![Page 1: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/1.jpg)
Unit B Nurse Aide Resident Care SkillsEssential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination, and urination needs. Indicator 6.02 Understand nurse aide skills needed to provide care for residents' elimination and urination needs.
Understand NAI skills needed to provide care for residents' elimination and urination needs.
Nursing Fundamentals 7243 16.02
![Page 2: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/2.jpg)
6.02
6.02 Introduction
Nursing Fundamentals 7243 2
Elimination is the process of expelling solid wastes made up of the waste products of food that are not absorbed into the cells of the body. Urination is the passage urine from the bladder to the outside of the body. Urine is made up of water and waste products filtered from the blood by the kidneys.
![Page 3: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/3.jpg)
6.02
6.02 Introduction
Nursing Fundamentals 7243 3
Residents often require assistance from the nurse aide in caring for elimination and urination needs. Reviews of the body systems involved assist the nurse aide in understand the importance of these excretory functions.
![Page 4: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/4.jpg)
There is intentional
repeat of some HSII course content in Nursing
Fundamentals.
Repeating course content distributes learning over time and increases long term memory.
Academic and skill competence must be maintained at a very high level for direct resident care.
Be GREEN. Recycle knowledge and build on it! Nursing Fundamentals 7243 46.02
![Page 5: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/5.jpg)
Digestive System
Nursing Fundamentals 7243 56.02
An excretory system
![Page 6: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/6.jpg)
Digestive System
• AKA gastrointestinal system
• Extends from mouth to anus
• Functions–Digestion–Absorption
Nursing Fundamentals 7243 66.02
![Page 7: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/7.jpg)
Digestive System - Structures
• Mouth
• Stomach – holds food until digestive juices chemically break it down into liquid chyme
Nursing Fundamentals 7243 76.02
![Page 8: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/8.jpg)
Digestive System - Structures
Nursing Fundamentals 7243 86.02
• Intestines – small intestine
• about 20 ft. long
• food digestion completed and nutrients absorbed into bloodstream
![Page 9: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/9.jpg)
Digestive System - Structures
Nursing Fundamentals 7243 96.02
• Intestines – large intestine
• 6 ft. long• absorbs water,
mineral salts and vitamins
• secretes mucus to aid in movement of feces
• has ability to add or remove water from feces
![Page 10: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/10.jpg)
Digestive System – Accessory Organs
Nursing Fundamentals 7243 106.02
– Liver – produces bile for breakdown of fats
– Gallbladder – stores bile produced by liver
– Pancreas - manufactures insulin and digestive enzymes
![Page 11: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/11.jpg)
Digestive System – Common Diseases
Nursing Fundamentals 7243 116.02
D Ulcer - a lesion or erosion of the lining of the stomach or small intestine
D Hepatitis – inflammation of the liverD Cirrhosis – chronic disease of liver
where scar tissue replaces liver tissueD Cholelithiasis - stones in the
gallbladder
![Page 12: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/12.jpg)
Digestive System – Common Diseases
Nursing Fundamentals 7243 126.02
D Pancreatitis – inflammation of the pancreas
D Cholecystitis – inflammation of the gallbladder
D Colitis – inflammatory disease of the colon
![Page 13: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/13.jpg)
Digestive System – Common Diseases
Nursing Fundamentals 7243 136.02
D Gastritis – inflammation of the stomach lining
D Enteritis – inflammation of the intestines
D Gastroenteritis - inflammation of the stomach lining and intestines
![Page 14: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/14.jpg)
Digestive System – Common Diseases
Nursing Fundamentals 7243 146.02
D Cancer - may occur anywhere along digestive tract
D Hernia – protrusion of organ through wall of cavity where it is normally contained
![Page 15: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/15.jpg)
Digestive System – Common Diseases
Nursing Fundamentals 7243 156.02
DDiverticulosis - chronic disease in which many diverticula (small blind pouches) form in the lining and wall of the colon
DDiverticulitis – inflammation of diverticula
![Page 16: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/16.jpg)
Digestive System – Common Diseases
Nursing Fundamentals 7243 166.02
D Diarrhea – watery bowel movementsD Constipation - difficulty in expelling
fecal material; incomplete or infrequent bowel movements- severe constipation leads to a FECAL IMPACTION
D Hemorrhoids - enlarged veins in anal area Care Point
![Page 17: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/17.jpg)
Digestive System – FECAL IMPACTION
Nursing Fundamentals 7243 176.02
![Page 18: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/18.jpg)
6.02 Nursing Fundamentals 7243 18
Be extra careful when inserting a thermometer, enema tip, or when cleaning the rectal area of a resident with hemorrhoids!
