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

output