A. pt education focus on pt's specific clinical problem
1. teach about proper hygiene to prevent infections when giving bath
2. teach pt early symptoms of urinary alterations
3. incorporate teaching when giving meds or administering fluids (talk about increasing
fluid intake)
B. promoting normal micturition maintain normal elimination
1. nurse can teach pt to relax to void. sit or squat, raise head of bed, assume normal position
2.sound of running water can help
3. stroke inner aspect of thigh stimulates sensory nerve & promotes urination
4. pouring water over perineum can create sensation to urinate
C. maintain elimination habits
1. post childbirth should urinate within 4 hrs.
2. prevent urinary stasis, incontinence
D. maintain adequate fluid intake a pt with normal renal function without heart, kidney
problems 2000-2500mL /day is good
1. an average of 1200-1500 mL is usually sufficient unless history of UTI
2. when fluid intake is increased, excreted urine flushes out solutes or particles that may
collect in urinary system
E. Preventing infection good perineal hygiene & adequate fluid intake, wipe front to back,
F. Acidifying urine inhibit microbial growth
1. meats, eggs, whole grain breads, prunes
2. cranberry juice & ascorbic acid lower pH
VIX. Medications
A. meds that are given for incontinence caused by bladder irritation: anticholinergics
1. the drugs depress the neurotransmitter acetylcholine which stimulates bladder ie.
Opropantheline, Oxybutenine chloride, Digipan
2. these meds can cause cardiac dysrhythmias not use on cardiac pts. anticholinergics can
cause constipation & dry mouth
B. When the bladder empties, detrusor muscle contracts in response to parasympathetic
stimulation
1. incomplete bladder emptying results from impaired enervation or weakness of detrusor
2. pt. experiences retention & overflow incontinence
3. cholinergic drugs increase contraction of the bladder
4. Bethanechol (Urecholine)
C. the dribbling or overflow incontinence seen in men with prostatic enlargement
1. Terazosin is given daily
2. It can also cause
X. Many falls in older adult make sure pathways clear
some meds cause transient hypotension
No comments:
Post a Comment