![Page 19: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/19.jpg)
Hemorrhoids
Nursing Fundamentals 7243 196.02
![Page 20: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/20.jpg)
Digestive System – Changes Due to Aging
Nursing Fundamentals 7243 206.02
• Loss of teeth and decreased number of taste buds• Decrease in amount of digestive enzymes and
saliva production• Difficulty chewing and swallowing• Altered taste and smell• Decreased appetite
![Page 21: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/21.jpg)
Digestive System – Changes Due to Aging
Nursing Fundamentals 7243 216.02
• Slower absorption of nutrients• Slowing of peristalsis causing
constipation• Loss of bowel muscle tone
![Page 22: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/22.jpg)
Digestive System – Observations
Nursing Fundamentals 7243 226.02
O Stool color and consistencyO Abdomen – flat or distendedO Date/time of last bowel
MmovementO Nausea and/or vomiting
![Page 23: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/23.jpg)
R Blood in emesis or stoolR Complaint of pain in stomachR Difficulty swallowingR Poor appetiteR Constipation and/or diarrhea6.02 Nursing Fundamentals 7243 23
![Page 24: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/24.jpg)
Digestive System – Bowel Retraining
Nursing Fundamentals 7243 246.02
Incontinence: Inability to control defecation
Embarrassing for resident
Uncomfortable
![Page 25: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/25.jpg)
Digestive System – Bowel Retraining
Nursing Fundamentals 7243 256.02
• Information collected: bowel pattern before
incontinence present bowel pattern dietary practices
• Plan developed to assist to return to normal elimination pattern and
• Recorded on care plan
![Page 26: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/26.jpg)
Digestive System – Bowel Retraining
Nursing Fundamentals 7243 266.02
• Participants in plan
–resident–family–all staff members
![Page 27: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/27.jpg)
Bowel Retraining - Guidelines
Nursing Fundamentals 7243 276.02
G Enemas may be ordered by physician and given by nurse aide, as directed by supervisor
G Regular, specific times to evacuate bowels established
G Fluids encouraged on regular basis
![Page 28: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/28.jpg)
Bowel Retraining - Guidelines
Nursing Fundamentals 7243 286.02
G High bulk foods given, (if not rrestricted)– fruits– vegetables– bread – bran cereals
![Page 29: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/29.jpg)
Bowel Retraining - Guidelines
Nursing Fundamentals 7243 296.02
G Bowel aids ordered by physician and administered by licensed nurse only:• laxatives• suppositories• stool softeners
G Regular exercise encouraged
![Page 30: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/30.jpg)
Nursing Fundamentals 7243 306.02
C Offer bedpan on set schedule
C Assist to bathroom when request is made
C Provide privacyC Display unhurried attitude
![Page 31: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/31.jpg)
Nursing Fundamentals 7243 316.02
C Offer warm drinkC Be patientC Encourage with positive
remarksC Do not scold when accidents
happen (this is verbal abuse) C Check on resident frequently
![Page 32: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/32.jpg)
Nursing Fundamentals 7243 326.02
Urinary System
An excretory system
![Page 33: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/33.jpg)
Urinary System - Structure
Nursing Fundamentals 7243 336.02
Kidneys:–Purplish brown, bean-
shaped organs
–Located at back of abdominal cavity
–Weighs 4-6 ounces each
![Page 34: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/34.jpg)
Urinary System - Structure
Nursing Fundamentals 7243 346.02
• Ureters - tubes that carry urine from kidneys to bladder
• Urinary bladder - muscular sac that expands to hold urine received from the kidney
• Urethra - tube extending from bladder to outside of body
![Page 35: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/35.jpg)
Urinary System - Functions
Nursing Fundamentals 7243 356.02
–Filters waste products from blood
–Produces urine
–Aids in maintenance of water balance
–Regulates acid-base balance of body
–Stores urine until passed from body
![Page 36: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/36.jpg)
Urinary System
Characteristics of Normal Urine
Nursing Fundamentals 7243 366.02
Pale yellow to amberClear (not cloudy)Acidic / pH 5.0 – 7.0Quantity (output)
1000-1500 ml. per day
![Page 37: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/37.jpg)
