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55 Cards in this Set
- Front
- Back
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How can urinary infection be prevented or reduce for a patient with an indwelling catherter?
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• Following good hand hygiene techniques
• Not allowing the spigot on the drainage bag to touch a contaminated surface • Not opening the drainage system at connection points to obtain specimens or measure urine • Wiping the ends of the tube with antiseptic solution, if reconnection is necessary • Having a separate receptacle to measure urine for each patient • Not raising the drainage bag above the level of the bladder • Not allowing any dependent loops of tubing • Draining all urine from tubing into bag before the patient exercises or ambulates • Avoiding prolonged clamping or kinking of the tubing • Emptying the drainage bag at least every 8 hours • Removing the catheter as soon as possible upon health care provider order • Securing the catheter in place • Performing routine perineal hygiene every 8-hour shift and after defecation |
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In Urodynamics
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Fasting is not required before the test
Patients will be cathterized during the procedure |
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Urgency
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Feeling the need to void immediately
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Hematuria
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presence of blood in the urine
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Oliguria
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Diminished urinary output in relation to fluid intake
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Retention
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Accumulation of urine in the bladder because of inability to to empty bladder completely
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Nocturia
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Urination particularly excessive at night
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Frequency
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Voiding very often
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Dysuria
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Painful or difficulty urinating
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Residual urine
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Volume of urine remaining in the bladder after voiding
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Hesitancy
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difficulty in initiating urination
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Polyuria
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Voiding large amount of urine
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Noninvasive procedures for examination of urinary function include:
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abdominal roentgenogram (radiograph of kidneys, ureters, and bladder [KUB]), intravenous pyelogram (IVP), renal scan, and computed tomography (CT).
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what are the indication of for the use of intermittent and indwelling urinary catheterization
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immediate relief of bladder distention
long-term management of patients with incompetent bladders sterile urine specimen collection assessment of residual urine, and instillation of medication. Indwelling catheters are used for urinary outflow obstructions, patients having surgery of the urinary tract or surrounding structures, prevention of obstruction from blood clots, accurate monitoring of I&O and prevention of skin breakdown in critically ill or comatose patients, and provision of bladder irrigations |
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What positions may a be used for cathterization of a female patient?
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A female patient may be placed in the lithotomy or Sims’ position for catheterization.
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what is the recommended daily fluid intake for dilution of urine , promotion of micturition, and flushing of the urethra of microorganism
What is the minimum urinary output for an adult per hour? |
200mL to 2500mL
Minimum output per hour is 30mL |
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How can Sociocultural factor influence urination?
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Privacy needs for urination and schedule expectations (e.g., intermissions/recesses)
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How can Fluid intake influence urinatio?:
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Fluid intake: Increased intake will increase output (if fluid/electrolyte balance exists); alcohol, caffeine, and foods with high fluid content promote urination
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How can Pathological condition influence urination?
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Diabetes mellitus and multiple sclerosis cause neuropathies that alter bladder function, Arthritis and joint diseases interfere with activity,
Renal disease influences amount and characteristics of urine, Fevers reduce urinary output, Spinal cord injuries disrupt voluntary bladder emptying |
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Stress incontinence
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The type of urinary that results from increased intra-abdominal pressure with leakage of a small amount of urine
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Treatment of Stress incontinence
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Treatment for stress incontinence may include conditioning (Kegel) exercises, estrogen replacement, alpha-adrenergic agonists, intravaginal electrical stimulation, bladder neck suspension surgery, an artificial sphincter, or penile clamp.
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What is the priority when managing a patient's condom catheter?
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The condom catheter should be changed every day, with the skin checked for signs of irritation and breakdown. Perineal care is provided with each catheter change. The tubing must be checked frequently to ensure that there are no kinks or other obstructions.
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To maintain the patient’s dignity AND self-esteem when assisting with urinary elimination, the nurse should:
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Provide comfort, privacy, time, access, and appropriate positioning
Provide gender-congruent care Recognize cultural practices Explain procedures |
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Manual compression of the bladder is
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Crede's Method
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Correct statements For urinary diversion
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A transureterostomy connects the ureters and repositions one ureter through the abdominal wall
Continent divertions have pouches created to store urine |
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Identify the methods a nurse may implement to stimulate a patient to void:
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The nurse should :
Run water near the patient, Place the patient’s hand in warm water, or Stroke the inner thigh of a female patient. |
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To assist the patient to strengthen the pelvic floor muscles the nurse teaches the patient
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Kegel exercises.
