Urinary elimination; GeorgiaCollegeStateUniversity; Susan Darby, RNC, MSN
responsibility (p. 1256-1258)
urinary elimination: kidneys, ureters, bladder, urethra, and urination.
voiding, and urination all refer to the process of emptying the bladder.
factors affecting voiding
·Infants:Brick dust: It is not unusual for the newborn’s first voiding to
be pink tinged due to an accumulation of uric acid crystals.
·Preschoolers:Myelinization of the sacral spinal
segments that control the bladder is complete at 12-18 months. Children can
then perceive bladder fullness. When a toddler begins _______, it is a good
indicator of the maturation of the spinal cord. At approximately 2 ˝ to 3 years
of age, can perceive bladder fullness, hold urine after the urge to void, and
communicate the need to urinate. Which
sex takes longer to potty train? ______ At 3 years of age, children usually achieve daytime continence
(the ability to control urination). Nighttime continence may not occur until 4
or 5 years of age.
passing of urine when control should be established (about 5 years of age). Nocturnal enuresis: Involuntary
urination at night.
·Elders:As a result of cardiovascular
changes that occur with aging, most older adults experience decreased perfusion
to the kidneys. The kidneys become a less effective regulator of the body’s
extra cellular fluids. The older adult
is at risk for: Urinary incontinence:Involuntary loss of urine from bladder. Nocturia frequency: The need for the older adult to
arise during the night to urinate. Urinary
urgency: Unable to voluntarily to delay the urge to void. Due to the
capacity of the bladder and its ability to empty diminishes with age. Urinary retention: Inability to
empty bladder of urine (due to loss of muscle tone). Predisposes them to
urinary tract infections (UTI).
factors (name 3)
·Fluid and food intake: Foods with a high water content
(soup, Jell-O, fruits, vegetables) _____urine output. Large quantities of salty
foods without increasing water intake _____urine output. Alcohol and foods that
contain caffeine (diuretic) _____urine output.
·Medications:Student responsibility: After
reading (Box 47-1; p. 1260), which of the following drugs cause urinary
retention (name four)?Aspirin,
antihistamine preparation, furosemide, anticholesterol, antispasmodic,
antipsycotic, antibiotic, and antihypertensive.
·Nephrotoxic antibiotics: Early
signs of nephrotoxicity are manifested by changes in the color of urine (urine
is cloudy, smoky, or pink).
·Muscle tone: If the client is obese, weight
loss methods should be discussed to help in the control of urinary ________.
burns, vomiting, diarrhea, excessive diaphoresis and wound drainage, or blood
loss from trauma or surgery. ______ urine output.
·Obstruction of urine flow: Structural
abnormalities within the urinary tract, urinary tumors (press against urinary
tract), prostatic enlargement, and catheters that become plugged or kinked. Hydronephrosis:Distention of the kidney pelvis with
urine secondary to the increased resistance caused by obstruction to urine
flow.If unrelieved, can cause permanent
·Other factors: Infections of the urinary tract.
Hypotension (_____urine output).
·Surgery and diagnostic procedures:A patient
should be able to void 10 hours after surgery. Spinal or regional block
anesthesia impairs the sensory and motor impulse that control voiding causing
urinary retention and edema.
·Anesthetic agents: Slow the glomerular filtration
rate (GFR) and reduces urinary output. GFR: The number of ml of filtrate
made by the kidneys per minute. The stress of surgery triggers the release of
antidiuretic hormone (ADH), which decreases urinary output. Surgery involving
the urinary tract, intestines, or reproductive systems may need a retention
·Polyuria or Diuresis: poly = many. Urine output of greater than 2,500 to 3,000
ml in absence of concurrent increase fluid intake.
·Polydipsia: Excessive thirst.
·Oliguria:Oligo = small. Urine output of less than 500 ml in 24 hours.
·Anuria:An = Without; away from; not. The formation and
excretion of less than 100 ml of urine in 24 hours.
·Dialysis: A technique by which fluids and
molecules pass through a semipermeable membrane according the rules of osmosis.
·Urinary frequency:Voiding at frequent intervals.
·Nocturia:Noct: night; Uria =
urine. Voiding two or more times per night. Indication of congestive heart
·What does dysuria mean?
·Urinary hesitancy: A delay and
difficulty in initiating voiding; often associated with dysuria.
·Hematuria:Hema = blood.
·Pyuria: pus in urine.
