Urinary Elimination When removing an indwelling catheter The nurse should use a slow, steady motion when removing an indwelling urinary catheter. Removing an indwelling urinary catheter while inflation solution remains in the balloon is likely to cause trauma to the urethral canal. Therefore, the nurse should deflate the balloon completely prior to removing an indwelling urinary catheter. Steps: Wipe the port with an alcohol swab or agency specified antiseptic is the first step. The nurse should wipe the port with an alcohol swab to decrease the amount of bacteria present. Attach a syringe to the collection port of the indwelling catheter is the second step. Attaching a syringe after disinfecting the port allows for withdrawal of the urine specimen. Withdraw 3 to 30 mL of urine is the third step. The amount of urine withdrawn will depend on the laboratory test prescribed. Transfer the urine to a sterile specimen container is the fourth step. While transferring the urine specimen to the sterile specimen container, the nurse should be careful not to touch the syringe to the outside of the container. This might result in contamination of the specimen, which could cause an incorrect diagnosis. Transport the specimen to the laboratory is the fifth step. Transporting the specimen to the laboratory is the last step in the process. The specimen should not be allowed to sit at room temperature. If the specimen cannot be immediately transported to the lab, the nurse should store the specimen according to laboratory policy. Applying a Condom Catheter The nurse should roll the condom catheter smoothly over the length of the penis Adhesive tape is painful to remove and it will not expand with size changes of the client's penis, which could cause impaired blood flow. Therefore, it should not be used to keep a condom catheter in place. The nurse should leave a space of 2.5 to 5 cm (1 to 2 in) between the tip of the penis and the end of the catheter. This space helps prevent irritation of the tip of the penis and allows full drainage of urine. During the Insertion procedure The nurse should instruct the client to bear down as if to void because this relaxes the external sphincter and aids in the insertion procedure. When preparing client for intermittent uretheral catherization Lifting the penis to a position perpendicular to the body, or at a 90° angle, while applying light traction straightens the urethral canal to facilitate catheter insertion. Urinary tract infections are treated with antimicrobial agents, increased fluid intake, and pain management. Treatment options for urge incontinence typically include pelvic floor exercises, medications, and bladder retraining The nurse should expect a prescription for urinary catheterization for this client because precise measurement of urinary output is crucial for managing fluid balance in clients who are critically ill. Incontinence due to cognitive decline is a type of functional incontinence that is typically treated with scheduled toileting and absorbent adult briefs. Urinary catheterization might be necessary as a last resort for a client who has incontinence due to cognitive decline. However, as this client is newly admitted, the nurse should not expect a prescription for urinary catheterization. If the catheter is blocked, the provider might have to prescribe catheter irrigation. The nurse should assess the extremities for peripheral edema. The nurse should palpate the bladder for distention The nurse should identify that output that is considerably less than intake is a sign that the catheter is blocked. Therefore, the first action the nurse should take is to check the tubing for kinks and ensure the client's urine flow is not obstructed.
