Urine and Bowel Elimination Flashcards
(139 cards)
1
Q
What is micturition?
A
Means to urinate. It is a complex process involving the bladder, urinary sphincters, and CNS
2
Q
How does the brain respond to the urge to urinate?
A
CNS sends message and external sphincter relaxes and bladder empties
3
Q
When does voiding happen?
A
When bladder contraction and urethral sphincter and pelvic floor muscles are used.
4
Q
How does the brain play a role in Micturition?
A
Impulses from the brain respond or ignore the urge
5
Q
What are the factors influencing urinary elimination?
A
-Growth and development- 18 to 24 months control, PT STARTS
-Sociocultural factors- personal habits, need for privacy
-Psychological Factors
- Personal habits
- Fluid intake
-Pathological conditions-DM, MS, spinal cord, stroke, dementia, affect CNS and how to interpret the signal
-Surgical procedures- trauma, Abdominal surgery, postop- urinary retention. Meds that affect UR- diuretics.
-Diagnostic Exam- urinary catheterization
6
Q
What are decreased urinary changes in older adults?
A
- Amount of nephrons
-bladder muscle tone
-bladder capacity
-Time between initial desire to void and urgent need to void
7
Q
What are increased urinary changes in older adults?
A
-bladder irritability
-bladder contractions during bladder filling
- risk of uriary incontinence
8
Q
What are three common urinary elim problems?
A
- Urinary Retention
- UTI
- Urinary Incontinence
9
Q
What is urinary retention?
A
Inability to partially or completely empty the bladder
10
Q
Can urinary retention be acute or chronic?
A
Yes.
acute- postop and post labor.
chronic- slow onset, decrease in voiding volume and straining to void over time. Frequency problems, incontinence, or sensations of incomplete emptying
11
Q
How do we diagnose urinary retention?
A
Post- void residual (PVR)
Bladder scan via ultrasound (Indep nursing intervention)
- also can do an INO cath can also be used.
12
Q
What type of incontinence is considered with urinary retention?
A
Overflow INCONTINENCE
13
Q
What is the most common cause of UTI?
A
E. Coli
14
Q
UTI can be located?
A
Anywhere along the urinary tract is in an infection
15
Q
Bacteria can be present but not always…
A
cause an UTI, will monitor for symptoms
16
Q
Who is at risk for UTI?
A
- indwelling cath patients
-any instrument in the urinary tract
-urinary retention
-incontinence
-poor perineal hygiene - females
- frequent sexual intercourse
-uncircumcised patients
17
Q
Do elderly patients normally present with typically UTI symptoms?
A
Not always, sometimes neurological or from a fall.
18
Q
CAUTI infection
A
- major risk of development
-costly for hospital
-can be reasonably prevented-good peri care
-focus on early recognition and treatment
-keep sterile on insert
19
Q
What is urinary incontinence?
A
involuntary loss of urine
20
Q
What are the types of urinary incontinence?
A
urgency (older adult- timing), stress (women- laughing, cough, sneeze) and overflow (bladder too full).
often multifactorial
21
Q
What are the incontinent risk factors?
A
- women and elderly
-Obesity
-Multiple pregnancies/ vaginal births
-Neurological disorders: Parkinson’s, CVA, spinal cord injury, MS
-Medication therapy: diuretics, opioids, anticholinergics, calcium channel blockers, sedatives/hypnotics
-Confusion
-Dementia
-Immobility
-Depression
Wendy and Ed, obesity pregnant nerves : medication, confusion, immobility and depression
22
Q
Assessment know how to address…
A
assess abdomen, kidneys, genitalia, urethal meatus, peri area
23
Q
Assessment considerations…
A
-Assess understanding and expectations of treatment
-Be professional
-Assess ability to perform necessary behaviors associated with voiding
-Assess for any culture or personal considerations
-Past medical & surgical history Medication use
-Normal bowel & urinary elimination
patterns
-Sleep, activity, & nutrition
24
Q
Assessment: What is the history of the patient with urination? (Pattern of Urination)
A
- Frequency and times of voiding
-Normal amount with each void
-History of recent changes
25
What are Symptoms of urinary alterations?
-Urgency
- Dysuria
- Frequency
-Hesitancy
- Polyuria
-Oliguria
-Nocturia
-Dribbling
-Hematuria
-Retention
26
Upper UTI can turn into what kind of infection ?
kidney (pyelonephritis) will see costovertebral tenderness- assess by palpitation over the kidney area.
