1. Urinary Elimination and Catheterization
Fundamentals of Nursing
B20

2. Factors Influencing Urination
Growth and development
Sociocultural factors
Psychological factors
Personal habits
Muscle tone
Volume status

3. Factors Influencing Urination
Disease conditions
Surgical procedures
Medications
Diagnostic Exams

4. Alterations in Urinary Elimination
Urinary Retention
Retention with overflow
Lower urinary tract infections
Urinary incontinence
Enuresis
Urinary diversions

5. Assessment Nursing History Physical exam Assessment of urine
Inspection
Palpation
Assessment of urine
Color
Clarity
Odor

6. 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

7. Assessment Diagnostic examinations Indirect visualization
Radiographic studies
Direct visualization
Cystoscopy
Cystouretoscopy

8. Nursing Diagnoses Impaired urinary elimination
Self-care deficit, tolieting
Risk for infection
Urinary retention
Urinary incontinence
Pain (acute or chronic)
Disturbed body image

9. Planning and Implementation
Promoting normal micturation
Normal position for voiding
Use sensory stimuli
Maintain elimination habits
Maintaining adequate fluid intake

10. 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

11. Catheterization Types of catheters Intermittent Indwelling Suprapubic
Condom

12. Indications for Catheterization
Relief of bladder distention
Sterile specimen
Measure residual
Long term management for incompetent bladders

13. 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

14. 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