Urinary System
Common Disorders
Nursing Fundamentals 7243 376.02
• Nephritis - inflammation of kidney due to infection
• Cystitis - inflammation of urinary bladder due to infection
• Calculi – kidney or bladder stones
![Page 38: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/38.jpg)
Urinary System
Common Disorders
Nursing Fundamentals 7243 386.02
• Uremia - accumulation of urea in blood due to kidney disease
• Urethritis - inflammation of the urethra
![Page 39: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/39.jpg)
Urinary System
Common Disorders
Nursing Fundamentals 7243 396.02
• Kidney failure – decreased ability of kidney to filter waste products from the blood
• Urinary incontinence -inability to control urination
![Page 40: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/40.jpg)
Urinary System
Common Disorders
Nursing Fundamentals 7243 406.02
• UTI - Urinary Tract Infection• Retention - inability to
completely empty the bladder
• Hematuria - blood in the urine
![Page 41: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/41.jpg)
Urinary System
Affects of Aging
Nursing Fundamentals 7243 416.02
• Decreased kidney size• Decreased elasticity of ureters,
bladder and urethra• Decreased muscle tone• Diminished blood flow to
kidneys
![Page 42: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/42.jpg)
Urinary System
Affects of Aging
Nursing Fundamentals 7243 426.02
• Decreased ability of kidneys to concentrate urine
• Difficulty emptying urinary bladder
• Enlarged prostate in males which presses on urethra
![Page 43: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/43.jpg)
Elevated temperatureSugar and/or acetone in urine
(NAIIs may check blood sugar via finger stick)
Urine color other than clear, pale yellow
6.02 Nursing Fundamentals 7243 43
![Page 44: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/44.jpg)
6.02 Nursing Fundamentals 7243 44
Complaint of burning on urination
Incontinence Polyuria - excessive
amounts of urine per voiding
![Page 45: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/45.jpg)
6.02 Nursing Fundamentals 7243 45
Hematuria - blood in urine Nocturia – excessive urination at
night Urine having strong odor or cloudy
appearance Voiding small amounts of urine
frequently
![Page 46: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/46.jpg)
Urinary System
Bladder Retraining
Nursing Fundamentals 7243 466.02
• Plan developed to assist to return to normal voiding pattern
• Recorded on care plan• Staff must be consistent
and follow plan
![Page 47: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/47.jpg)
Urinary System
Bladder Retraining
Nursing Fundamentals 7243 476.02
• Individualized plan includes:–schedule that specifies
time and amount of fluids to be given
–schedule for attempting to void
![Page 48: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/48.jpg)
Urinary System
Bladder Retraining Guidelines
Nursing Fundamentals 7243 486.02
G Get resident’s cooperationG Record incontinent timesG Provide with opportunities to void:
• when resident awakens• one hour before meals• every two hours between meals• before going to bed• during night, as needed
![Page 49: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/49.jpg)
Urinary System
Bladder Retraining Guidelines
Nursing Fundamentals 7243 496.02
G Provide for comfortable voiding position
G Be supportive and sensitiveG Provide encouragementG Offer fluids according to schedule
![Page 50: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/50.jpg)
Urinary System
Bladder Retraining Guidelines
Nursing Fundamentals 7243 506.02
G Provide stimuli as needed:–run water in sink–pour water over
perineum–offer fluids to drink–place hands in warm
water
![Page 51: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/51.jpg)
Urinary System
Bladder Retraining Guidelines
Nursing Fundamentals 7243 516.02
G Provide good skin care to prevent skin breakdown
G Retraining may take 6-10 weeks– be patient– be supportive– ignore accidents– respect resident’s feelings
![Page 52: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/52.jpg)
Urinary System
Bladder Retraining Guidelines
Nursing Fundamentals 7243 526.02
Follow facility procedure for use of:
– incontinent pads– adult protective pants– incontinent briefs
![Page 53: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/53.jpg)
Indwelling Catheters
Nursing Fundamentals 7243 536.02
Balloons filled with fluid help prevent the catheter from slipping out of the bladder. Pulling on the catheter may damage soft
tissue if the inflated balloon is pulled.