27
How do you do an assessment of urine?
1. Intake and output
- Evaluates bladder emptying
- Renal function
-Fluid & electrolyte balance
-Can be an HCP order or nursing judgement
-Normal urine output >30 mls/hr
- Concerned if < 30 mls/hr for 2 hours*
2. Characteristics of urine
* Color
* Clarity
* Odor
28
Color of urine
Color
- Normal
* Pale straw color to amber- depends on concentration
-Abnormal
* Hematuria
* Color changes
29
clarity of urine
Clarity
-Normal- transparent at first void
-Urine that sits- cloudy
-Thick and cloudy- bacteria and WBCs
- Early morning void-can appear this way as well since it sat in bladder all night
30
Oder of urine
Normal
- Odorless
-Ammonia smell
- Abnormal- Offensive- May indicate UTI
- Some foods change odor- Fruity- acetone
31
How do we measure urine?
with a catheter.
Urometer- more detailed measurement.
30 mL is normal for every 1 hour
Normally change bag every 4-8 hours.
If patient is Independent..
- use male or female urinal
-speci- hat in the toilet
32
Urine testing
- label the correct way! know how to collect the specimen.
-Send as soon as you receive unless it is a timed test
-Know if you need a preservative or not
33
What is an urinalysis?
To test for a UTI
34
What does the nurse need to know about urinalysis?
- must be fresh urine
-Collect during normal voiding, indwelling catheter, or urinary diversion
- Must have freshly voided urine
-Cannot take urine from catheter bag
-Possibly use Reagent strips
35
urinalysis chart
Appearance & Color= Clear, amber, yellow=Bacteria, certain foods, blood, medications,hydration status
Odor= Aromatic= infection
pH 4.6-8.0 =Alkaline- loss of acid. Acidotic=urine that sits for hours, sleep.
Protein Up to 8mg/100ml = Sensitive indicator of kidney function
Glucose= Negative= Diabetes Mellitus (DM)
Ketones=Negative DM= Dehydration, starvation
Excessive aspirin ingestion
Specific Gravity 1.005-1.030
High= reflects concentrated dehydration
Low- overhydration
RBC= Up to 2= Damage to glomeruli, trauma, catheter
trauma
WBC= 0-4 = Inflammation or infection
Bacteria =Negative= Possible UTI
Leukocyte esterase= Negative= Possible UTI
Casts= Negative= Indicate renal disease
Crystals= Negative= Indicate increased risk of renal calculi
36
Culture and Sensitivity
Can obtain from:
* Clean-voided or clean-catch/mid-stream urine specimen
* Urinary catheter
* Urinary diversion
* Send to lab within 30 minutes
* Preliminary report should be available within 24 hours
* Must use STERILE specimen cup
-Obtained to determine presence of pathogenic bacteria
-Important to test the sensitivity of any growing bacteria to various antibiotics
-Should obtain before any antibiotic administration
-To save money culture only done if urinalysis suggest infection
37
what is an abdominal Xray-KUB?
-Determines size, shape, symmetry, location of structures of the urinary tract
-Common Uses:
-Detect & measure urinary calculi
-NO Special Preparation
38
Nursing Problems r/t Urinary Elimination
*Impaired Urinary Elimination
*Urinary Retention
*Incontinence
* Functional urinary
* Overflow urinary
* Reflex urinary
* Stress urinary
* Urge urinary
*Impaired Comfort or Pain
*Impaired Skin Integrity or Risk for impaired skin integrity
*Knowledge Deficit
*Body Image Disturbance
*Risk for Infection
39
Health promotion and patient education
Promote self-care practices
Maintain normal routine
Promote healthy nutrition and fluid intake
Things to avoid:
◦ Constipation
◦ Smoking
Strengthen pelvic floor muscles
Men: Be vigilant about your prostate health
Report any changes in urinary tract
40
Maintaining Adequate Fluid Intake
2300 mls/day - if renal function is
ok, no heart disease & no need for fluid restriction
Helps flush solutes to limit bladder irritability
If fluid intake needs increased:
◦ Schedule times to drink
◦ Identify fluid preferences
◦ High fluid foods (fruits)
◦ Stop drinking about 2 hours before
bedtime to prevent nocturia
41
Urinary Retention: Nursing Care
Assess & monitor urine output
Assess for bladder distention
Assist patients to normal position for urination
Run water or flush commode
Apply cold compress to abdomen
Encourage double voiding
If bladder does not empty fully, try around the clock voiding
Using the crede method is not recommended unless approved
by HCP
Intermittent catheterization or catheterization
42
Preventing Infection..
