question

What are some reasons a patient might need a catheter?

answer

1. patient unable to void (not incontinence) 2. output monitoring 3. sometimes to keep open wounds and ulcers clean

question

Which catheter is used for one time use and removed immediately after the insertion and drainage of urine?

answer

Straight Catheter

question

Which catheter is used short-term and provide a closed drainage system for urine?

answer

Indwelling catheters

question

Which catheter is most commonly used postoperatively because they have multiple lumens to allow for the drainage of urine, irrigation of the bladder, and instillation of medications into the bladder?

answer

Retention catheter

question

Which catheter is used for patients who have prostatic hyperplasia (enlargement)?

answer

Coude catheters ( curved tip to allow for easier insertion)

question

Which catheter is placed through a surgical opening in the abdomen rather than through the urethra?

answer

Suprapubic catheters

question

A nurse can insert all but which catheter type?

answer

Suprapubic catheter

question

A urine assessment includes?

answer

Color, odor, presence of sediment or blood, and amount

question

When must catheter care be performed?

answer

A minimum of every 8 hours

question

In the perineal area of a female patient, a nurse should always use which method to clean?

answer

A front-to-back cleansing method, Cleanse the external genitalia (labia majora) and the internal genitalia (labia minora, urethra opening, and vaginal canal opening)

question

Appropriate cleansing method for male patients?

answer

Circular motion from the center outward starting at the meatus near the catheter

question

Suprapubic catheters should be cleansed with what solution?

answer

Half strength hydrogen peroxide to reduce the risk of infection

question

What are some adverse effects of prolonged catheter use?

answer

UTI, Falls, mechanical injuries, prolonged hospital stays, and death

question

A nurse is likely to receive an order for urinary catheterization of a newly admitted patient who: A) has a persist UTI B) has urge incontinence C) is in the ICU for GI bleed D) is incontinent due to cognitive decline

answer

C. Precise measurement of urinary output is crucial for managing fluid balance in patients who are critically ill

question

A nurse is assessing a patients indwelling cath drainage at the end of the shift and notes the ouput is considerably less than the fluid intake. Which of the following actions should the nurse take first after checking for kinks? A) Irrigate the cath B) Assess for peripheral edema C) Palpate for bladder distention D) Milk the cath

answer

D. Output that is less than intake is a sign that the cath is blocked. First action is to milk the tubing by squeezing then relwasing the drainage tube

question

Which of the following actions should a nurse take when removing a patients indwelling cath? A) Pull the cath out as quick as possible B) Deflate the balloon completely before removal C) Make sure the patient has voided within 12 hr post removal D) Tell the patient to expect to feel a tugging sensation on removal

answer

B. If any inflation solution remains in the balloon, trauma to the urethral canal is likely with removal of the cath

question

A nurse is planning on obtaining a urinary specimen from a patients closed urinary system. Identify the sequence of steps: 1) Insert a 10 ml syringe/needle into the port 2) Transfer the urine to a sterile specimen container 3) Withdraw 5 ml of urine 4) Wipe the port with an alcohol swab 5) Transport the specimen to the lab

answer

Sequence is 41325

question

A nurse who is preparing to insert a straight cath for a male patient should: A) grasp the penis at its base B) apply light traction to the penis C) hold the penis parallel to the patients body D) lift the penis to a 45 degree angle to the patients body

answer

B. Lifting the penis to a position perpendicular to the body while applying light traction straightens the urethral canal to facilitate cath insertion

question

A nurse is applying a condom cath for an older adult patients who is uncircumcised. Which of the following is an approp step in the procedure? A) Stretching the cath along the length of the penis B) Securing the cath with adhesive tape C) Leaving a space between the penis and catheters tip D) Repositioning the foreskin after application

answer

C. A space of 2.5 to 5cm should be left between the tip of the penis and the end of the catheter.

question

A nurse is preparing to insert an indwelling urinary cath for a female patient. When beginning the insertion procedure, the nurse should instruct the patient to: A) bear down B) take deep breaths C) sip water D) hold her breath

answer

A. Bearing down as if to void relaxes the external sphincter and aids in the insertion procedure.

question

When providing perineal care for a female patient who has an indwelling cath, which of the following areas should the nurse cleanse last? A) The urethral meatus B) The labia minora C) The perineum D) The anus

