Bladder Dysfunction Quiz

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40 Questions

What is a key intervention to prevent infection in urinary drainage systems?

Maintaining a closed urinary drainage system

Why is prompt removal of an indwelling catheter important?

To decrease the incidence and prevalence of infection

What type of irrigation provides intermittent or continuous irrigation of the urinary catheter without disrupting the sterile connection?

Closed catheter irrigation

What is the purpose of continuous bladder irrigation (CBI) following genitourinary surgery?

To keep the bladder clear and free of blood clots or sediment

What are two available alternatives to urethral catheters?

Condom catheters and suprapubic catheters

What is the primary purpose of promoting adequate fluid intake in preventing UTI?

To flush out solutes or particles that collect in the urinary system

What is the purpose of responding quickly to requests for assistance with toileting?

To minimize delays and promote normal urination

What is the benefit of having patients assume the normal position for voiding?

To stimulate bladder contractions

What is the significance of maintaining a 24-hour urine specimen?

To measure urinary output

Why is it suggested that patients avoid drinking fluids 2 hours before bedtime?

To prevent nocturia

Which condition can cause symptoms such as frequency, urgency, and incontinence of small volumes of urine?

Impaired bladder contractility

What might be the reason for a patient experiencing dribbling of urine?

Failure of the sphincter to prevent urine passage

What is the term for incontinence caused by urinary retention?

Overflow incontinence

Which microorganism is usually the culprit in causing urinary tract infections?

Escherichia coli

What characteristic of urine can be indicative of cystitis?

Foul-smelling and cloudy urine

What is the primary reason for catherization in patients with urinary retention?

To empty the bladder completely

Which type of incontinence is characterized by a sudden, intense urge to urinate?

Urge incontinence

What is the primary cause of functional incontinence?

Mobility or dexterity issues

What is the term for the combination of stress incontinence and urge incontinence?

Mixed incontinence

Which type of incontinence is characterized by frequent or constant dribbling of urine?

Overflow incontinence

What is the purpose of using a urine hat for patients in the toilet?

To maintain patient privacy during voiding

Which of the following nursing diagnoses can be made based on urinary functioning data?

Stress urinary incontinence and urge urinary incontinence

What should always be worn when disposing of urine as a healthcare worker?

Gloves

What might cloudy urine indicate?

Infection

Which factor guides the selection of nursing interventions for toileting self-care deficit?

Impaired mobility status

What is the primary goal of maintaining sufficient urinary output?

To regulate electrolyte and acid-base balance

What is the significance of monitoring urinary output?

To monitor fluid and electrolyte balance

What can affect the color of urine?

Diet, medication, and underlying medical conditions

What is a characteristic of normal urine?

Clear and odorless

What should be done with urine specimens collected for laboratory testing?

Label them with the patient's name, date, time, and type of collection

Why is it important to process urine specimens promptly?

To prevent bacterial growth and changes that affect test accuracy

What is a potential consequence of delaying urine specimen processing?

All of the above

What is a key factor influencing urine characteristics?

Diet, hydration status, and underlying medical conditions

What is a normal characteristic of urine?

Pale yellow with a mild odor

What can affect the odor of urine?

Diet, hydration status, and underlying medical conditions

Which type of catheter is most suitable for patients with prolonged immobilization?

Indwelling catheter

Which type of urinary catheter is used for one-time bladder emptying?

Straight catheter

Which catheter type is specifically designed for continuous bladder irrigation?

3-way Foley catheter

What is the purpose of the balloon in an indwelling catheter?

Inflating to secure the catheter in place

For which purpose is a single-lumen catheter most suitable?

Obtaining a sterile urine specimen

Study Notes

Urinary Catheterization and Care

  • Maintain a closed urinary drainage system to prevent infection and urine backflow into the bladder.
  • Check for kinks or occlusion in the drainage tubing or catheter in the absence of urine drainage.
  • Irrigate or flush the catheter with sterile solution to maintain patency, with two types of irrigation: closed catheter irrigation and open irrigation.

Continuous Bladder Irrigation (CBI)

  • CBI is a continuous infusion of a sterile solution into the bladder, usually using a three-way irrigation closed system with a triple-lumen catheter.
  • Frequently used following genitourinary surgery to keep the bladder clear and free of blood clots or sediment.