-Follow hospital protocol
-Assess for s/s of infection
-Perform perineal hygiene
-Void at regular intervals
-Adequate fluid intake
-Female considerations
43
Incontinence Care
-Be respectful of patient’s feelings
-Pelvic floor muscle training
-Lifestyle changes
-Bladder retraining
-Toileting schedule
-Intermittent catheterization
-Meticulous skin care
-Absorbent pads & catheters
44
incontinence care continued
electrical Stimulation
There are meds that can help – example = anticholinergics
Interventional Therapies:
◦ Bulking material injections
◦ Botox
◦ Nerve stimulators
Surgery:
◦ Sling
◦ Bladder neck suspension
◦ Prolapse surgery
◦ Artificial urinary sphincter
45
Meticulous Skin Care, what do you do?
Do’s:
◦ Identify & treat early
◦ Use skin risk assessment tools
◦ Use appropriate skin barrier products
◦ Ensure adequate hydration
◦ Consult WOCN if needed
46
Meticulous skin care, what do you not do?
DO NOT:
Use traditional soap & water
◦ Double padding the bed
◦ Leave soiled pads
47
What are the Types of catheters to use?
Single lumen
Indwelling catheter
3-way/ 3 lumen
Coude tip
◦ Curved rounded- prostate
Suprapubic External Catheters
Suprapubic -placed in the bladder
through abdominal wall
◦ Sutured in place
◦ Used when blockage of urethra
or when indwelling catheter causes irritation
External catheters
◦ Males: condom cath
◦ Females: Purewick
48
Nursing care: cath, What does the nurse do?
-Regular perineal care (Peri-Care)
-Provide catheter care or baths per hospital protocol
-Secure catheter to prevent movement or pulling
-Empty drainage bags when ½ full
-Ensure no kinks in catheter tubing & below bladder
-Do not allow catheter drainage bag to touch the floor
-Maintain a closed drainage system
-Accurate monitoring of output
-Timely removal
49
Before cath insertion...
Peri-care
◦ Females- front to back
◦ Males- uncircumcised
Can delegate to nursing assistant or patient
CHG or castile wipes
50
Post- Catheter Removal
Patient should void within 6-8
hours post-removal
Monitor ability to void and empty
Measure accurate urine output
Patient educational
◦ First voids can cause discomfort
51
Factors Influencing Bowel Elimination
-Age
-Diet
-Fluid Intake
-Physical Activity- be more active
-Psychological Factors
-Personal Habits
-Positioning During Defecation
-Pain
-Pregnancy Surgery & Anesthesia Medications -Diagnostic Tests
52
Older adult care focus
Trouble chewing
* Esophageal emptying slows
* Impaired absorption
* Weakened sphincters
* Decreased
* Hydrochloric acid
* Absorption of vitamins
* Peristalsis
* Sensation to defecate
* Lipase to aid in fat digestion
53
common bowel elimination problems
Constipation
Impaction
Diarrhea
Bowel Incontinence
Flatulence
Hemorrhoids
54
constipation, What is it?
-Constipation is a symptom- not a disease
-Having fewer than 3 bowel movements a week*
- hard dry stools
-can very from person to person
55
Symptoms of constipation
Symptoms
* Infrequent BMs
* Discomfort
* Hard, dry stools= difficult to pass
56
Causes of constipation?
