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Module 2 > UNIT 4- Urinary Elimination > Flashcards

UNIT 4- Urinary Elimination Flashcards

1
Q

What is urinary catherization?

A
  1. The placement of a tube through the urethra into the bladder to drain the urine
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2
Q

How long can a patient have an indwelling catheter?

A
  1. May be short term (2 weeks or less) or long term (more than 1 month)
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3
Q

What is intermittent catheterization used to measure?

A

Is used to measure PVR (post void residual) when bladder scanner not available or to manage chronic urinary retention.

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4
Q

What are the appropriate indication for indwelling urethral catheters?

A
  1. Acute urinary retention or bladder outlet obstruction
  2. Need for accurate urine output measurements
  3. To assist in healing of open sacral or perineal wounds
  4. Prior to certain surgical procedures
  5. Patients requires prolonged immobilization
  6. To improve comfort for end of life care
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5
Q

What is the purpose of condom/external catheters/urine collection devices?

A

1.Safe and non invasive way to continue urine

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6
Q

What pre-application consideration should we have with condom/external catheters/urine collection devices?

A
  1. Requires a provider order
  2. Check for allergies and sensitivities
  3. Assess skin integrity
  4. Wash and dry well- non-emollient soap
    • retract foreskin (if applicable) and replace
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7
Q

True or false: You need to tape Condom catheters to secure them?

A

False

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8
Q

What does care look like for a condom catheters?

A
  1. Change daily
  2. Clean site
  3. Check tubing for patency
  4. Check skin for break down
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9
Q

What are the securement measures for an external catheter?

A
  1. Wash and dry well-non emollient soap
  2. Follow directions to secure
  3. Hang below bladder
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10
Q

How do you care for an external catheter?

A
  1. Empty when 1/2 full
  2. Change when device turns white (24-48)
  3. assess tubing for kinks and free flow
  4. Assess skin for breakdown
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11
Q

What should we know about a female external catheter?

A
  1. Urinary incontinence
  2. non-invasive, external device
  3. Clean procedure
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12
Q

What is the purpose of a pure wick?

A
  1. Wicks urine away from patient via suction into a designated collection canister (suction below 40)
  2. Replace 8-12 hours
  3. Assess skin at least every two hours for proper placement
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13
Q

What are contraindications for female external catheter?

A
  1. agitated, combative or uncooperative patients
  2. Frequent, lose stools
  3. Skin breakdown, or irritation
  4. Barrier cream-impedes suction
  5. Latex allergy
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14
Q

Things to consider/do for male urinary catheter placements?

A
  1. hold penis at 90 degree angle
  2. proceed slowly
  3. stop if you meet resistance, may be a spasm
  4. Wait and proceed unless increased pain
  5. Advance to bifurcation
  6. clean your patient
  7. hang bag below level of bladder
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15
Q

Things to consider/do for female urinary catheter placement?

A
  1. always need help
  2. don’t depend on lithotomy position
  3. very easy to contaminate with patients skin, gown, pubic hair
  4. hold onto catheter before inflation
  5. clean patient
  6. leave enough loop not to pull before securing
  7. hang bag below level of bladder
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16
Q

When should we be concerned if no urine is in catheter bag and what should we do?

A
  1. 2 hours
  2. Check for kinks, irrigate, increase fluids, bladder fullness
17
Q

What should we do if a patient experiences pain with balloon inflation?

A
  1. withdraw fluid back into syringe, advance catheter than inflate balloon
18
Q

What should we know about closed syringe irrigation?

A
  1. Sometimes need to irrigate catheter if large amount of mucous or hematoma
  2. Use room temperature, sterile solution to prevent cramping and discomfort
19
Q

What are the steps of discontinuing of indwelling catheter?

A
  1. preform peri care
  2. remove all water from balloon (double check)
  3. Gently remove catheter

post removal
- monitor voiding
- should void 4-8 hours
- may experience discomfort 1st void
- monitor s/s of UTI, especially 2-3 days after removal

20
Q

What are some monitoring considerations post removal of urinary catheter?

A
  1. assess for voiding within 6 hours removal
  2. If patient spontaneously voids within 6 hours but it is less than 200 mL, perform bladder scan. Initiate straight catheterization if post void residual (PVR) is greater than 200mL
  3. If patient spontaneously voids within 6 hours but is incontinent, perform bladder scan, straight catheterization if PVR is >200mL
  4. If patient has not voided within 6 hours after straight catheterization, notify hCP
21
Q

Using HOUDINI what are the criteria needed for a patient to keep urinary catheter in?

A
  1. H-Hematuria: gross or continuous bladder irrigation
  2. O- Obstruction: Urinary retention
  3. U- urologic: surgery or urology placed catheter
  4. D- Decubitus: To assist in healing of open sacral or perineal wounds in incontinent patients
  5. I- I&O: critical for patient management or hemodynamic instability needing hourly I & O’s
  6. N-Neurogenic: Bladder dysfunction or chronic indwelling catheter
  7. I- Immobilization: due to physical constraints (i.e., potentially unstable fracture, spinal, anesthesia, multiple traumatic injures) or improved patient comfort for end of life care
22
Q

What are the important peri care considerations when a patient has a urinary catheter?

A
  1. Hold on to the catheter to keep from pulling.
  2. Clean catheter from meatus down… NEVER UP
  3. Keep bag off floor and tubing downward from patient without kinks or loops
23
Q

What are the steps from collecting a urine sample from a urinary catheter?

A
  1. HH & Gloves
  2. Clamp tubing about 3” below sampling port to accumulate port
  3. Remove swab cap
  4. Scrum sampling port with alcohol prep 20 seconds and allow to dry
  5. Connect vacutainer to port
  6. Collect at least 3mL in first gray tube— shake VIGROUSLY
  7. Collect at least 7mL urine in second tube- tiger striped. invert 8-10 times
  8. remove vacutainer and replace with new swab cap
  9. label in patients room -place in lab bag for transport
  10. Remove gloves and hh

Module 2 (14 decks)

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