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Nursing Skills
Test 5 - Elimination/Bladder
| Question | Answer |
|---|---|
| Placement of tube in bladder to remove urine | Urinary Catherization |
| What steps do you take to determine if a urinary cath is needed? (4) | Obtain sterile specimen, check for PVR, verify that client is unable to void independently and or retain urine, obtain precise measurement of urinary output |
| the process of flushing the bladder with normal saline to prevent or treat clot formation. | Bladder irrigation |
| Used to irrigate bladder on scheduled basis or to obtain urine specimen | Straight catheter |
| Type of tip on end of urinary catheter used for men with large prostates and usually put in my a doctor | Coude tip |
| Continuous use catheters | Indwelling, Retention, Foley catheters |
| Type of catheter used for men with large prostates to help keep them from clotting | Three way indwelling for CBI |
| Catheter goes right into bladder and avoids urethra | Suprapubic catheter |
| Measurement device attached to a catheter drainage bag | Urimeter |
| What FR is used for peds up to 3, 4-8, 8-12? | 5-8, 8-10, 12-14 |
| What size balloon for indwelling is used with peds? | 3-5cc |
| What FR is used for adults? | 16-Dec |
| What size balloon is used for indwelling with adults? | 5-10 cc |
| What FR is used for CBI? | 16-18 FR triple lumen |
| What size balloon is used for indwelling with CBI? | 30cc |
| How do you know what the FR size is for an in dwelling catheter? | It should be on the MD order |
| What four types of materials are catheters made of? | Rubber, plastic, silastic, Teflon |
| The bladder is normally a _____ cavity | Sterile |
| Can the urethral meatus be sterilized? | No |
| What causes UTIs | Pathogens introduced into the bladder |
| What causes kidney infections? | When microbes ascend the ureter |
| What helps the bladder maintain a sterile environment? | Defense mechanisms |
| What three things make an individual more susceptible to a UTI? | Stress, disease, injury |
| What are signs/symptoms of a UTI? (13) | Dysuria, bladder spasm, burning pain when voiding, urinary urgency/frequency, cloudy urine; urine may have sediment, be blood tinged &/or have foul smell, fever, flank pain, tenderness over posterior CVA, (s/sx of nephritis) |
| How can a nurse prevent a UTI in a urinary cath patient? | Maintain strict sterile technique when inserting or irrigating a catheter |
| What are measures taken to avoid obstruction of urine flow for patient with in dwelling catheter? (4) | Make sure line is patent, check for outflow, check for I and O, make sure not kinked |
| What are measures taken to avoid backflow of urine for patient with indwelling catheter? | Keep bag below bladder |
| What are measures taken r/t urine PH for patient with in dwelling catheter? | Keep urine pH at 5.5 or under |
| How often is peri care performed? | Regularly |
| How much of catheter is cleaned during per care and in what direction is it cleaned? | 6” – 8” moving from the meatus downward |
| What things get documented? (7) | Reason for cath, color/clarity/amount of urine return, type and size of catheter used and placed, client response to procedure |
| What additional two things get documented for an indwelling catheter? | Balloon size, initiate I and O |
| What are two situations that would necessitate intermittent bladder irrigation | To remove blockage from in-dwelling catheter tip or tubing, to instill medication |
| What is a situation that would necessitate constant bladder irrigation? | To keep bladder free of clots and sediment |
| What does CBI stand for | Constant Bladder Irrigation |
| What supplies do you need for CBI?(4) | Use solutions per MD order, need stable IV pole, solution warmer prn, pt should have 3-way Foley with 30 cc balloon |
| What is the procedure for CBI? | Prime CBI tubing (use aseptic technique), Connect tubing to in-flow port on catheter (be sure to ID CORRECT port!), Adjust flow rate per MD order |
| Document | |
| What are possible areas of contamination during CBI? | Soluton bag port or tubing tip when “spiking” bag, Contamination of tubing tip or catheter end when hooking tubing to catheter, with ANY break of an “in-line” system urinary drainage system, you risk contamination / introducing microbes |
| What are possible areas of contamination during intermittent drainage? | On “closed drainage system” - Failure to disinfect aspiration port, contamination of needle used to instill NaCl flush or medication |
| Where is a Suprapubic catheter inserted? | Through abdominal wall, into bladder (above symphysis pubis) |
| Suprapubic catheters are usually inserted in the OR. True/False | TRUE |
| Suprapubic catheters can be done outside of the OR if________________, | Using sterile technique and a special kit |
| What is an example of when a Suprapubic catheter would be placed? | s/p GU or GYN procedure when perineum is too swollen to allow voiding via urethra |
| When maintaining a new Suprapubic catheter, what is completed as a part of the assessment | A visual inspection, note if the catheter is patent |
| How do you cleanse a Suprapubic catheter? | Circ. motion, start at cath insert. site & continue in outward circles for 2-3”. With fresh gauze, cleanse base of catheter, moving proximal to distal. With sterile gloved hand, apply drain dressing) and tape. Coil extra tubing & tape. |
| What supplies are needed to remove an in-dwelling catheter? | Syringe, waterproof pad, clean gloves |
| Is it normal for patient to feel a burning sensation as catheter is removed? | Yes |
| When removing an indwelling catheter, connect the hub of syringe to ________ and _____________. | Inflation valve and allow plunger to expand |
| What is a way that you can verify that the balloon is fully deflated? | Aspirate |
| Is there ever a situation where you would cut the port to deflate the balloon? | No |
| What do you do with the catheter once removed? | Wrap in waterproof pad and measure remaining output |
| After removing the catheter, urine should be monitored for what? (3) | PVR or urinary retention, have patient void urine in a hat |
| What are bladder scanners used for? | Assessing urinary retention |
| What specifically do bladder scanners measure | Post Void Residual (PVR) |
| What are benefits of using a bladder scanner?(2) | Noninvasive, accurate |
| A surgical technique for the diversion of urine after a patient has had their bladder removed. Ureters are surgically resected from the bladder and end result is to drain the urine into a detached section of ileum. | Ileal Conduit |
| is a surgical procedure performed to provide an alternate pathway to release urine from the body when there is functional or anatomical abnormalities to the lower urinary tract. | Continent Urinary Diversion |
| An individual should be able to void within how many hours after removal of a urinary drainage bag | Four to Six |
| What is the normal amount of urine produced an hr? | 30 mL |
| After voiding, PVR should be less than | 100 |
| What signs would an elderly person with a UTI exhibit? (2) | Change in behavior, confusion |
Created by:
anastasia158
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