irregular bowel habits
* Improper diet- fiber
* Reduced fluid intake
* Lack of exercise
* Stress
* Certain medications
* Advanced age
* Ignoring the urge to defecate- creates more problems
* GI disorders
57
Older adults and constipation
Lack of muscle tone (bowel & abdomen)
* Slowed peristalsis
* Lack of exercise
* Inadequate fluid intake
* Too many dairy products
* Lack of fiber
* Medications
58
Complications of constipation
Hemorrhoids
Anal fissure
Fecal impaction
Rectal prolapse
59
Prevent Constipation
include plenty of high-fiber foods
-Drink plenty of fluids
-Stay active
-Manage Stress
-Don’t ignore urge to go
-Create a schedule
60
Types of Laxatives & Cathartics
1. Bulk Forming- can be taking consistently (only one)
* Methylcellulose (Citrucel)
* Pysllium (Metamucil)
* Polycarbophil (Fibercon)
2. Emollient or Wetting
* Docusate Sodium (Colace, Doss)
3. Osmotic
* Saline- based
* Magnesium Citrate
* Magnesium
Hydroxide (Milk of Magnesia)
* Sodium Phosphate (Fleet Phospho-Soda)
* Polyethylene
Glycol (Miralax)
* Lactulose
4. Stimulant Cathartics
* Bisacodyl (Dulcolax)
* Senna (Ex-Lax, Senokot)
other meds do not give/ take routinely
61
implementation: Cathartics & Laxative
Medications that initiate or facilitate stool passage
- Available PO or Rectal (Suppositories) form
- Short-term action
- May be used to cleanse the bowel for a GI dx test, procedure or surgery
- Teaching Point: Potential harmful effects if overuse
- Classification of laxatives based on the way it promotes defecation
62
Nursing care- Enema
How do you give an enema? 10:30 on powerpoint
Verify Order
- Gather Equipment
- Position- side sims
- Patient Teaching
-Administration of Enema
-If patient c/o cramping/pain- slow rate by lowering height of bag
-If abdomen rigid- STOP
63
enema Precautions/Complications
Fluid & electrolyte imbalance
Tissue trauma
Vagal nerve stimulation
Abdominal pain/cramping
Pain
Perforation
64
What is impacation?
Results from unrelieved constipation
and the inability to expel the
hardened feces retained in the rectum
- If not resolved - intestinal obstruction
- Individuals most at risk
- Debilitated
- Confused
- Unconscious
- Perform digital examination of the
rectum
65
Symptoms of impaction
Inability to pass stool for several days despite repeated urge to defecate
Continuous oozing of liquid stool Loss of appetite N/V
Abdominal distention
Cramping
Rectal pain
66
Nursing Interventions: Digital Removal of Stool
Assess
Digital Removal of Stool
Nurse uses finger to break up fecal mass and removes it in sections
VERY PAINFUL
Risks involved
67
What is diarrhea?
Diarrhea
- Can happen frequently and with urgency
Loose watery bowel movements
68
Causes of Diarrhea
Foodborne pathogens
- Food intolerances & allergies
-Surgery
-Diagnostic Testing
-Enteral Feeding
69
Common complications of diarrhea
Skin irritation
-Dehydration
-Nutritional concerns
70
Antidiarrheal Agents
Decrease intestinal muscle tone to slow the passage of feces
- Body absorbs more water
- Must determine cause of diarrhea
-Examples: loperamide or diphenoxylate w/ atropine
-Antidiarrheal agents with opiates
- Use with caution b/c habit forming
71
Nursing Care: Diarrhea
identify the problem & eliminate
- Provide soft easily digestible food
- Doesn’t mean to place on clear liquids
- Maintain fluid & electrolyte balance
-Prevent spread - practice good hand hygiene
72
nursing Interventions: Management of Fecal Incontinence & Diarrhea
- Meticulous Skin Care
- Prevention & Monitoring for
Dehydration
-Fecal Management Systems
73
Nursing Interventions: Maintenance of Skin
Integrity
-Meticulous skin care
-Frequent Checks
- Apply skin barrier
-Consult WOCN
74
C-DIFF, what is it and who is at risk?
Health-care associated infection -leads to diarrhea
-Who is at risk?
- Antibiotics
-Elderly
- Immunocompromised
-Long term care facility
-GI procedure
-Previous C. diff
75
C. diff, what are the complications?
Complications
- Dehydration
-Kidney failure
- Toxic megacolon
- Bowel perforation
- Death
Prevention
-Wash hands w/soap & water
- Avoid unnecessary use of
antibiotics
- Clean surfaces with
BLEACH
- Place in isolation – Contact D or SPORE
76
C. Diff Diagnosis & Treatment
Treatment
- Hospital Protocols
- Stool sample
Diagnosis
- Plenty of fluids & good nutrition
-Antibiotics
- Surgery
- Fecal implantation
- probiotics
77
What is Bowel incontience?
Inability to control passage of feces and gas from the anus
78
What are the causes of bowel incontinence?
Muscle or nerve damage
- Any physical condition that impairs the anal sphincter function
- Constipation or diarrhea
- Large volume of stools
- Surgery
- Rectal prolapse
79
Bowel Incontinence Risk Factors
Risk Factors
* Age
* Female
* Nerve Damage
* Dementia
* Physical disability
A female never demands physical disability
80
Complications of Bowel Incontinence
Complications
* Body image
disturbance
* Skin Irritation
81
Prevention of Bowel Incontinence?
