Exam (elaborations)
NUR 1022C Fundamentals Final Review/ NUR-1022C Fundamentals Final Review; Complete Answered (all)
NUR 1022C Fundamentals Final Review/ NUR-1022C Fundamentals Final Review; Complete Answered (all)
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Keiser University> NUR 1022C Fundamentals FinalReview/ NUR-1022C Fundamentals Final Review;
Complete Answered (all)
Discuss factors that influence urinary elimination. - ANSWER Brain structures,
physiological factors, psychosocial conditions (anxiety, stress, privacy) , and
diagnostic or treatment- induced factors (medication/medical procedures),
sociocultural factors, fluid balance
Describe types of urinary elimination complications - ANSWER common urinary
problems involve the inability to store urine or fully empty urine from the bladder.
Problems can result from infection, an irritable or overreactive bladder, obstruction of
urine flow, impaired bladder contractibility, or issues that impair innervation to the
bladder, resulting in sensory or motor dysfunction.
Discuss indications for catheter usage - ANSWER -obtaining sterile specimen
(intermittent straight cath)
-hourly monitoring
-inability to void
-surgical procedures
-instillations of medications into the bladder
Identifying nursing care for patients with urinary catheters - ANSWER - keep meatus
free of secretions/encrustations
-pericare and cleansing first 4 inches of catheter (every 8 hrs or less)
- After defecation
-some agencies use chlorhexidine wipes
RN Assessment
- COCA
- Assess Urethral meatus and catheter
-Assess patient for signs and symptoms of infection which include fever, chills,
burning, flank pain, back pain, blood in urine, mental status change
-Assess patient's knowledge for catheter care
Discuss health promotion patient education for healthy bladder function - ANSWER
-limit caffeine
-avoid drinking 2 hours before bedtime
-practice good voiding habits
- every 3-4 hours while awake, proper positioning
-empty completely
- keep bowels regular
-prevent UTI
-stop smoking
, Discuss diagnostics used to identify the presence of urinary elimination
complications - ANSWER -Urinalysis
-Urine culture and sensitivity
- KUB
-Computerized tomography
-Intravenous pyelogram
-Ultrasound
-Cytoscopy
Urinary retention (diagnostics) - ANSWER Characterized by a distended abdomen,
reports of pressure, restlessness, No Urinary output or scant for hours
- use bladder scanner to measure post void residual
urinary tract infection (UTI) - ANSWER Assessment
UTIs are characterized by location and have signs and symptoms of infection.
Symptomatic infections of the bladder can lead to a serious upper UTI
(pyelonephritis) and life threatening bloodstream infection (bacteremia or urosepsis)
and should be treated with antibiotics.
Symptoms of a lower UTI (bladder) can include burning, pain with urination (dysuria),
irritation of the bladder (cystitis) characterized by urgency, frequency, incontinence,
or suprapubic tenderness, and foul smelling cloudy urine.
Elderly people with infections/UTIs experience nonspecific symptoms such as
delirium, confusion, fatigue, loss of appetite, decline in function, mental status
changes, incontinence, falls, or subnormal temperature
Interventions- patient teaching- fluids, void at regular intervals, women wipe front to
back, avoid tight clothing and bubble baths
CAUTI - ANSWER UTIs account for 40% of infections acquired by acute care
hospitals. Major risk factors for CAUTIs are indwelling catheters and their length of
use.
Prevention:
training and education of HCPs and increasing awareness of basic infection control,
knowledge of optimal hand hygiene practices and methods for handling indwelling
catheter and urine collecting systems appropriately, securing catheters properly, and
maintaining unobstructed urine flow and closed drainage system using sterile
technique properly
-Do not allow any obstruction of urine flow
-urine bag below level of bladder
-urine bag never touches the ground
- Empty urine bag when 1/2 full, clean tip with alcohol
-perform perineal and catheter care
- insertion using aseptic technique
-avoid dependent loops in urinary drainage tubing
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