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Identify distance of cathter insertion:
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Female adult patient: 2 to 3 inches (5 to 7.5 cm)
Male adult patient: 7 to 9 inches (17.5 to 22.5 cm) |
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Appropriate techniques for indwelling catheter care
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Keep the drainage bag below the level of the bladder
Avoid having any dependent loops of tubing Drain all urine in the bag before patient ambulate or excercise |
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To prevent nocturia, the nurse instructs the patient to:
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Avoid drinking fluids at least 2 hours before bedtime. If the patient is taking a diuretic, the medication should be given early in the day.
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Identify how the mobility status of and older adult may influence urination
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An older adult may need to have an assistive device for ambulation to the bathroom, such as a walker.
There may also be difficulty in removing clothes or getting on and off of the toilet. |
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Correct statements for Urodynamic Testing
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Fasting is not required before the procedure
Patients wil be catheterized during the procedure |
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Correct statements regarding cystoscopy
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The procedure may be performed under general anesthesia
Antibiotics are often administer intravenously Bed rest is usually indicated immediately after the test Bloody or cloudy urine may be observed after the test Fluid is encourage after the test is complteted |
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How can Urinary tract infections may be prevented in patients with indwelling catheters?
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•Following good hand hygiene techniques
•Not allowing the spigot on the drainage bag to touch a contaminated surface •Not opening the drainage system at connection points to obtain specimens or measure urine •Wiping the ends of the tube with antiseptic solution, if reconnection is necessary •Having a separate receptacle to measure urine for each patient •Not raising the drainage bag above the level of the bladder •Not allowing any dependent loops of tubing •Draining all urine from tubing into bag before the patient exercises or ambulates •Avoiding prolonged clamping or kinking of the tubing •Emptying the drainage bag at least every 8 hours •Removing the catheter as soon as possible upon health care provider order •Securing the catheter in place •Performing routine perineal hygiene every 8-hour shift and after defecation |
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For patience with Diabetes the nurse anticipate that the patience will experince
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Polyuria
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stress incontinece is associted with :
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coughing and sneezing
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A patient with prostate enlargement will have
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Bladder distention
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Reflex incontinence
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involuntary loss of urine occurring at somwwhat predictable interval when the patient reaches specific bladder volume
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CAUSES of Reflex incontinenece
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upper spinal cord injury
Disease involving areas above reflex arc Blocking cerebral awareness Lower spianal cord injury blocking reflex arc |
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SYMPTOMS of Relex incontinence
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Lack of awareness of bladder filling,
No urge to void Uninhibited bladder contraction or spasm at regular intervals |
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What is Toatal incontinence
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Total uncontrollable and continous loss of urine
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CAUSES of Total incontinence
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Nueropathy of sensory nerves
Trauma or disease to the spinal nerves or urethral sphincter |
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SYMPTOMS of Total incontinenece
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Constant flow of urine unpredictable times
Nocturia Lack of awareness of bladder filling or incontinence |
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What is FUNCTIONAL incontinence
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Involuntary unpredctable passage of urine in patient who has a mental or physical disability and intact urinary and nervous systems
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Causes of Functional Incontinence
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Fistula between bladder and vagina
Change in environment Sensory, cognitive, or mobility deficits |
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Symptoms of Functional incontinence
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Strong urge to void with loss of urine before reaching appropriate receptacle
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Treatment of FUNCTIONAL incontinence
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Toileting program/bladder training
Environment alterations |
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STRESS INCONTINENCE
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Increase intraabdominal pressure causing leakage of small amount of urine
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Cause of Stress Incontinence
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Coughing, laughing, vomiting, or lifting with full bladder
Obesity Inconprtent bladder outlet Weak pelvic musculature |
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Symptoms of Stress incontinence
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Dribbling of urine with increased intraabdominal pressure
Urinary urgency Frequency |
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Treatment of Stress Incontinence
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Conditionaing (KEGEL) Exercises
Estrogen replacement, Alpha-adrenergic agonists, Intravaginal electrical stimulation, Bladder neck suspension surgery, an artificial sphincter, or penile clamp. |
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What is URGE incontinence
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Involuntary passage of urine after strong sense of urgency to void
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What is the Causes of Urge incontinence
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Decreased bladder capacity
Irritation of bladder stretch receptors Alcohol or caffeine ingestion Increase fluid intake Intestinal cystitis |
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Symptoms of Urge inconitnence
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Urinary urgency
Abdomal frequency (more often than every 2 hours) Bladder contracture or spasm Nocturia Voiding in small (less than 100mL) or in Large (more than 550mL) amount |
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Treatment of Urge incontinence
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Anticholinergic drug therapy
Biofeeding Tx of associate UTI Tx of associate vaginitis or intestinal cystitis Diet modification to minimize bladder irritants |