1.In the nursery,
you are caring for Baby Girl Jones who is healthy and newly born.What color would you anticipate this infant’s
first voiding to be?
2.The next day, you
are taking care of the baby’s mother, Gabriel.After removing Gabriel’s Foley catheter, she does not have the urge to
void. Since surgery triggers the release of the ADH, how will this affect her
confined to bed after the birth due to postpartum complications. What two
interventions would you implement for her to promote urinary elimination?
4.You assess and
report Gabriel’s urine output of less than 30 ml. What medical term would you
use to document this in her chart?
orders for Gabriel to have bathroom privileges. When Gabriel voids, she
complains of a burning sensation on urination. How would you document this in
to you that her 7 year old boy is bed wetting at night. What is this condition
that her son goes to the bathroom frequently. After measuring the urine for 24
hours, the total urine output is 2000 mL. What is this called?
8.Your other patient, Mrs. Ingle, tells you,
“The need to urinate comes on me all of a sudden, and it feels as though I have
to go immediately –that I can’t wait.” How would you document this in the
9.Mrs. Ingle is 70
years old. What are some common complaints for the older adult related to
incontinence: A small loss of urine
as a result of coughing, sneezing, laughing, and jumping. These activities
increase abdominal pressure. Associated with the weakening of the pelvic floor
muscles. Instruct client to avoid
bladder irritants (name four):
·Urge incontinence: An
involuntary loss of urine after a strong feeling of the need to urinate.
Associated with UTI, diuretics, consuming caffeine and alcohol, increased fluid
intake, and after removal of catheter.
·Reflex incontinence: Seen in
patients with neurological problems - spinal cord lesion, Cerebral Vascular
Accident (CVA), or brain tumor. The person is unable to sense bladder fullness,
and the bladder empties when a certain degree of bladder stretch occurs.
Inability or unwillingness of a person with normal bladder and sphincter
control to reach the bathroom in time to void. Examples:Environmental
barriers: A poorly lit, cluttered room. Physical barriers: Raised
side rails or call bell. Sensory and cognitive factors: Confusion,
disorientation, and sedatives. Motor deficits: Impaired gait and loss of
fine motor control needed to release necessary clothing.
·Total incontinence: The
continuous, involuntary, unpredictable loss of urine from a distended bladder.
Used when the incontinence does not fit any other category and does not respond
to usual treatment methods.
1.Jack suffered a
spinal cord injury in a motorcycle accident nine months ago. He has no
awareness of bladder filling, urge to void, or feelings of bladder fullness. He
reports loss of urine at fairly frequent intervals- about every two hours. What
type of incontinence is he most likely experiencing?
2.Jane has a
history of three full-term pregnancy. What type of incontinence is she at risk
of involuntary urination with little or not warning. What type of incontinence
is he most likely experiencing?
4.You should always
clear a client’s room of environmental barriers to prevent what type of
the normal mechanisms of urine elimination in which the client does not
perceive bladder fullness and is unable to control. the urinary sphincters.
Result of impaired neurologic function.
True or False
1. Clients find it easier to describe their
normal elimination pattern than to describe alterations in urinary elimination.
2. The nurse should not use words like
“potty” or “peeing” because this is unprofessional. ___
3. Clients who have experienced problems
with urinary retention, incontinence, and flow over long periods of time may
not report these conditions unless specifically asked. ___
•“When did you
•“How many times
per day do you urinate?”
•“Do you urinate a
small, medium, or large amount of urine?”
•“Do you wake
during the night to urinate?”
•“Have you noticed
any problems with passing your water?”
history indicates that she has a problem with urination, so you assess her skin
for color texture, tissue turgor, and edema. What is the rationale for these
•Inspect for a
bulge above the symphysis pubis. Percussion
Draw an arrow of where you would begin and end to percuss the
•Percussion is the
most reliable method for determining the degree of bladder distention. Distended
bladder:Palpation: Bladder distention of more than 600
ml can often be palpated.
thinking: Assessing urine
•Urine in the
bladder stimulates stretch receptors and triggers the need to void. In the
adult, the need to void is signaled after how much urine enters the bladder? _______
Color: Ranges from light to a darker yellow, to a dark yellow-brown
(amber). Clarity: Clear without sediment. Odor: Aromatic.
1.You are assessing
an adult patient, Miss Pope, for renal function. You note that in the past 24
hours, she has voided 850 cc of urine. What does this finding indicate?
the color of Miss Pope’s urine, you note the color to be dark amber. What does
this assessment indicate?