-Reduce constipation
-Control diarrhea
-Avoid straining
82
Treatment of bowel incontinence
Antidiarrheals and Bulk laxatives
83
Symptoms of Flatulence
-Abdominal distention
- Cramping
-Bloating
- Pain
84
Causes of Flatulence?
Causes
- Constipation
- Food intolerance
- GI diseases
- Stress
85
Nursing care: Flatuence
-Avoid foods that cause gas
-Eat small, more frequent meals
Eat & drink slowly
86
What are hemorrhoids?
Dilated or engorged veins in lining of rectum
-Causes of hemorrhoids
-Increased venous pressure from straining
- External or internal
-Treatment- sitz bath
87
Colon Cancer risk Factors and Warning Signs
Race: African Americans
- Diet: High intake of red meat
or processed meats, low fiber
-Obesity
-50+
-Lack physical activity
-Alcohol, tobacco use
-Family history
- History of inflammatory bowel
disease
88
Screenings for CC
patients at average risk and asymptomatic start
screening at ge 45
Scope:
Flex Sig - q. 5 years
Colonoscopy- q. 10 years
Scan Q. 5 every years
Stool Sample
FOBT q 1 yr
FIT q 1 yr
DNA q 3 yrs
89
Assessment: Nursing History for Bowels
- Determine usual elimination pattern
- Description of stool
-How does individual defecate
-Dietary and fluid intake
-History of GI disorders or surgeries
- Medication history
-Emotional state
- Activity & mobility
90
Assessment: Fecal Characteristic
Amount
Color
Odor
Consistency
Frequency
Shape
Constituents
91
Physical Assessment
Mouth
Abdomen:
- Inspection
- Auscultation
- Percussion
- Palpation
Rectum
92
Lab Tests
No blood tests for most GI disorders
-If blood is detected in stool- order H&H
- Fecal Specimens
- Know how to collect
- Correctly label & send to lab immediately
-Types of test
- Fecal Occult Blood Test (FOBT)
- Culture & sensitivity
- DNA
-Fats
- WBC
- Ova & Parasites (O&P)
93
Fecal Occult Blood Test (FOBT)
Check for hidden blood
Ordered to detect cancer or evaluate
possible causes of unexplained anemia
Stool sample should be from 2 different areas
Often ordered for 3 different occurrences
Be aware of false positives
94
Nursing Problems Associated with Bowel Elimination Issues
Constipation
* Chronic Functional Constipation
* Risk for Constipation
* Risk for Functional Constipation
* Diarrhea
* Risk for Electrolyte Imbalance
* Deficient Fluid Volume or Risk for
* Dysfunctional Gastrointestinal Motility or Risk for
* Bowel Incontinence
* Nausea
* Risk for Impaired Skin Integrity
* Disturbed Body Image
* Deficient Knowledge
95
Goal & Outcome
Goal:Patient will have normal bowel elimination pattern
When developing the goal, consider the
patient as a whole
* Ask yourself how long will it take my patient to reach this goal?
Outcome:
Ask yourself what will the patient demonstrate to prove their bowel elimination pattern is normal?
96
implementation: Health Promotion
Promoting normal defecation
Promoting regular exercise
Promoting well balanced diet
97
Nursing Interventions: Inserting & Maintaining a NG Tube
- Purpose of NG Tubes
-Decompression -keeping things OUT of the stomach
-Enteral feeding or medication
-Administration
-Lavage
98
Assessment of NG tube
Abdominal
- Respiratory
- Nose/skin
- Tube
- Suction
99
Nursing care of NG Tube
Verify HCP
orders
-Assessment
-Verify Placement
- Know how to
hook to suction
-Administration
of feeding &
medications
-Recording I&Os
100
Bowel Training
Patients with chronic constipation or
fecal incontinence
Set up daily routin
Requires time, patience & consistency
Program Includes:
-Assessment & documentation
-Choosing patient-centered time
-Offer fluids to stimulate defecation around normal time
- Assistance in using commode
- Provide privacy
*-Normal exercise regimen
101
Diet Considerations
Well balanced diet- Whole grains, legumes, fresh fruits & vegetables
Fiber intake varies per individual-Take fiber, must increase fluid intake
102
Older Adult considerations..
Encourage screening
Adequate fiber intake
Adequate fluid intake
Regular exercise program
Older adults are less able to compensate from fluid loss from diarrhea
103
What is a colostomy?
a surgical operation in which a piece of the colon is diverted to an artificial opening in the abdominal wall so as to bypass a damaged part of the colon.