answer

D. The anus

question

anuria

answer

absence of urinary production or excretion

question

autonomic dysreflexia

answer

a condition of exaggerated reflexes typically occurring as a result of spinal cord injury

question

balloon

answer

a compartment of a device such as a urinary catheter that, when positioned inside a cavity or hollow organ such as the bladder and then inflated, prevents accidental dislodgement of the catheter from that organ

question

bladder

answer

a membranous muscular sac, as in urinary bladder, the sac that stores urine prior to excretion

question

bladder spasms

answer

contractions, possibly painful, of the musculature of the urinary bladder

question

catheter

answer

a flexible tube passed into the body to remove or instill fluids or to keep a passageway open

question

coude catheter

answer

a type of curved-tip urinary catheter used for intermittent removal of urine from the bladder

question

dialysis

answer

a technique by which fluids and molecules pass through a semi-permeable membrane via osmosis, most often referring to the removal of waste products from the blood of a patient with renal failure

question

Perineal care involves...

answer

cleansing around the catheter, the patient's genitalia, and the anus.

question

The only type of catheter that does not warrant a drainage system is

answer

a straight catheter because you'll drain the urine from this type of catheter directly into a basin or other container.

question

The kidneys are located...

answer

in the retroperitoneal space just below the ribcage on the back, the external landmark for the kidneys is known as the costovertebral angle

question

distention

answer

the state of being stretched out or enlarged

question

diuresis

answer

excessive production or excretion of urine

question

dribbling

answer

involuntary leakage of small amounts, as of urine from the urethra

question

Foley catheter

answer

a common type of indwelling urinary catheter

question

French

answer

a measurement unit of the French scale, a system indicating the size of the outer diameter of a catheter or other tube or device, with each unit of the scale approximately equivalent to one third of a millimeter

question

hematuria

answer

blood in the urine

question

hesitancy

answer

difficulty starting urination

question

incontinence

answer

involuntary release of urine from the bladder or feces via the anus

question

kidney

answer

one of two bean-shaped organs located below the rib cage on either side of the spine that function to produce urine

question

meatus

answer

an opening, passage, or channel, as in urinary meatus

question

medical asepsis

answer

infection-control practices aimed at reducing the number of organisms present and transmissible from a source; also called clean technique

question

micturition

answer

urination, the voluntary releasing of urine from the bladder

question

nephron

answer

the functional unit of the kidney

question

nocturia

answer

excessive or frequent urination at night or during the usual sleeping hours

question

oliguria

answer

scant urinary production or excretion; diminished urinary output compared with fluid intake

question

patent

answer

open or unobstructed

question

pH

answer

a measure of the acidity or alkalinity of a substance, with a low pH indicating acidity and a high pH indicating alkalinity; a measure of the concentration of hydrogen ions

question

polyuria

answer

excretion of abnormally large amounts of urine

question

proteinuria

answer

presence of protein (such as albumin) in the urine

question

residual

answer

amount remaining or left behind, as in residual urine

question

retention

answer

accumulation within the body of something that is usually expelled, as in urinary retention

question

sediment

answer

material that settles to the bottom of a liquid

question

specific gravity

answer

the weight or degree of concentration of a substance compared with that of an equal volume of another substance, most often, urine compared with distilled water

question

suprapubic

answer

above the symphysis pubis or pubic arch, as in a urinary catheter inserted through the abdominal wall above the symphysis pubis into the bladder

question

surgical asepsis

answer

techniques used to destroy all pathogenic organisms, also called sterile technique

question

ureter

answer

a narrow tubular duct that transports urine from the kidney to the bladder

question

urethra

answer

a narrow tube through which urine passes from the bladder to the outside of the body

question

urinary frequency

answer

the need to urinate repeatedly and more often than usual

question

urine

answer

liquid waste material produced by the kidneys and excreted through the bladder

question

void

answer

urinate, release urine from the bladder voluntarily

question

assessment before insertion

answer

1. assess mental status 2. assess urine for color, odor, presence of sediment or blood, and amount 3. assess voiding patterns both for increased and for decreased urination 4. assess vital signs to monitor for fever, alterations in blood pressure, and any other changes 5. assess skin for hydration status and potential areas for skin breakdown, 6. assess abdomen for information about bladder distention in patients unable to sense the need to urinate 7. Always be sure to document all pertinent findings in the patient's chart.