![Page 54: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/54.jpg)
6.02 Nursing Fundamentals 7243 54
Hold the catheter securely near the meatus to prevent tugging while cleaning the indwelling catheter.
![Page 55: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/55.jpg)
Indwelling Catheters
Nursing Fundamentals 7243 556.02
Used to continuously drain urine from bladder
Inserted by licensed nurse or NA II after being ordered by physician
Attached to tubing that connects to urinary drainage bag
![Page 56: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/56.jpg)
Indwelling Catheters
Nursing Fundamentals 7243 566.02
When are they ordered?–Residents with nerve injury:
• following spinal cord injury• after stroke
–After surgery–Some incontinent residents
![Page 57: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/57.jpg)
Indwelling Catheters
Nursing Fundamentals 7243 576.02
Increased Risk of Urinary Tract Infections
–Urinary meatus and surrounding area must be kept clean
–Catheter care given at least daily and PRN
![Page 58: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/58.jpg)
Indwelling Catheters Guidelinesmaintain-drainage-bag-dependent-position.html
nih.gov/ccc/patient_education/pepubs/bladder/foley
Nursing Fundamentals 7243 586.02
G Never pull on catheterG Keep catheter tubing and
drainage tubing free of kinks, so that urine can flow freely
![Page 59: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/59.jpg)
Indwelling Catheters Guidelines
Nursing Fundamentals 7243 596.02
G Keep collection bag below bladderG Attach collection bags to bed frame,
never to side railG Never leave on floorG Follow facility policy for securing
catheter to resident’s leg without tension on catheter
![Page 60: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/60.jpg)
Indwelling Catheters Guidelines
Nursing Fundamentals 7243 606.02
G Never disconnect catheter from tubing to drainage bag
G When emptying urinary drainage bag, never touch drain with measuring container or graduate
![Page 61: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/61.jpg)
LeakageComplaints of painBurningNeed to urinate
6.02 Nursing Fundamentals 7243 61
![Page 62: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/62.jpg)
SwellingSkin irritationDiscoloration
6.02 Nursing Fundamentals 7243 62
![Page 63: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/63.jpg)
When measuring urinary output note color, odor and appearance of urine.
6.02 Nursing Fundamentals 7243 63
![Page 64: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/64.jpg)
Routine Urine Specimens
Nursing Fundamentals 7243 646.02
• Collected for laboratory study–Aids physician in diagnosis–Evaluates effectiveness of treatment
• Laboratory requisition slip completed and sent to laboratory with each specimen
![Page 65: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/65.jpg)
Routine Urine Specimens - Guidelines
Nursing Fundamentals 7243 656.02
G Wash hands carefully before and after collection of urine specimens
G Wear glovesG Collect specimen at appropriate
timeG Use proper container and do not
touch inside of lid or container
![Page 66: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/66.jpg)
Routine Urine Specimens - Guidelines
Nursing Fundamentals 7243 666.02
G Label container accurately and transport to laboratory as soon as possible
G Tell resident not to have bowel movement or discard tissue in bedpan when collecting urine specimen
![Page 67: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/67.jpg)
6.02 Nursing Fundamentals 7243 67
Other Types of Urine Collections
1. Clean Catch Urine Specimen2. 24-Hour Urine Collection3. Straining Urine for Stones
![Page 68: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/68.jpg)
Clean Catch Urine SpecimenAKA: Mid-Stream Specimen
Nursing Fundamentals 7243 686.02
Cleansing of perineum prior to collection of urine reduces number of microbes that may contaminate specimen
![Page 69: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/69.jpg)
Clean Catch Urine Specimen - Procedure
Nursing Fundamentals 7243 696.02
1. Follow standard precautions2. Assure resident’s perineum is cleaned
prior to collection3. Instruct resident to begins voiding into
appropriate receptacle and stop midstream
4. Place container in urine stream and collect specimen
![Page 70: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/70.jpg)
24-Hour Urine Collection
Nursing Fundamentals 7243 706.02
All urine voided in 24-hour period collected
Urine chilled on ice to prevent growth of microorganisms
Some tests may require preservativeUrine usually collected in dark
colored gallon jug
![Page 71: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/71.jpg)
24-Hour Urine Collection
Nursing Fundamentals 7243 716.02
Imperative that resident and staff understand procedure and exact time period for urine collection
![Page 72: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/72.jpg)
24-Hour Urine Collection - Procedure
Nursing Fundamentals 7243 726.02
1. Follow Standard Precautions 2. Begin test with resident’s bladder
empty 3. Discard first voiding4. Collect all voidings for next 24
hours 5. Restarted collection with new
gallon jug if test is interrupted
![Page 73: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/73.jpg)
Straining for Kidney Stones
Nursing Fundamentals 7243 736.02
![Page 74: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/74.jpg)
Condom Catheters
Description and Use
Nursing Fundamentals 7243 746.02
– External catheter used for incontinent men
– Made of soft rubber sheath that fits over penis with tubing connected to urinary drainage bag
– Ambulatory residents may prefer leg bags during day
– New condom catheter is applied daily
![Page 75: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/75.jpg)
Observe penis for reddened or open areas and report to supervisor prior to new condom being application.
