Reasons for Urinary Catheterization
- monitor output
- keep bladder empty
- monitor critically ill
- mechanical obstruction: swelling, childbirth, prostatitis, prolapsed uterus
- relieve urinary retention
- epidural anesthesia
- obtain specimen
normal bladder function
- frequently empties
- acidic environment (antibacterial advantages): defense mechanism
how are indwelling catheters designed
with a ballon that inflate after insertion to keep it from coming out
2 types of drainage bags
-
considerations about lower urinary tract
- bladder is sterile
- bladder infection can ascend to kidneys
- external opening to the urethra can never be sterilized
- kidney infection(pyelonephritis) can be serious
Catheter associated urinary tract infactions
- catheterization should be avoided
- catheters should be removes asap
- duration of catheter is biggest risk for UTI
types of catheter
- intermittent/ straight catheter
- self cauterization
- indwelling catheters/ foley
- indwelling with irrigation
- suprapubic catheters
male and female positions for catheterization
- female: dorsal recumbent
- male: supine
- side lying/sim/later: for patient with limited hip/knee movement
factors to consider for urinary catheterization
- patient positions
- privacy and comfort
- catheter graded on French scale according to lumen size: range for adults 14Fr- 20Fr
Catheter size
- 14-20Fr for adults
- 16Fr most common
- 18Fr can increase erosion of the bladder neck and urethral mucosa and cause formation fo strictures
whenshould you seek help during urinary catheterization
-if patient is experiencing pain with Foley catheter
bacteriuria
bacteria in the urine, asymptomatic condition
irrigating a close system: procedure
- irrigate through part
- solution: room temp, 18G needle, instill 30-60 slowly
- subtract irritant from U/O
2 types of irrigation
- intermittent
- continuous
urinary diversion: ileal conduit
Type fo incontinent cutaneous urinary diversion. that involves a surgical resection of the small intestine which transplantation of the ureter to an isolated segment for the small bowel.-ureters are attached to a section of ileum
- ileum is separated for small bowel and Brought to abdominal wall
- incontient
- stoma
cutaneous ureterostomy
-second type of incontinent cutaneous diversion where the ureters are directed though the abdominal wall and attached to a n opening in the skin
continent urinary reservoir
ureters are diverted into a segment of ileum and cecum in an Indiana pouch
-this s a surgical alternative that uses a section of the intestines to create an internal reserves that hold urine, with the creation of a ctheterizatiobale stoma. The external stoma must be catharized at regular intervals to drain urine
continent urinary reservoir
ureters are diverted into a segment of ileum and cecum in an Indiana pouch
-this s a surgical alternative that uses a section of the intestines to create an internal reserves that hold urine, with the creation of a ctheterizatiobale stoma. The external stoma must be catharized at regular intervals to drain urine
ostomy
surgically formed opening from inside an organ to the outside
stoma
the part of the stony that is attached to the skin and is formed by suturing the muscosa to the skin
ileostomy
allows fecal content from the ileum of the small intestine to be eliminate through the stoma
-can be temporary
colostomy
permits formed stool in the colon to exit though the stoma
Colostomy and Ileostomy care:
- stoma assessment: inspect regularly, color, moisture, size
- peristomal skin
- general assessment: monitor peristalsis and I&O
- patient teaching
Changing ostomy bag
-keep skin around peristomal area clean and dry: avoid candida or yeast infection
