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 Assessment of urine Inspection Palpation Assessment of urine Color Clarity Odor

Assessment Laboratory tests Collect samples for analysis 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 output