Nursing

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  • Topic: Urinary bladder, Urethra, Urinary catheterization
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  • Published : March 4, 2013
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The University of the West Indies
Faculty of Medical Sciences
The UWI School of Nursing, Mona
Year II Semester II
BScN

Catheterizing the Female Urinary Bladder

Overview:
Urinary Catheterization is the introduction of a catheter through the urethra into the bladder for the purpose of withdrawing urine.

Purpose of the Urinary Catheterization is to
1. Prevent or relieve bladder distension
2. Promote urinary elimination
3. Obtain a sterile specimen of Urine
4. Obtain accurate measurements of bladder function
5. Provide continuous urinary drainage
6. Instil medication
7. Measure the amount of residual urine
8. Monitor the output of a critically ill patient
9. Facilitate studies of the urinary system
10. Prevent skin breakdown in incontinent bedridden patients.

Equipment:
• Sterile Catheter kit that contains:
o Sterile Gloves
o Sterile Drapes (fenestrated)
o Cotton balls or Gauze
o Forceps
o Medium size receiver/kidney basin
o Receiver
• Basin with soap and water (For perineal care)
o Wash cloth
o Disposable gloves
• Sterile Catheter (Appropriate size Catheter)
• Additional pack of cotton balls
• 20cc syringe with sterile needle
• Antiseptic lotion (sterile savlon 1:200 for swabbing) • Urine collecting bag
• Sterile water base lubricant
• Water to inflate the balloon
• Waterproof disposable pad
• Hand sanitizer
• Tape
• Sterile specimen container

Assessment
1. Assess the patient’s normal elimination habits
2. Assess patient’s ability to understand information and to cooperate 3. Assess for patency of the urethra and for contraindication for insertion of the catheter. 4. Assess for latex allergy

Nursing Diagnosis
1. Impaired Urinary Elimination
2. Urinary Incontinence
3. Risk for Infection
4. Risk for Impaired skin integrity
5. Risk for Injury

Outcome Identification and Planning
Expected outcomes may include:
• Patient’s urinary elimination will be maintained, with urine output of at least 30ml/hr • Patient’s bladder will not be distended.
• Patient’s skin remains clean, dry, and intact, without evidence of irritation or breakdown. • Patient verbalizes an understanding of the purpose for and care of the catheter, as appropriate.

Patient Goal:
To insert the catheter with sterile technique, results in immediate urine flow and to relieve the bladder.

Implementation

| Action |Evidence-Based Rationale | |Wash hands |Hand washing/Hand hygiene reduce the risk of spreading micro-organisms. | |Assemble the equipment |To prevent unnecessary trip to storage and saves time. | |Identify the patient. |Identifying the patient ensures that the right patient receives the right | | |intervention and helps prevent errors. | |Explain procedure and rationale to patient |It promotes reassurance and provides knowledge about the procedure. | |Close curtain around the bed |Provide privacy to the patient | |Provide good light |Proper lighting is necessary to visualize the urinary meatus | |Place patient in dorsal recumbent position |Proper positioning allows adequate visualization of the urinary meatus | |Place absorbent pad under patient’s buttocks...
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