3.You would notify
Miss Pope’s physician if her urinary output falls below ___ml per hour.
presents to the doctor’s office for a routine checkup. A urine specimen is
obtained and is noted to be 250 mL of light yellow, cloudy, odorless urine.
Which characteristic of the urine specimen is abnormal?
should be within approximately ____ to ____ of intake within a 24-hour period.
Absence of voiding during any
hour period suggests acute urinary retention.
in the bladder following the voiding. Client voids frequent, small amounts (50
to 100 ml).Nursing interventions:
Assess for a distended bladder. After obtaining a physician’s order, catherize
the client immediately after voiding and measure both the void and catheter
amount. Critical thinking:
You catherize a bed-bound patient, Mrs. Moss, just after she voids 600 cc of
urine. The catherization procedure yields an additional 275 cc of urine. What
is an appropriate nursing diagnosis for Mrs. Moss?
specimen: Used when sterile specimen
is not required. Can be collected in urinal, bedpan, hat, or from a specimen
cup. Nursingcare: Teach patient to avoid
contaminating specimen with feces or toilet paper. If a woman is menstruating,
note this finding on the specimen.
·24 hour specimen: Collect urine
for 24 hours. Discard the first morning urine. May void into urinal, hat, or
bedpan then transfer to urine container. Keep urine container in the fridge or
on a bucket of ice. Discarding even a small amount of urine invalidates the
test results and must start all over again (place sign over bed and in
bathroom.). If there are feces in the sample, the test has to be started all
over again. At the end of the 24 hours, ask the patient to empty bladder and
add this urine to the collection container.
·Collecting urine from children: Plastic collection bag is most appropriate for
infants and small children.
·Specific gravity: What is used to measure the
weight or concentration of urine as compared to water? __________ Normal range: NR: 1.010 to 1.025 g/ml. Low: Less
concentrated urine or overhydration. High: More concentrated urine or
fluid volume deficit. Critical
thinking: Jimmy is admitted to the medical unit with a medical
diagnosis of dehydration. What would you expect his urine-specific gravity to
·Reagent strips (dipsticks): Determines the amount of substances (e.g. protein,
glucose) in the urine. Protein:
If found in the urine, is a sign of __________ injury.
·Blood Urea Nitrogen (BUN) level:
A measure of blood level of urea, the end product of protein metabolism.
·Creatinine clearance (requires two test)
urine and serum creatinine levels to determine the ___.A high serum creatinine level is a reliable
indicator of impaired _____ function. NR: Men: 95-104 ml/min; Women:
·KUB:X-ray of the abdomen to observe kidneys, ureters, and
·Intravenous pyelogram (IVP): X-ray that visualizes the urinary system by the use
of a radiopaque dye. Assess for
allergies (name two):
oAs the dye is injected, the client may experience (name two):
Flexible tube with light at the end. Inserted into the urethra and guided into
the bladder to look for tumors, stones, or structural problems. Specialized
instruments can be passed through the cytoscope to remove small stones or to
take tissue biopsies. Patient
teaching (name 4):
oAfter the procedure: Assess for
hematuria (indicates hemorrhage), urinary retention, bladder spasms, and
symptoms of UTI
·Urodynamic studies:A special catheter measures the
pressure in the bladder, urethra, and abdomen. Electrodes measure sphincter
muscle activity. Computer records and integrates information.
diagnosing, planning, and implementing (p. 1265- 1269), name medical problems
that would require a client to increase or decrease their fluid requirements.
Read Home care assessment on p. 1267.
·Jessica, a 24
year old female, comes to the ambulatory clinic with complaints of cloudy urine
with offensive odor, dysuria, severe burning on urination, frequency and
urgency. What do you think is wrong with her?
·Critical thinking: The Nurse
Practitioner (NP) orders a clean catch urine. Which is the preferred method for
obtaining this specimen? Voiding or Catherization. Rationale:To
decrease the risk of introducing microorganisms into the urinary tract.
·You need to
instruct Jessica on the correct technique for obtaining a clean catch urine.
How would you teach her to do it?
·How would you
teach a male patient to cleanse for a clean catch urine?
·True or False: A clean catch
sample is acceptable if contaminated with stool, vaginal secretions, or
·Send clean catch
specimen to laboratory within 15 minutes, or place specimen in refrigerator.
