urinary output in critically ill patients
Assisting in healing open sacral or perineal wounds in incontinent patients
Emptying the bladder before, during, or after select surgical procedures and before certain diagnostic examinations.
Providing improved comfort for end-of-life care
Documentation of the Use of a Bedside Commode
Document the patient’s tolerance of the activity, including ability to use the commode.
Record the amount of urine voided and/or stool passed on the intake and output record, if appropriate.
Document any other assessments.
Unusual urine or stool characteristics
Alterations in the patient’s skin
Expected Outcomes When Assisting a Patient to Use a Urinal
Patient voids using the urinal with assistance.
Patient maintains continence.
Patient demonstrates how to use the urinal.
Patient maintains skin integrity.
Positioning on Bedpan
Prevent muscle strain and discomfort
Elevate head of the bed 30 to 45 degrees
Wear gloves when handling bedpans
When patients are immobile or it is unsafe to allow them to raise their hips, they remain flat and roll onto the bedpan.
Assessments Before
Using a Bedpan
Assess usual elimination habits.
Determine why needs to use a bedpan.
Assess degree of limitation and ability to help with the activity.
Assess for health problems which would contraindicate certain patient actions.
Check for devices that could interfere with the patient’s use of a bedpan.
Assess characteristics of the urine and patient’s skin.
Patients at Risk for Urinary Tract Infections (UTI
Sexually active women
Women who use diaphragms for contraception
Postmenopausal women
Individuals with indwelling urinary catheter
Individuals with diabetes mellitus
Older adults
heath promotion for micturition
patient education Promoting normal micturition Maintaining elimination habits Maintaining adequate fluid intake Promoting complete bladder emptying Preventing infection
what are some ways you could maintain Normal
Voiding Habits
Schedule Urge to void Privacy Position (for men especially) Hygiene (educate them with wiping)
Promoting Normal
Urination
Maintaining normal voiding habits
Promoting fluid intake
Strengthening muscle tone
Assisting with toileting
planned patient goals
Produce sufficient quantity of urine to maintain fluid, electrolyte, and acid–base balance.
Empty bladder completely at regular intervals without discomfort.
Provide care for urinary diversion and know when to notify physician.
Develop plan to modify factors contributing to current or future urinary problems.
Correct unhealthy urinary habits.
what are some factors contributing to peeing?
Developmental considerations
Children (might have anurisis)
Elderly(decrease tone in bladder and pectoral nerve process)
Food and fluid intake(flush toxin out of the body)
Psychological variables (men being able to be up when peeing, do not stare at patient)
Activity and muscle tone
Pathologic conditions (diabetes would make you urinate more, kidney stones)
Medications
what are some diseases associated with renal problems?
Congenital urinary tract abnormalities Polycystic kidney disease Urinary tract infection Urinary calculi Hypertension Diabetes mellitus Gout Connective tissue disorders
Urine Specimens
Routine urinalysis Clean-catch or midstream specimens Sterile specimens from indwelling catheter Urine specimen from a urinary diversion 24-hour urine specimen Specimens from infants and children