question

Why are urinary catheters used?

answer

Urinary catheters are used in many clinical situations for patients who are unable to void or need constant monitoring of fluid status.

question

What are the 6 types of Catheters?

answer

1. straight catheters 2. indwelling (Foley) catheters 3. urinary retention (multiple-lumen) catheters 4. Coude catheters 5. condom catheters 6. suprapubic catheters.

question

What does catheter care entail?

answer

1. cleansing of the perineal area and around the catheter itself and... 2. assessing the drainage system for leaks.

question

perineal care for females

answer

1. use a front-to-back cleansing method in the perineal area. 2. cleanse the external genitalia (labia majora) and the internal genitalia (labia minora, urethra opening, and vaginal canal opening). 3. clean catheters in a circular motion directly around them.

question

perineal care for males

answer

1. use a circular motion from the center outward 2. start at the meatus near the catheter itself. 3. for uncircumcised patients, retract the foreskin and cleanse the area completely, replace the foreskin after cleansing to reduce the risk of swelling and pain. 4. cleanse down the shaft of the penis and then clean the scrotum.

question

suprapubic catheter care steps

answer

1. cleanse the area with half strength hydrogen peroxide to reduce the risk of infection 2. mix 10 mL of hydrogen peroxide with 10 mL of sterile saline in a medicine cup 3. use a sterile cotton swab to mix the solution and then 4. cleanse around the catheter using a circular motion to remove debris (not to vigorously) 5. replace the bandage over the area if indicated. 6. if using gauze bandaging, it is best to use a drain sponge to slip the catheter through and then tape the drain sponge shut with a small piece of tape. 6. change dressings over suprapubic catheters a minimum of every 24 hours. Assess this area at least every 8 hours.

question

Adverse events associated with prolonged catheter use include:

answer

urinary tract infections, falls, mechanical injuries, prolonged hospital stays, and death

question

Should a nurse test the balloon

answer

Evidence suggests that testing the balloon may lead to integrity compromise and failure.

question

Always use ________ to inflate catheter balloons.

answer

sterile saline

question

Prior to performing perineal care...

answer

1. position the patient so that you have access to the genitalia but can also keep the patient comfortable. 2. if the patient will remain in bed for perineal care, place an absorbent pad beneath the patient to keep the sheets clean and dry. 3. close the curtains around the bed if it is a double-occupancy room. 4. always have all supplies ready before starting perineal care 5. explain the procedure to the patient. 6. perform hand hygiene, wear gloves, and observe medical asepsis throughout the procedure.

question

True or False, you can also give perineal care while showering a patient or after a patient is still seated after using the toilets

answer

True

question

What 5 things should be used during perineal care?

answer

1. warm water 2. a basin 3. washcloths 4. gloves 5. an approved perineal wash solution or soap

question

What 3 things should not be used during perineal care?

answer

1. povidone-iodine 2. alcohol 3. any other strong agent on the genital area.

question

This front-to-back cleansing method helps....

answer

reduce the risk of vaginal and urinary tract infections developing from contamination with fecal material.

question

perineal care steps for females

answer

1. retract the labia 2. cleanse from the symphysis pubis toward the anus with the washcloth and warm water, always using a clean side with each wipe. 3. next, cleanse the first few inches of the external portion of the catheter closest to the patient 4. replace the patient's clothing and ensure that she is comfortable and that any items she'll need are within her reach.

question

perineal care steps for males

answer

1. first cleanse the upper thighs and then the insertion site of the catheter. 2. for a circumcised male patient, cleanse around the meatus and glans, working your way down the shaft of the penis to the scrotum. 3. remember to change sides of the washcloth to clean each area. 4. if your patient is uncircumcised, retract the foreskin, cleanse the head of the penis, then release the foreskin. 5. for uncircumcised males, just cleanse from the meatus down the shaft of the penis. 6.or both, cleanse the scrotum to the anus, always using a clean side of the washcloth. 7. after you have cleansed the genitalia, clean the first 4 inches of the external portion of the catheter that is closest to the patient. 8. replace the patient's clothing and ensure that he is comfortable and that any items he'll need are within reach.

question

Perform perineal care routinely for patients who have indwelling catheters because...

