Urinary Vocabulary
Puss in urine
What questions do you want to ask about the urinary system?
Pain, burning, straining, hesitancy, urgency, dribbling, the number of times they go to the bathroom, past urinary problems, medications, nocturia.
What are some methods/devices to help urinary elimination?
Indwelling catheters, Intermittent catheters, external catheters, suprapubic catheters, and urinary diversion
Why would we irrigate an intermittent catheter?
To prevent/relieve an obstruction. This can be done continuously (CBI) or intermittently (With a syringe)
Why would an external catheter be used over an indwelling/intermittent catheter?
They reduce the risk of CAUTI's and they're non invasive
Polyuria
Excessive urine output
What does COCA stand for? When would we use this acronym?
Color, odor, consistency, amount.
When examining urinary output
What are the catheter size ranges for adults, adolescents, and infants?
Adult: 12-16F
Adolescents: 8-14F
Infants: 5-8F
The larger the number, the larger the diameter
What do you know about indwelling catheters?
These are placed for continuous drainage. A balloon is inflated to maintain the foley placement (5-10mL of water. The foley packaging will tell you how many to administer) There are 2-3 lumens.
2: One drains the urine from the bladder, the other is to inflate the balloon
3: One drains the urine from the bladder, one inflates the balloon for continuous placement, and one irrigates the foley.
What do you know about suprapubic catheters?
Surgically inserted above the pubic area into the bladder. These are used when there is a blockage in the urethra and may be temporary or permanent depending on the obstruction.
Anuria
Less than 50mL of urine output in 24 hours.
What does Nocturia stand for?
Awakening in the night to urinate
What is a coude catheter? Who are they usually used for?
Catheters with a curved tip to follow the natural curve of the urethra. Usually used for males with enlarged prostate glands.
True or False: Intermittent catheters stay in place
False. They're inserted for a short period to empty the bladder and then are removed.
How do you collect an indwelling urinary specimen
Clamp the tube below the port, clean the port, draw up 3-5mL from the sterile syringe, transfer into sterile specimen cup, label the cup, unclamp the tubing.
Oliguria
Decreased urine output. Less than 400mL in 24 hours
What objective data would we want to collect for a urinary system assessment?
Vital signs and weight (what does weight measure?), abdomen (urinary retention symptoms), urethral meatus (odor, discharge, inflammation), skin integrity, hydration status, I/O's, urine characteristics (COCA),
When should you empty an indwelling catheter bag?
When it is 1/2- 2/3 full
What are intermittent catheters used for?
For urine retention and sterile specimen collection
Patient education after removing urinary catheter
A slight burning sensation with first urination is normal, dribbling is normal for the first few days, you should be able to void 6 hours after catheter removal and the output should be measured and assessed, monitor for the s/sx of infection/UTI: Fever, polyuria, dysuria, cloudy urine, etc.
Frequency VS Urgency
Frequency: Increased incidence of voiding
Urgency: Strong desire to void
Dysuria
Discomfort/pain while voiding.
What are some considerations to keep in mind when a patient has an indwelling catheter bag?
Peri care should be provided per facility policy and after each BM. Keep the bag below the patient's bladder. Assess the tubing to verify that it's not kinked or coiled. Provide slack. Never let the bag touch the floor. Irrigate the catheter as ordered.
What are we at risk for when using catheters? Why?
CAUTI's- Catheter-associated urinary tract infections
We're opening up that passageway to allow microorganisms to enter.
Explain how you would remove an indwelling catheter
1. Empty collection bag
2. Allow the balloon to deflate before removing the catheter
3. Provide peri-care after removal
4. Document removal and patient tolerance