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School
University of California, Davis *
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Course
120
Subject
Medicine
Date
Feb 20, 2024
Type
docx
Pages
3
Uploaded by faizanashraf0710
1.
Drain an indwelling catheter drainage bag. – Remove catheter from securing device. Hang a bag of irrigating solution on IV pole to irrigate a closed catheter. (aseptic technique) insert tip of sterile tubing into designated port on solution bag. Squeeze the drip chamber to fill it halfway. Release the clamp and allow the solution to fill the tubing. Keep the end of the tubing sterile. Close the clam p with tubing is full. Connect the tubing to the patient’s catheter. Adjust the clamp on solution tubing to start the follow into the bladder. Adjust roller clamp according to provider’s orders. If drainage is bright red or has blood clots increases the irrigation rate until it turns pink. Follow guidelines for specific rates. Keep an eye on the outflow and empty the bag as needed. Open vs closed irrigation system
2.
State rationale for and describe and/or demonstrate procedures for:
o
Application of external urinary collection systems and urinals
Condom Catheter: Done with appropriate PPE and with waterproof pad under hips. Secure the drain bag to bed frame or have leg bag ready. Close the drain. Remove tape securing old catheter and roll sheath off the penis. Disconnect drain tubing from condom and discard tape and condom. Cap tubing. Perineal care performed. Change gloves with hand hygiene. Holding penis firmly, roll the condom on to it leaving 1 inch space in between penis and end of catheter and secure condom with elastic tape or as advised. Connect condom to drainage tubing. Coil and secure any excess tubing to bed. Leg bags can be used as alternatives. Remove and discard waterproof
pads, gloves and used items. Do follow up care of measuring the drain
bags. Urinal:
can use absorbent pad under patient if needed. If possible, have patient (especially males) hold the urinal and position penis in it.
If needed help them. After finishing, assist the patient with perineal care and have them perform hand hygiene. Adult urinary output averages 2200 to 2700 mL in 24 hours. An hourly output of 30 mL/hr in 2 hours indicates a need for further evaluation.
Suprapubic catheter:
in care urinary catheter causing discomfort a suprapubic catheter is inserted through the abdominal wall is used to drain the bladder. Remove existing dressing and note any drainage or
tissue trauma. Change gloves. Catheter in non=dominant hand, clean the area surround while no tension is placed. Clean with soap and water in circular motion. Clean catheter tubing. Clean gauze can be used to secure the tubing. Document. o
Urinary catheter care and discontinuation
Remove catheter from securing device and examine the skin around the securing device for irritation. Separate labia to reach urethral meatus and catheter. Assess the surrounding tissues for any trauma and ask pt for any pain. Provide perineal care. Rinse away all traces of soap. Avoid pulling the catheter tubing. Secure catheter tubing on securing tube. Change the drain bag when half filled. Document o
Measurement of intake and output
3.
Identify the landmarks for palpating the bladder region for distention.
Press and palpate the bladder region to confirm nothing is hurting while patient is in supine position. Palpating for distention and tenderness. Locate the pubic bone and palpate above the pubic bone.
4.
Discuss indications for bladder scanning and describe the procedure.
Ultrasound probe scan patient's bladder. Palpate the area, apply gel. Place probe on gel and aim it downward behind the pubic bone towards the location of
the bladder. Press and release the button on probe. When it beeps, scn is complete and the volume displays on screen. If all 8 arrows are flashing on probe, the aim is accurate.
Indications include: have patient urinate before scanning for PVR, do not scan over a scar, do not scan over ascites, and rock probe for patient with large abdominal girth.
Bowel Elimination
1.
State rationale for and describe and/or demonstrate procedures for:
o
Administration of enemas
Can be used to treat constipation or to prepare the bowel for certain procedures. Have patient in left side-lying position with right knee flexed. Explain to the pt that they will be in the same position until the
procedure is complete. Cover so that only anal area is exposed. Clean gloves. Place bedpan or BSC in accessible position. Apply water soluble get to tip of enema bottle. Have them breath slowly. Insert towards the angle of umbilicus with appropriate depth. Roll the bottle
from bottom to tip until all the solution is instilled into rectum. When finish clean, discard enema container.
o
Use of commodes, bedpans (standard & fracture), & incontinence briefs
If pt had total hip replacement, be sure not to dislodge the abduction pillow placed in between legs to prevent dislocation. Use a fracture pan.
Drains, dressings, IV lines, and traction make assisting with the procedure difficult for the patient. Additional health care team members may be needed to help place the patient on a bedpan.
o
Positioning simulated patient (classmate or manikin) on standard and
fracture type bedpan.
o
Measurement of intake and output
o
Fecal management systems
2.
Describe procedure for measuring:
o
Stool contents for blood (guaiac)
3.
Classify stool utilizing the Bristol Stool Chart.
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