Rationale: Microorganisms grow quickly in urine, especially at room
·If specimen is
for microbiology testing, it must be sent immediately and not refrigerated. Rationale:
Refrigeration retards bacterial growth.
·The NP diagnoses
Jessica with cystitis and prescribes Bactrim Double Strength (DS) one orally
BID x 3 days. The NP instructs Jessica to take all the pills then return to the
clinic for a urine culture. Patient
teaching: Bactrim DS
“How did I get this urinary tract infection.” You would explain that cystitis
is caused by an ascending infection from the __________.
·Jessica asks you,
“What can I do to relieve this pain?” What would you include in her teaching
plan? Heat or cold therapy? Rationale:
To promote relaxation and help relieve urgency, discomfort, and spasms.
·Avoid bladder irritants
·Void at least
every ____ hours and empty the bladder at each voiding. Rationale: To
avoid stagnant urine from remaining in bladder.
·You teach Jessica
the importance of increasing her fluid intake to flush microorganisms out of
the urinary system. Jessica responds, “Exactly how much fluids should I drink
·True or False: Cranberry and
blueberry juice prevents bacteria from adhering to bladder wall and may prevent
another UTI. ___
prescribed phenazopyridine hydrochloride (Pyridium) 200 mg orally TID x 2 days.
Drug action: Provides an analgesic effect on the bladder mucosa. Pyridium
turns the color of the urine ____________. Common side effects:
Headaches, GI disturbances, and rash.
·Void 15 minutes
after intercourse to flush any sperm out of urethra. Wipe front to back. Rationale:
care is essential during menstruation and during the postpartum period.
·Bladder training: Client
postpones voiding, resists or inhibits the sensation of urgency, and voids
according to a timetable rather than according to the urge to void.
·Habit training: Attempts to keep clients dry by having them void at
regular intervals. Also referred to as timed voiding or scheduled toileting.
·Prompted voiding: Supplements
habit training by encouraging the client to try to use the toilet (prompting)
and reminding the client when to void.
·Critical thinking: Joe has a
spinal-cord injury and is starting on a bladder training program. What program
requires Joe to void on a regular schedule?
·Case Study: Ethel Jackson is a 78 year old client with urinary
incontinence. Ethel lives independently at home. She reports that she has
curtailed many of her social activities due to her incontinence. How would you
instruct Ethel on managing her incontinence (name four)?
·Pelvic muscle exercises: You are instructing Ethel Jackson, how to perform
Kegel Exercises. You teach Ms. Jackson that Kegel exercises facilitate urinary
control and prevent incontinence by tightening what muscles?
oKegel Exercises: Tighten the perineal muscles together and hold the
squeeze for 3 seconds. Relax the muscles. Repeat 10 times TID. Exercises can be
performed sitting up, lying down, or standing. Another method: Sit on the toilet and start and stop the flow
of urine. Muscle tone can be restored in about 6 weeks of regular practice.
maintaining skin integrity (p. 1271), answer the review question 47-2 on p.
•Purpose: Provides a means of collecting urine and controlling
incontinence without the risk of infection that an indwelling urinary catheter
Wash hands. Assist client to supine position with only genitalia exposed. With
disposable gloves wash genitals with soap and water. Towel dry. Trim or shave
excess pubic hair from base of penis, prn. Apply thin film of skin protector on
penis shaft (found in kit). Allow to dry for 30 seconds. Apply the adhesive
strip to the penis in a spiral fashion before placing the condom catheter. RationalePrevent a constricting tourniquet effect on the penis that could
•A one inch space
should be left between the penis and the end of the condom. Attach funnel end of
condom to collection system. Tubing is taped leg or attached to a leg bag.
Avoid kinks or loops in the tubing. Wash hands. Observe penis, 15 to 30 minutes
after application for swelling or changes in skin color. Document procedure. Safety alert: Remove the external
catheter daily to cleanse the penis and surrounding tissues and to assess the
skin for any edema or areas of excoriation. Critical thinking: The wife of an elderly client, Mr. Jacobs,
asks why her husband is wearing a condom catheter instead of having a “tube”
inside of him. How would you respond?
urinary retention: Flaccid bladder
•Weak, soft and
lax bladder muscles. Critical
thinking:Janet has multiple sclerosis and is diagnosed with a
flaccid bladder. What technique could you teach Janet in order to assist with
·Definition: Placing a flexible tube through the urethra into the
bladder. Purposes: To
drain the bladder for therapeutic purposes (surgery or inability to void). Critical thinking: Mrs. Alford is incontinent and
requires frequent linen changes by the nursing staff. The nursing assistant
suggests a urinary catheter be inserted. How would you respond?
