FINAL REVIEWED TEST FOR ATI URINARY ELIMINATION

FINAL REVIEWED TEST FOR ATI URINARY ELIMINATION Bedside sonography/bladder scanner - CORRECT ANSWER-noninvasive portable ultrasound scanner for measuring bladder volume and residual volume after urination kidneys, ureters, and bladder (KUB) - CORRECT ANSWER-x-ray to determine size, shape, and position of the structures intravenous pyelogram - CORRECT ANSWER-injection of contrast media (iodine) for viewing of ducts, renal pelvis, ureters, bladder, and urethra. ALLERGY TO SHELLFISH CANNOT DO THIS renal scan - CORRECT ANSWER-View of renal blood flow and anatomy of the kidneys without contrast renal ultrasound - CORRECT ANSWER-view of gross renal structures and structural abnormalities using high-frequency sound waves cytoscopy - CORRECT ANSWER-Use of a lighted instrument to visualize, treat, and obtain specimens from the bladder and urethra urodynamic testing - CORRECT ANSWER-Test for bladder muscle function by filling the bladder with CO2 or 0.9% SODIUM CHLORIDE and comparing pressure readings with reported sensations cystourethroscopy: visualizes the inside of the bladder uroflowmetry: measures the rate and degree of baldder emptying promoting urinary elimination - CORRECT ANSWER-equipment: urinal for men OR toilet, bedpan, or commode > fracture pan: for clients who must remain supine and clients in body or leg casts > regular pan: for clients who can sit up NURSING CONSIDERATIONS: 1. Have clients sit up when possible 2. provide privacy needs with adequate time for urinating. Input and Output - CORRECT ANSWER-equipment: >Hard plastic urometer on an indwelling catheter drainage bag >Graduated cylinders, urinal, or toilet receptacle NURSING CONSIDERATIONS: 1. measure output from a bedpan, commode, or collection bag into a graduated container 2. use a receptacle (container) to measure urine clients void into the toilet 3. use markings on the side of the urinal to measure urine *LESS than 30mL/hr for more than 2 hours is a cause for concern Bladder retraining for the treatment of urge incontinence: - CORRECT ANSWEREquipment: clock NURSING CONSIDERATIONS: 1. Use timed voiding to increase intervals between urination 2. have clients perform Kegel exercises 3. assist clients to perform relaxation techiques 4. offer undergarments while clients are retraining 5. teach clients NOT to ignore the urge to urinate 6. positive reinforcement as they remain continent 7. eliminate or decrease caffeine drinks 8. instruct to take diuretics in the morning specimen collection - CORRECT ANSWER-equipment: container (catheter, urinal, receptacle in toilet, commode), soap or cleansing solution and towel, gloves, label, > NONSTERILE for URINALYSIS > STERILE for CLEAN-CATCH MIDSTREAM & SPECIMENS FROM A CATHETER Urinalysis: random nonsterile specimen - CORRECT ANSWER-NURSING CONSIDERATIONS: 1. explain the procedure 2. label the container with clients identifying information, and follow the facility's policy for transporting the specimen to the lab. clean catch midstream for culture and sensitivity (C&S) - CORRECT ANSWERNURSING CONSIDERATIONS: 1. teach the technique for obtaining the specimen 2. after thorough cleansing of the urethral meatus, clients catch the urine sample midstream catheter urine specimen for C&S - CORRECT ANSWER-NURSING CONSIDERATIONS: 1. obtain a sterile specimen from a straight or indwelling catheter using surgical asepsis (sterile technique) Timed urine specimens - CORRECT ANSWER-NURSING CONSIDERATIONS: 1. collect for 24 hrs or other duration 2. discard the first voiding 3. collect all other urine. Refrigerate, label, and transport the specimen. Straight or Indwelling Catheter Insertion - CORRECT ANSWER-Equipment: Usual size and type of catheter > 8-10 Fr for CHILDREN > 14-16 Fr for WOMEN > 16-18 Fr for MEN USE SILICON OR TEFLON FOR PATIENTS WITH LATEX ALLERGIES - Catheterization kit with a sterile drainage bag for indwelling catheter insertion - soap and water - collection container for straight catheterization NURSING CONSIDERATIONS: 1. explain the procedure 2. use the correct technique for inserting an indwelling catheter or for straight catheterization Routine catheter care - CORRECT ANSWER-Equipment: soap & water, washcloth, gloves NURSING CONSIDERATIONS: 1. use soap & water at the insertion site 2. cleanse the catheter AT LEAST 3 TIMES A DAY and after defecation 3. Monitor the patency (open, expanded, or unobstructed) of the catheter - For reports of fullness in the bladder area, check for kinks in the tubing, and check for sediment (matter that settles to the bottom of a liquid) in the tubing. - Make sure the collection bag is at a level below the bladder to avoid reflux Condom catheter application - CORRECT ANSWER-equipment: gloves, condom catheter, elastic tape, leg or standard collection bag NURSING CONSIDERATIONS: 1. explain the procedure 2. use correct technique for application of condom catheter UTI's - CORRECT ANSWER-most due to E. Coli