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level 5

What is urinary retention?

an accumulation of urine resulting from an inability of the bladder to empty correctly

How can urinary retention occur?

urethral obstruction
surgical or childbirth trauma
alterations in motor/sensory innervation of bladder
med side effects

What are UTIs, and what can they lead to?

the most common HAI
"bladder infection" characterized by bacteriuria (ecoli most commonly)
can lead to bacteremia, urosepsis

What are causes/risks factors of UTIs?

if there is residual urine
urinary retention
poor hygeine
frequent sex
invasive procedures

What are SS of UTIs?

cloudy urine (WBC or bacteria)

What is pyelonephritis?

can occur from untreated UTI, it is a kidney infection characterized by flank back pain, tenderness, fever, chills

What is urinary incontinence?

inability to control leakage of urine

What is residual urine?

urine retained in the bladder after urinating

What is a random (routine) specimen collection?

collection of urine during normal voiding from a catheter or cather bag, use clean specimen cup, best after 1st void of morning

What is a midstream (clean-voided) specimen collection?

collection of urine from the person, they urinate into a sterile specimen cup, used for culture and sensitivity

What is a timed specimen collection?

it is collection of urine for a period of time (2,12,24 hrs) used to measure certain things such as creatinine clearance, hormones, etc.

What is specific gravity?

it is the weight or degree of concentration of a substance compred with an equal volume of water

What are kegal exercises?

exercises used to strengthen the pelvic floor muscles

What is a external (condom) catheter used for?

incontinent or confused or comatosed male

What is reflex incontinence?

involuntary loss of urine characterized by the loss of sensation of urge to void ( ex: spinal cord dysfunction)

What is functional incontinence?

loss of urine caused by factors outside the urinary tract
( emotional barriers, sensory, cognitive, mobility issues)

What is stress incontinence?

loss of urine due to increased abdominal pressure in the absense of bladder muscle contraction
(laughing, sneezing, coughing, etc)

What is urge (overflow) incontinence?

loss of urine after a strong sense of urgency to void

What are characteristics of normal urine?

not much odor

What are chracteristics of abnormal urine?

thick-concentrated-non transparent-cloudy
bloody, red, black
ammoniia odor, foul-smell

What are factors that can influence urinary voiding?

Emotions (psychological)
Privacy (sociocultural)
Volume status
Diagnostic tests

How can we promote normal voiding?

Toilet schedule
Sensory aspect (water running)
Fluids (1200-1500mL)
Health weight
Avoiding bladder irritants (smoking, caffeine)

How can we reduce incontinence?

Clothing modifications
Environmental alterations
Scheduuled tolieting
Absorbent products
Electrical stimulation
Lifestyle modifications

What measures can we use to reduce UTI infections?

Good perineal, and hand hygeine
Fluid intake
Promoting bladder emptying
Acidifying urine
Educate patient- how to wipe, how tighter clothes irritate

How do we apply external catheters?

We want to make sure they are not to tight
They slip over the top of the penis ( leaving 1-2 in between the tip of penis and end of catheter)
Secure with elastic adhesive

What routine care do we do for patients with indwelling/external catheters?

Perineal hygeine at least 3 times a day or PRN, can use soap and water
Also clean after every defacation or bowel incontinence to minimize discomfort/infection
Enourage fluid intake of 2000-2500 mL
Irrigate and instill catheter PRN

What spots on the catheter are most common for infection to enter?

site of insertion
drainage bag
tube junction
junction of tube/bag

How do we collect a specimen from a catheter?

collect urine from port on drainage tubing using a sterile needle

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