·Female anatomy: Labia majora,
labia minora, clitorus, urethral opening, vagina, and anus. Male anatomy: Bladder, urethra,
·Equipment:Light source. Inside wrapper is
sterile field. Sterile gloves on top –carry extra pair of well-fitting gloves
with you. Two drapes. Sterile cotton balls or swabs. Forceps or pick-ups for
cotton balls. Cleansing solution. Water-soluble lubricant. Specimen container.
·Foley catheter: Balloon at end
that is inflated inside bladder. Pre-filled syringe with sterile solution to
fill balloon. Balloon usually hold about 5-6 cc, but may hold 30 cc. Drainage
·Straight catheter: Inserted and
removed as soon as bladder is empty. Plastic tray to collect urine (graduated).
Select smallest usable size. 8 French for children and infants. 16 French for
·Special considerations: Sterile procedure! Tie hair back. Review procedure before you do it for the first time.
physician’s orders and identify the patient.Explain the procedure and rationale to client. Wash hands
·Position the client: Female:
Dorsal recumbent or Sims (on back with both legs drawn up). Male: Supine.
·Set up light
source. Open kit in convenient place. Save plastic bag cover for soiled items.
Open sterile drape by corners maintaining sterility. Slide drape under buttocks
(soft side toward patient). Don the gloves away from the sterile field.Second
drape is optional. Cover gloves with corner of drape as you place over penis or
·Open cleansing packet Pour solution over cotton balls or swabs. Open
lubricant and place packet on end of catheter and leave in place. Put syringe
on Foley balloon port. Check balloon and leave syringe attach.
·Cleanse patient: Use each swab
or cotton ball only once. Use forceps with cotton balls to keep dominant hand
sterile. Use non-dominant hand to expose meatus. Male: Raise penis to 45
degree angle. Begin at meatus; retract foreskin if present. Cleanse in circular
motion starting at meatus. Female: Fingers inside both labia majora and
minora. One side first, than other. Last stroke of swab or cotton ball down
·Insert catheter: Move tray closer (be careful), and grasp catheter.
Insert 2-3 inches for female; 6-9 inches for male. Don’t force; have patient
take deep breaths. Watch for urine. Insert about 1 inch further. Hold straight
cath in place till bladder empty.
·Indwelling Foley: Inflate
balloon. Tape, leaving slack in catheter Male: Tape to lower abdomen or
thigh. Women: Tape to thigh. Rationale: Taping the catheter
reduces urethral irritation, allows drainage, and prevents excessive traction
against the bladder wall.
bag lower than bladder to prevent backflow of urine. Clean up area and
·Document:Type of catheter, specimen, amount/character
of urine, and patient’s response. Example
16 FR Foley catheter inserted with return of 500 cc of clear yellow
urine. U/A obtained and sent to lab. Pt tolerated procedure well.
1.You are inserting
a straight catheter on Mrs. Chen and accidentally contaminate the catheter.
Should you throw away the entire catheter kit or only replace the catheter you
straight catherization of Mrs. Chen, the catheter slips into the vagina. What
will you do?
3.While inserting a
Foley catheter on Mr. Smith, he complains of pain after you inflate the
balloon. What will you do?
4.You need to send
Mr. Smith to a chest x-ray today. He is ambulating but still has his indwelling
catheter. What instructions should you give to the x-ray technician who
accompanies Mrs. Smith to the radiology department to prevent backflow of urine?
5.Mr. Smith is
being discharged to home with a urinary-retention catheter. Part of the
discharge instructions included encouraging the client to eat whole grains,
cranberries, plums, prunes, and to limit fruit, vegetables, and milk products.
What is the purpose of the instructions?
·Observe the flow,
color, odor and abnormal constituents every 2 to 3 hours.
·Intake and Output: Empty at
least every shift.
·Wash meatus and
catheter every shift with soap and water to prevent UTI. Drainage: Keep
bag below bladder and keep off floor.
•Clamp tubing to
allow urine to collect. Cleanse the aspiration port of the drainage tubing with
alcohol. Insert needle into aspiration port. Draw urine sample into syringe by
gentle aspiration. Transfer urine from syringe into a sterile specimen
•Check order and
if specimen is needed.
