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Procedures Unit 3

NI, Caths & Irrigation

QuestionAnswer
Nursing Intervention Def Specific nursing activities or actions that a nurse must perform to prevent complications, provide comfort & promote, maintain & restore health
How to determine interventions (2) cause of problem; what can I do to fix problem
Guidelines for Intervention (8) Interventions to reduce or eliminate problem, look at goal, identify strengths, individualize nursing actions, be realistic, consistent therapies & utilize other resources, teach whenever possible, scientific rationale - reason, expected affect & hazards
When writing NI's (5) date, verb, subject, descriptive phrase, signature
Implementation (3) put plan into action, record everything, when doing intervention, reaccess to see if plan is working. *no less than 2 or 3 interventions for every goal*
Interpersonal communication methods/processes (4) reading, writing, speaking, listening
Social vs interpersonal social is equal exchange; interpersonal/therapeutic is patient centered - meets needs and is unequal return
3 steps involved in interpersonal communication listening, understanding, supporting
Goals for interpersonal communication (3) establish relationship, work w/ them, want to accomplish
Communication Process - 3 steps Perception (receiving), Evaluation (sensory reaches brain where its evaluated), Transmission (give response)
Methods for communication (2) verbal & nonverbal
Verbal def written or spoken, least reliable form - doesnt include emotions
nonverbal def not spoken or written - incorporates senses and emotions
Categories of nonverbal (senses)(5) Vocal, action, object, space (amount), touch
Ineffective styles of communication (5) giving advice, false reassurance, dont be judgmental or stereotypical, avoid being defensive,changing subject of conversation
Factors to improve communication(3) Communicate empathy (understanding feelings, listening and conveying feelings), Communicate respect (dont argue/make fun of),Communicate warmth
respect def belief in value and potential of person
Factors that encourage communication (6) Acknowledging, offering of self, open ended questions, reflecting/restating/phrasing, silence - good thing along w/ touch, listening
Summary in roles of communication (5) decrease pt anxiety, minimize nurses verbal participation, allow pts to express negative feelings, accepts pds of silence & remember nurses presnse can communicate alot more, dont talk down to pt
Cleveland Clinics Communication Technique (HEART) Hear story, Empathy, Apologize, Respond to problem, Thank pt
Catheters def & size long, slender, hollow tube used to w/drawl drain or inject fluid through a body opening - balloon inflats and thats how it stays in place available in 14,16,18 for normal adult
Catheterization def removal of urine from urinary bladder by inserting a tube through the urthera
Categories of caths (2) and their sub categories (2,5) Straight-robinson(no balloon),coude(curved tip used in pt w/enlarged prostate);Retention-foley (inflate balloon),3x lumin(for irrigating cath/continuous drainage),malecott(2-4wings,no balloon, nephrostomy in surgery) depezzer(surgery only cystomy), coude
potential complications for caths (3) 50% or more pts develop UTI's, become septic, avoid caths to avoid problems
Indwell cath complications (5) pain, bladder spasms, urtheral erotion, peri-uretheral absess, atrophy
Purposes for straight caths (4) obtain sterile urine specimen, measure residual urine (amt left in bladder after voiding),used in short term surgery, relieve bladder distension & provide gradual decompression of over-extended bladder
Purposes for Retention Caths (5) Keep incontinent pt dry, provide for continuous bladder irrigation, prevent urine from coming in contact w/ incision, spliint urethra after surgery, keep accurate measurement of output
Prep of Equipment for caths (3) need order - mostly PRN, if pt retaining urine, never w/drawl great than 1000ml - cause hypovolemic shock & puts pressure on nerves, check order for size - check for infection & C&S
Charting for cath care pt tolerance, color & amount; self pts can clean themselves w/clean gloves b/c its their own organisms
Different Aspects of Cath Care (3) Proper drainage, Protect against accidental dislodgment, Prevent infection
Removing Cath Need order to discontinue, make sure balloon size to ensure its all out - pull back on syringe to ensure all water out, empty bag & record output, afterwards can pts still void? - if greater than 8 hours then theres a problem
Irrigation def Flushing/washing out using a specified solution - taken out immediately
Bladder irrigation def When intro of fluid to bladder and its immediate removal
Bladder irrigation purposes (2) maintain patency of cath, treat bladder infection or inflammation by irrigating w/ a medicated solution
Different option for irrigation (3) open, closed, clamping with rubber band
Open irrigation def open system & separate from cath
Closed irrigation def Either continuous or intermittent, DR orders frequency; if intermittent temp close of line/bag - bladder irrigation - you need 200ml, irrigating cath - 30-50ml - remember to deduct & use syringe
Documentation of irrigation (3) what solution used, amount, pt response, returns - clear,mucus,blood?
Bladder instillation (3) Stays in place - ordered amount of time (usually 30-60 min), used in severe inflammation or infection, remember to deduct from output
Created by: breinard