Indwelling Catheter Care

  • Promptly remove the indwelling catheter after it's no longer needed, followed by perineal care, to decrease the incidence and prevalence of infection.
  • Monitor patients for timing of voiding after catheter removal and quantity voided.

Alternatives to Urethral Catheters

  • Suprapubic and condom catheters are available alternatives to avoid the risks associated with urethral catheters.

Urine Specimens

  • Collect routine urinalysis, clean-catch or midstream specimens, and sterile specimens from indwelling catheters.
  • Obtain 24-hour urine specimens as needed.

Promoting Normal Urination

  • Maintain normal voiding habits through schedule, urge, privacy, position, and hygiene.
  • Create a conducive environment by closing the door and bedside curtain, asking visitors to leave the room, and masking the sounds of voiding with running water.
  • Respond to requests for assistance with toileting as quickly as possible.

Preventing Urinary Tract Infections (UTIs)

  • Promote adequate fluid intake, perineal hygiene, and voiding at regular intervals to prevent UTIs.
  • Suggest avoiding fluids 2 hours before bedtime to prevent nocturia.

Urinary Retention and Incontinence

  • Urinary retention is the inability of the bladder to empty, leading to overflow incontinence or incontinence associated with chronic retention of urine.
  • Postvoid residual (PVR) is the amount of urine left in the bladder after voiding, measured by ultrasound or straight catheterization.
  • Incontinence caused by urinary retention is characterized by frequency, urgency, small volume voiding, or incontinence of small volumes of urine.

Urinary Tract Infections (UTIs)

  • UTIs are usually caused by Escherichia coli and are characterized by location (upper or lower urinary tract) and signs and symptoms of infection.
  • Symptoms of a lower urinary tract infection (bladder) include burning or pain with urination, irritation or inflammation of the bladder, urgency, frequency, incontinence, suprapubic tenderness, and foul-smelling cloudy urine.

Catheter-Associated UTIs (CAUTIs)

  • CAUTIs are associated with increased hospitalizations, morbidity, mortality, longer hospital stays, and increased hospital costs.

Urinary Incontinence (UI)

  • UI is the involuntary leakage of urine, with common forms including:
    • Stress incontinence: involuntary loss of urine associated with pressure exerted on the bladder.
    • Urge incontinence: sudden, intense urge to urinate followed by an involuntary loss of urine.
    • Overflow incontinence: frequent or constant dribbling of urine due to a bladder that doesn't empty completely.
    • Functional incontinence: caused by factors that prohibit or interfere with a patient's access to the toilet or other acceptable receptacle for urine.
    • Mixed incontinence: incontinence that has multiple interacting risk factors.

Nursing Diagnosis and Interventions

  • Urinary problems amenable to nursing therapy may lead to one or more nursing diagnoses, including:
    • Functional urinary incontinence
    • Stress urinary incontinence
    • Urge urinary incontinence
    • Risk for infection
    • Toileting self-care deficit
    • Impaired skin integrity
    • Impaired urinary elimination
    • Urinary retention
  • Goals for nursing interventions include:
    • Producing sufficient quantity of urine to maintain fluid, electrolyte, and acid-base balance.
    • Emptying the bladder completely at regular intervals without discomfort.
    • Providing care for urinary diversion and knowing when to notify the physician.
    • Developing a plan to modify factors contributing to current or future urinary problems.
    • Correcting unhealthy urinary habits.

Laboratory and Diagnostic Testing

  • Nurses are responsible for collecting urine specimens for laboratory testing, with the type of test determining the method of collection.
  • Label all specimens with the patient's name, date, time, and type of collection.
  • Urine specimens must reach the laboratory within 2 hours of collection or be preserved according to laboratory protocol.

Catheterization

  • Urinary catheterization is the placement of a tube through the urethra into the bladder to drain urine and requires a medical order and aseptic technique.
  • Reasons for urinary catheterization include:
    • Relieving urinary retention
    • Prolonged patient immobilization
    • Obtaining a sterile urine specimen
    • Accurate measurement of urinary output in critically ill patients
    • Assisting in healing open sacral or perineal wounds in incontinent patients
    • Emptying the bladder before, during, or after select surgical procedures and before certain diagnostic examinations
    • Providing improved comfort for end-of-life care

Test your knowledge on problems related to bladder dysfunction such as infection, obstruction of urine flow, and impaired bladder contractility. Learn about symptoms like frequency, urgency, and incontinence, as well as the significance of postvoid residual (PVR) measurement.

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