Urinary Elimination: Bedpans, Urinals and Asepsis

• Urinary elimination is an important bodily function

Theory Review

• Dysuria is painful or difficult urination.
• Hematuria is the presence of blood in the urine.
• Nocturia is excessive urination at night.
• Oliguria is the production of abnormally small amounts of urine.
• Polyuria is the excessive production of urine.
• Urinary frequency is the need to urinate many times during the day or night.
• Urinary incontinence is the involuntary leakage of urine.
• Urinary urgency is a sudden, compelling need to urinate.

Giving Bedpans

• Fracture or slipper pans are used for individuals with mobility limitations.
• Regular bedpans are also available.
• Bedpans are emptied into the toilet, rinsed, and wiped down with antibacterial wipes after use.

Urinals

• Regular urinals can be used while sitting or standing.
• No-spill urinals are designed for use while lying in bed.

Medical Asepsis

• Placing bedpans or urinals on over-bed or bedside tables is not recommended.
• Urinals should be hung on the side rail.
• Promptly empty to prevent odors, spills, and the spread of microbes.
• Urine should be emptied into a toilet and rinsed, not poured down the sink.

Types of Catheters

• A straight catheter drains the bladder and is immediately removed.
• Straight catheters are used to collect sterile urine samples when other methods haven't worked.
• Indwelling or Foley catheters are left in the bladder for continuous drainage into a bag.
• A balloon near the tip of indwelling/foley catheters is inflated after insertion to prevent slippage.

Drainage Bags

• Most drainage bags have a capacity of 2000 mL of urine.
• Health Care Assistants (HCAs) typically empty drainage bags at the end of each shift.
• The amount, color, clarity, and odor of the urine are assessed and recorded when emptying the bag

Leg Bags

• Leg bags hold less than 1000 mL of urine.
• Leg bags are used only for residents who are walking during the day.

Catheter Securing Devices

• Catheter tubing must be secured to the leg or abdomen to prevent complications.
• Securing the catheter is the responsibility of the HCA.

Caring for Clients with Catheters

• Provide pericare with a circular motioned wipe away from the urethra and down the catheter tubing 10 cms..
• The tubing should never have kinks.
• Make sure residents are not lying or sitting on the tubing.
• Ensure that the catheter is securely connected to the drainage tubing.
• Ensure the emptying clamp is closed.
• Keep the drainage bag below the level of the bladder.
• Attach the drainage bag to the bed frame, not the bed rail.
• When a client is in a wheelchair, attach the bag to the back or beneath the wheelchair.
• Keep tubing away from the wheels of the wheelchair.
• Fabric bags should be used when possible.

Cleaning and Reusing Drainage Bags

• Drainage bags and measuring jugs are discarded weekly on bath day by the HCA.
• New drainage bags are labeled with the resident's name and date.
• Cleaning bags is only done if switching back and forth to a leg bag during the day.
• Vinegar is the cleaning agent and it is found in soiled utility room or in the clients BR.

The Condom Catheter

• Condom catheters are typically used for nighttime incontinence.
• The condom is applied like a regular condom.
• Hold the penis for 10 seconds for adhesive to take or use provided tape
• Leave 1 inch of space between the end of the penis and the condom to allow drainage.
• Attach the catheter to an overnight drainage bag.

Collecting a Urine Specimen

• Collection of a urine specimen requires attention to the following details:
• Type
• Time
• Container
• Sterile
• Routine
• Label with Name
• Where to put it after collection?

Urine Specimen Types

• Routine and Microscopic (R&M) specimens use a non-sterile container.
• Urine for Culture and Sensitivity (C&S) specimens require a sterile container.