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Urinary Elimination and Catheterization
Fundamentals of Nursing
B20
Factors Influencing Urination
• Growth and development
• Sociocultural factors
• Psychological factors
• Personal habits
• Muscle tone
• Volume status
Factors Influencing Urination
• Disease conditions
• Surgical procedures
• Medications
• Diagnostic Exams
Alterations in Urinary Elimination
• Urinary Retention
• Retention with overflow
• Lower urinary tract infections
• Urinary incontinence
• Enuresis
• Urinary diversions
Assessment
• Nursing History• Physical exam
Inspection Palpation
• Assessment of urine Color Clarity Odor
Assessment
• Laboratory tests Urinalysis Culture and sensitivity
• Collect samples for analysis Midstream UA 24 hour timed collection Aspirated urine sample Random specimen Double voided specimen
Assessment
• Diagnostic examinations Indirect visualization
• Radiographic studies
Direct visualization• Cystoscopy
• Cystouretoscopy
Nursing Diagnoses
• Impaired urinary elimination• Self-care deficit, tolieting• Risk for infection• Urinary retention• Urinary incontinence• Pain (acute or chronic)• Disturbed body image
Planning and Implementation
• Promoting normal micturation Normal position for voiding Use sensory stimuli Maintain elimination habits Maintaining adequate fluid intake
Planning and Implementation
• Promoting complete bladder emptying and control bladder emptying Kegel exercises Medications
• Anticholinergics- decrease bladder irritation
• Cholinergics- increase bladders ability to contract
Bladder retraining Catheterization
Catheterization
• Types of catheters Intermittent Indwelling Suprapubic Condom
Indications for Catheterization
• Relief of bladder distention
• Sterile specimen
• Measure residual
• Long term management for incompetent bladders
Key Points When Inserting a Catheter
• Check doctor’s orders
• Appropriate size
• Sterile technique
• Ensure catheter is in bladder
• Proper care to prevent UTIs Nursing measures w/ drainage system Proper peri care for clients with indwelling
Removal of an Indwelling Catheter
• Don’t cut balloon tip• Remove inflation solution with syringe• Check label on catheter for solution quantity• Connect syringe and ensure complete removal of
solution before withdrawing• Ask client to take a deep breath, let it out, and
remove catheter.• Measure urine in drainage bag and record as
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