•Equipment Nonsterile gloves and
10 cc syringe.
•Procedure:Identify the patient and explain procedure. May feel
urge to void immediately after removal. Wash hands. Privacy.Place pad or towel under catheter. Remove
fluid from balloon never cut a balloon. Pinch catheter and have patient bear
down as if to void. Remove smoothly and quickly. Empty bag and measure. Discard
in red plastic biohazard bag. Teach the signs and symptoms of UTI. Measure
output after removal. Should expect 250-400 cc and patient should void within
6-8 hours. RationaleWhen
an indwelling catheter is in place for an extended period, the bladder may lose
tone, contributing to urinary retention.
•Patient should maintain hydration.
•Taught to clients
with urinary retention to enhance their independence, reduce the risk of
infection, and eliminate incontinence.
•Critical thinking: Janet has
multiple sclerosis and is diagnosed with a flaccid bladder. You are planning to
instruct her on clean-intermittent self-catherization. What would you assess
prior to instructing Janet on the catherization procedure (name five)?
·Purpose: Instillation of solutions to help remove mucus,
blood clots, or other tissue in the bladder (particularly after GU surgery),
and the application of medications to the bladder wall.
·Closed method: Performed
without disruption of the drainage system using a triple-lumen indwelling
urethral catheter. Closed catheter irrigations may be either continuous or
·Triple lumen: First lumen inflates the balloon
of the catheter to keep it securely inside the bladder. Second lumen removes
urine into a closed drainage system. Third lumen connects to a container of
sterile irrigating solutions.
·Open method: Performed with a double-lumen
indwelling catheter.After cleansing the
junction between the urethral catheter and the drainage tubing and using
sterile technique, the catheter and drainage tube is disconnected. The solution
is administered either with a sterile syringe or by gravity; then the catheter
and drainage tube is reconnected. This method is associated with a higher risk
·True or False: The irrigant is
considered intake as it may be absorbed once it enters the bladder.
·Case study:Mr. Adams had a transurethral resection of the
prostate has an indwelling catheter. You notice that Mr. Adams has had less
than 100 cc or urine over the last 4 hours. Upon talking with the surgeon, Mr.
Adams is ordered bladder irrigations by the closed method.
1.What type of irrigation is used?
order is not complete. What additional information would you need to obtain
from the surgeon regarding the irrigation?
•A leg bag can be
used during the day for a long-term indwelling catheter.
1.Mrs. Shamrock is
being sent home with an indwelling catheter. What type of solution would you
instruct Mrs. Shamrock to cleanse the urinary drainage bag to prevent the
growth of microorganisms?
tells you that she has been soaking in a warm tub to ease the irritating
feeling from having a catheter. How will you respond?
·Created when the
bladder must be removed, for example, because of cancer or trauma. The ureters
may be brought directly to the surface of the skin to form small stomas
·Ileal conduit: Ureters joined to bowel loop to
drain urine into bag. Most common diversion and requires that the client wear a
urine collection device continually over the stoma. Less chance of an ascending
·Critical thinking: What type of
client would a urinary diversion procedure be performed?
through the abdominal wall above the symphysis pubis into the urinary bladder. Student responsibility: After
reading page 1284, what type of nursing care would you provide a client with a
After viewing the catherization video (20 minutes),
answer the following questions:
True or False.
Inspection of the lower abdomen is the most reliable method for
determining the degree of bladder distention.
the purpose of urinary catherization?
preparing to insert a catheter, what will you place on the tip?
if the following areas of the catheter must be kept sterile or clean. Mark
“S” for sterile or “C” for clean.
the collection bag ___
a. Where do you tape a
catheter for a male?
b. For a female?
c. Why is it necessary to tape the catheter?
When inserting a urethral catheter the nurse
Instruct the client
that the procedure will cause no pain or discomfort.
Instruct the female
client to hold her urethra perpendicular to her body to straighten the
intermittent catherization is a clean procedure, but insertion of an
indwelling catheter is a sterile procedure.
drainage is ordered, inflate balloon with prefilled syringe to check for
Teaching regarding home care of modifications for
the client discharged with an indwelling catheter should include:
regarding the need to place the catheter bag on the side rail of the bed.
methods of kinking the catheter tubing to relieve intermittent bladder
Information on signs
and symptoms of urinary tract infection with directions of who to
The need to limit
fluid intake in order to concentrate urine and promote urinary function.