Skills: ATI: Urinary Elimination Specimen Collection Procedure:

Skills: ATI: Urinary Elimination
Specimen Collection Procedure:
Clean catch mid stream (CCMS) - CORRECT ANSWER CCMS for culture and
sensitivity (C&S)
Teach technique for obtaining specimen
After thorough cleansing of the urethral meatus, the pt catches the urine sample
midstream
Specimen Collection Procedure:
Catheter urine specimen for C&S - CORRECT ANSWER Requires obtaining a sterile
specimen from a straight or indwelling catheter using surgical asepsis (sterile technique)
Specimen Collection Procedure:
Timed urine specimens - CORRECT ANSWER Collect for 24 hrs or prescribed
duration
Discard first voiding
Collect all other voidings following facility policy on appropriate refrigerated storage,
labeling, and transport.
Routine Catheter Care - CORRECT ANSWER Need:
Soap, water, washcloth, gloves
Procedure: Use soap and water at insertion site
Cleanse catheter at least 3 times a day and after defecation
Monitor patency of catheter
If pt reports fullness in bladder area check for kinks in tubing and check for sediment in
tubing.
Make sure catheter in bag/system is a level below pt's bladder to avoid reflux.
Most UTI's are due to: - CORRECT ANSWER Escherichia coli
Factors that increase risk of UTI's - CORRECT ANSWER Close proximity of the
urethral meatus in women to anus
Frequent sex
Menopause decreasing estrogen levels and increasing susceptibility to UTI's
Uncircumcised males
Use of indwelling catheters
Nursing implications:
Clean females from FRONT to BACK
Clean beneath foreskin in males
Provide catheter care regularly
6 types of urinary incontinence - CORRECT ANSWER stress, urge, overflow, reflex,
functional, total
Stress Incontinence - CORRECT ANSWER the loss of small amounts of urine when
laughing, sneezing, or lifting primarily due to weak pelvic muscles, urethra, or
surrounding tissues
Urge Incontinence - CORRECT ANSWER the inability to stop urine flow long enough
to reach the bathroom due to an overactive detrusor muscle with increased bladder
pressure
Overflow Incontinence - CORRECT ANSWER Urinary retention from bladder
overdistention and frequent loss of small amounts of urine due to obstruction of the
urinary outlet or an impaired detrusor muscle.
Reflex Incontinence - CORRECT ANSWER The involuntary loss of a moderate
amount of urine usually without warning due to hyperreflexia of the detrusor muscle,
usually from altered spinal cord activity
Functional Incontinence - CORRECT ANSWER The inability to get to the bathroom to
urinate due to physical, cognitive, or social impairment
Total Incontinence - CORRECT ANSWER The unpredictable involuntary loss of urine
that does not generally respond to treatment
**urinary incontinence is a significant contributing factor to altered skin integrity and falls
(in older adults)
Assessment Risk Factors - CORRECT ANSWER -female
-history of multiple pregnancies and vaginal births, aging, chronic urinary retention,
urinary bladder spasm, renal disease, chronic bladder infection (cystitis)
-Neurological disorders: Parkisons disease, cerebrovascular accident, spinal chord
injury, multiple sclerosis
-Medication therapy: diuretics, opioids, anticholinergics, calcium channel blockers,
sedative/hypnotics, adrenergic antagonists
-Obesity
-confusion, dementia, immobility, depression
-physiological changes of aging
-decreased estrogen levels and decreased pelvic muscle tone
-immobility, chronic degenerative diseases, dementia, diabetes mellitus, CVA,
-urinary incontinence increases the risk for falls, fractures, pressure ulcers, and
depression.
Subjective Data: - CORRECT ANSWER -loss of urine when laughing, coughing,
sneezin