104
What is an ileostomy?
a surgical operation in which a piece of the ileum is diverted to an artificial opening in the abdominal wall.
105
What is Ileus?
Ileus means that the intestines are not moving correctly and cannot push food through the digestive system. Surgery is a common cause of ileus, but medications, cystic fibrosis, other health issues, injuries, and infections can also cause the condition.
106
what is peristalsis?
the involuntary constriction and relaxation of the muscles of the intestine or another canal, creating wave-like movements that push the contents of the canal forward.
107
What is a polyp?
A colon polyp is a small clump of cells that forms on the lining of the colon. Most colon polyps are harmless.
108
What is a stoma?
stoma is an opening on the abdomen that can be connected to either your digestive or urinary system to allow waste (urine or faeces) to be let out
109
What is bacteremia?
refers to viable bacteria in the blood.
110
What is bacteriuria?
the presence of bacteria in the urine
111
What is cystitis?
inflammation of the bladder.
112
What is dysuria?
you feel pain or a burning sensation when you pee (urinate).
113
What is hematuria?
Blood in urine
114
What is Nephrostromy?
A nephrostomy tube is put in to drain the urine directly from your kidney.
115
What is proteinuria?
High level of protein in the urine
116
What is pyelonephritis?
a type of urinary tract infection where one or both kidneys become infected
117
What is an ureterostomy?
A ureterostomy is a surgery to create a urinary diversion (a change in the path by which urine leaves the body).
118
How to do a focus assessment on the abdomen?
Inspect contour, symmetry, umbilicus, skin, pulsation, and demeanor
Auscultate bowel sounds in all four quadrants. (Listen in 3 areas/quadrant) Describe
Auscultate over aorta for vascular sounds. Use bell of stethoscope. Report findings
Percuss in all 4 quadrants (Percuss in 3 areas/quadrant) Describe
Palpate all 4 quadrants lightly for tenderness and rigidity, and deeper for tenderness and masses. Report findings
119
How to insert a foley?
Student Resource Checklist
120
What is missing?
- NOTES FROM THE BOOK
- INFORMATION TO PULL FORWARD FROM LAB
-STUDY GUIDE Lecture
121
How do you care for someone with a cath?
Peri care
122
How do you care for a patient with an enema?
123
What are some common problems of constipation in the in patient population?
Immobility
Drugs
anesthesia
age
124
Do you use laxatives daily?
No. Fiber is used daily. Bulk forming med is only able to use daily.
125
With constipation we might need to consider what?
dehydration and electrolytes
126
Bowel Elimination:Nursing Care of Older Adults
Encourage screening
-Adequate fiber intake
-Adequate fluid intake
-Regular exercise program
-Older adults are less able to compensate from fluid loss from diarrhea
127
GI Distress...what’s next?
Cues:
- Bowel sounds,
distention, bowel
habits/patterns
128
NG wall to low wall suction
Low suction is 80 or less
Normal above 80
129
How do you measure a NG tube?
Nose, ear, and xphoid process
130
How do you secure a NG tube?
tape to nose
131
NG tube assessment
Bowel sounds and gas. what other assessments?
132
How to give meds through an NG tube?
Stop suction.
confirm placement
check ph of aspirate
give meds
Don't turn suction back on
133
Two I& O on the exam
134
What are independent nursing interventions you can do for a patient with incontinence?
Skin integrity
peri care
moisture barriers
cath is an option but more as last resort
pure wicks
male condom caths
bowel and bladder training
135
Nursing Interventions: Maintenance of Skin Integrity
Meticulous skin care
Frequent Checks
Apply skin barrier
Consult WOCN
136
Process of doing an I&O CATH
Inserted long enough to drain bladder- then removed
-Use a new catheter each time!
-Usually done every 4-6 hours
137
How to prevent infections with a cath?
Below the bladder
- Off the floor
- Don’t kink tubing/sleeping
- Wash hands when touching
- Placement - Sterile technique
138
You are caring for a 39-year-old male s/p status post) back surgery who feels the urge to void but has not been able to since surgery 6 hours ago. He received 800 mls of intravenous fluids (IVFs) in the Operating Room (OR). He received a clear liquid tray and finished 100%.
What should you do?
Abdominal assessment
Bladder scan
Ask the patient if they have to pee.
139
What is Oliguria?
Small amounts of urine
