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Maintaining Adequate Urinary Drainage

Maintaining adequate urinary drainage is crucial for overall health, aiding in waste elimination and electrolyte balance. Conditions that disrupt urinary flow can lead to serious health crises due to toxin buildup in the bloodstream. Catheters, including urethral, ureteral, and suprapubic types, are used for drainage, requiring proper insertion techniques. This guide emphasizes infection prevention, patient teaching, and techniques such as self-catheterization and bladder training to enhance urinary function and independence.

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Maintaining Adequate Urinary Drainage

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  1. Maintaining Adequate Urinary Drainage

  2. Urine clears the body of waste material • -aids in the balance of electrolytes • -conditions that interfere with urinary • drainage may create a health crisis • -important to re-establish urine flow as • soon as possible to prevent build up of • toxins in the bloodstream • -urinary catheters are used to maintain urine • flow, divert urine flow to facilitate healing • post-op and dilate or prevent narrowing of • some portion of the urinary tract

  3. Catheters • - may be used for intermittent or continuous • drainage • -may be introduced into the bladder, ureter, or • kidney • -type and size determined by location and cause • of the urinary tract problem • -measured by the French system • -Urethral catheters range in size from 12Fr-24Fr • -Ureteralcatheter: 4FR-6Fr and always inserted by • the physician

  4. Types of Catheters • -Coude’ -tapered tip, easier to insert when • enlarged prostate is suspected • -Foley -simple uretheral catheter, balloon near the • tip to anchor • -Malecot, Pezzer, or Mushroom –used to drain • urine from the renal pelvis of the kidney, can also • be used for suprapubic drainage • -Robinson –a straight catheter with multiple openings in the • tip to facilitate intermittent drainage • -Ureteral –long, slender catheter passed into the • ureter • -Whistle-tip –has a slanted, larger opening at its tip • to be used if blood is in the urine

  5. Coude’ catheter • Robinson catheter • Ureteral catheter

  6. -Cystostomy, Vesicostomy or suprapubic • catheter –inserted by the physician through • the abdominal wall above the symphysis • pubis; used to divert urine flow from the • urethra, is connected to a sterile closed • drainage system. • -External (Texas or condom0 catheter – • -drainage system connected to the penis • -noninvasive • -removed daily for cleaning and skin • inspection

  7. Nursing Interventions and Patient Teaching • -Principle to prevent and detect infection and • trauma • Aseptic technique for insertion • Record I & O • Adequate hydration • Do not open drainage system after it is in place • except to irrigate the catheter per MD order. • Catheter care twice a day, inspect insertion site • Check system daily for leaks • Avoid placing the drainage bag above the level • of the bladder!

  8. -Prevent tension on the system of backflow • wile transferring patient • -Ambulate the patient or turn and • reposition every 2 hours • -Observe characteristics of the urine • -Sterile specimen collected through the • drain port • -Report and record assessment findings

  9. Self-Catherization • -Uses for spinal cord injury or other • neurological disorders • -Promotes independent function of the • patient. • -Instruct about surgical asepsis, however • at home there is less risk of cross- • contamination and patient will probably • use a modified clean technique • -Instruct in symptoms of UTIs

  10. Bladder Training • -Developing the use of the muscles of the • perineum to improve voluntary control over • voiding • -In preparation for removal of a urethral • catheter, the p[physician may order a clamp/ • unclamp schedule to improve bladder tone • -Kegal exercises –tightening the muscles of the • perineal floor • -Voiding schedule may be established

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