6.02 Nursing Fundamentals 7243 75
![Page 76: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/76.jpg)
Nursing Fundamentals 7243 766.02
The Endocrine System
Endocrine glands secrete chemicals called hormones directly into the blood stream. Why discuss it?
![Page 77: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/77.jpg)
Nursing Fundamentals 7243 776.02
The Endocrine System
Endrocrine System
affects the function of
the
Urinary System
and other body functions
![Page 78: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/78.jpg)
Nursing Fundamentals 7243 786.02
Endocrine System - Function
Secretes hormones that regulate: growth and development,metabolism and reproduction, and the immune response.
![Page 79: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/79.jpg)
Nursing Fundamentals 7243 796.02
Diabetes Mellitus
The most common disorder of the endocrine system.
![Page 80: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/80.jpg)
Nursing Fundamentals 7243 806.02
Diabetes Mellitus
80% of diabetics over 40 years of age
Incidence increases as people age
5% of people over age 65 require treatment
![Page 81: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/81.jpg)
Nursing Fundamentals 7243 816.02
Diabetes Mellitus
USA has highest morbidity and mortality rates
Disorder of carbohydrate metabolism with decreased insulin production from pancreas
![Page 82: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/82.jpg)
Nursing Fundamentals 7243 826.02
Diabetes Mellitus Uncontrolled diabetes leads to
damage to eyes, kidneys, circulation Diabetes characterized by consistent,
elevated blood glucose levels requiring oral medication to stimulate pancreas or insulin injections
![Page 83: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/83.jpg)
Nursing Fundamentals 7243 836.02
Diabetes Mellitus
HypoglycemiaLW
Low blood sugar
![Page 84: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/84.jpg)
Nursing Fundamentals 7243 846.02
Diabetes Mellitus
Hyperlycemia
High blood sugar
lava
ted
![Page 85: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/85.jpg)
Endocrine System – Changes Due to Aging
Nursing Fundamentals 7243 856.02
• Decrease in thyroid, parathyroid, adrenal and sex hormone secretions
• Decreased glucose tolerance (Diabetes M)
• Multiple physical changes due to decrease of sex hormones
![Page 86: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/86.jpg)
Endocrine System – Observations
Nursing Fundamentals 7243 866.02
O Irritability & restlessnessO NervousnessO ConfusionO Weight lossO DiaphoresisO EdemaO Excessive thirstO Sweet, fruity odor to breath
![Page 87: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/87.jpg)
Endocrine System – Observations
Nursing Fundamentals 7243 876.02
O Complaint of headacheO DrowsinessO Rapid, weak pulseO Low blood pressureO Nausea or vomitingO Flushed, dry, hot skinO Excessive urination
![Page 88: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/88.jpg)
Observations previously listed must be reported
to the nurse.
6.02 Nursing Fundamentals 7243 88
![Page 89: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/89.jpg)
Endocrine system & diabetesHave we got it?
Let’s check and see
Stick diagnostics
Student Name A
Student Name B
Nursing Fundamentals 7243 896.02
![Page 90: Unit B Nurse Aide Resident Care Skills Essential Standard NA6.00 Understand nurse aide skills needed to provide for residents’ nutrition, hydration, elimination,](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649d965503460f94a7fbb2/html5/thumbnails/90.jpg)
Understand nurse aide skills needed to care for residents' elimination and
urination needs.
END
6.02
6.02 Nursing Fundamentals 7243 90