answer

of the increased risk of skin breakdown and irritation. This procedure also gives you an opportunity to ensure that the catheter is functioning properly and not causing any harm.

question

Suprapubic catheters are prone to _______, which can cause a discharge around the catheter

answer

colonization of bacteria

question

A standard collection bag is the most commonly used drainage system. The primary benefit of using a standard collection bag is...

answer

its size; it has a large capacity (much greater than the human bladder) for holding urine.

question

Collection bags should always be fit to either an appropriate __(1)__ or __(2)__.

answer

1. non-movable part of the patient's bed 2. patient's wheelchair.

question

steps to draining urine from collection bag

answer

1. open the drain valve and allow the urine to flow into a urinal, a basin, or a measuring container. 2. then, flush the urine down a toilet. 3a. some facilities promote cleansing collection bags with a diluted bleach solution, studies have shown that this is an effective method of reducing infection as well as the cost of replacing equipment 3b. others however, some facilities elect to replace collection bags on a routine basis. Of course if a collection bag leaks, replace it.

question

List 5 reasons leg-bag drainage systems are beneficial.

answer

1. they have the benefit of being smaller in size and attaching directly to the patient. 2. the plastic collection bag is simply a smaller version of the standard bag and is attached using small elastic bands that wrap around the patient's leg. 3. typically hold much smaller amounts of urine than standard bags hold 4. easily concealed beneath clothing, which helps to promote the patient's autonomy and dignity. 5. an excellent choice for patients who are able to participate in their own care.

question

What are two disadvantages of leg-bag drainage systems?

answer

1. they must be emptied more often. 2. can also be difficult to use with patients who are confused or are not ambulatory.

question

What are some reasons urinary specimens would be collected?

answer

1. ruling out infection 2. monitoring hydration status.

question

Why should urine samples be taken from the tubing and not the collection bag?

answer

After urine passes through the tubing into the collection bag, it sits in an unclean environment. Bacteria can develop in the collection bag, resulting in unreliable test results.

question

To obtain a sample from the tubing...

answer

1. cleanse the port using an alcohol swab. 2. using a sterile syringe, withdraw a sample of urine directly from the tubing of the catheter. 3. use surgical asepsis

question

After obtaining sample...

answer

1. label with the patient's name, birth date, and the date/time the sample was obtained, along with any other information the facility's policies require. 2. refrigerate them or place them on ice to preserve them until they are transported to a laboratory

question

dipstick

answer

small pieces of paper with squares of chemically treated areas that identify pH, specific gravity (an indicator of hydration status), white blood cell content, the presence of blood, and other factors.

question

Although dipsticks provide immediate feedback...

answer

they are not considered diagnostic.

question

urinalysis

answer

a formal laboratory study of a urine sample that requires a provider's order, it provides in-depth information about a urine sample from blood to protein to white blood cells

question

________ perform most of the bodily functions of filtering, reabsorbing, and excreting.

answer

nephrons

question

The left kidney is slightly higher in position than the right kidney because the right kidney...

answer

lies beneath the liver.

question

Where does most of the blood supply to the kidneys come from?

answer

Most of the blood supply to the kidneys arrives via the renal arteries, which branch from the abdominal aorta.

question

The kidneys are innervated by the ________ component of the autonomic nervous system.

answer

sympathetic

question

Each nephron contains a.... (4 components)

answer

1. glomerulus 2. proximal convoluted tubule 3. descending loop of Henle 3. ascending loop of Henle 4.collecting tubule.

question

rennin

answer

enzyme that converts angiotensin I into angiotensin II. This cascade of events increases blood volume.

question

How much urine does the average adult produce per day?

answer

Most adults produce between 1,500 and 2,000 mL of urine per day.

question

The kidneys filter ____ liters of fluid per hour, 99% of which is reabsorbed

answer

7

question

The kidneys also play a role in...

answer

the production of erythropoietin and in the activation of vitamin D.

question

ADH

answer

anti-diuretic hormone, a hormone secreted by the pituitary gland that increases the permeability of cells membranes, so they absorb more water, especially from urine, that results in small amounts of concentrated urine

question

How often should catheter care be performed?

answer

Perform catheter care a minimum of every 8 hours, regardless of the type of catheter the patient has.

question

For perineal care, always use...

answer

1. warm water 2. a clean washcloth, and 3. an approved perineal wash solution. .

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