NUR 330 Week 5
- External urinary catheter
Answer fits over the penis, providing a safe and noninvasive way to contain urine
catheter may be attached to a small-volume (leg) drainage bag or a large-volume (bedside) urinary drainage bag, both of which need to be kept lower than the level of the bladder
suitable for incontinent patients who have complete and spontaneous bladder emp- tying
less risk for urinary tract infection (UTI) than indwelling catheters; excellent option for the male with urinary incontinence
applying a condom catheter can be delegated to NAP make sure to monitor urine intake and output
Condom catheters can be applied only to intact skin and The pubic area should not be shaved because it may increase risk for skin irritation
Penile shaft should be at least 2 cm (5 inches) in length to ensure successful application. If too small, condom catheter may fall off and compress urethra, stopping urine flow or causing local tissue trauma; if too big the catheter may leak or fall off
Excessive wrinkles or creases in external catheter sheath after application may mean that patient needs smaller size
Be sure that condom is not twisted. Twisted condom obstructs urine flow, causing urine pooling, skin irritation; and weakening and deterioration of adhesive, causing catheter to come off
- Fecal Impaction and Digital Removal
Answer Fecal impaction is the inability to pass a collection of hard stool, mentally incapacitated individuals and institutionalized older adults are at greatest risk
Symptoms of fecal impaction include constipation, rectal discomfort, anorexia, nau- sea, vomiting, abdominal pain, diarrhea (leaking around the impacted stool), and urinary frequency. 1 / 2
Prevention is the key to managing fecal impaction. However, once it occurs, digital removal of stool is the only alternative
removing a fecal impaction digitally cannot be delegated to nursing assistive person- nel (NAP) Hypoactive bowel sounds may result from partial obstruction of the gastrointestinal (GI) tract.Because of the potential to stimulate the sacral branch of the vagus nerve, patients with a history of dysrhythmias or heart disease have a greater risk for changes in heart rhythm.
Determine if patient is receiving anticoagulant therapy. If so Procedure may be contraindicated.Manipulation of rectum can cause bleeding, which is prolonged with anticoagulants.
teach patient about high-fiber nutritional products to increase bulk and the need for adequate fluid intake."
Do not digitally remove stool in a pediatric patient because of the risk for anal fissures and pain that trigger stool withholding
- Functional Constipation
Answer
Defined as 2 or more of the following
straining with defecation at least one fourth of the time lumpy or hard stools (or both) one fourth of the time
sensation of incomplete evacuation at least one fourth of the time two or fewer bowel movements in a week
- Enema
Answer instillation of a solution into the rectum and sigmoid colon to promote defecation by stimulating peristalsis.
used to treat constipation or empty the bowel before diagnostic procedures or certain types of
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