A female patient is having difficulty voiding in a bedpan but ...

[KimWrice]

A female patient is having difficulty voiding in a bedpan but states that her bladder feels full. To stimulate micturition, which nursing intervention should the nurse try first?
 
  a. Exiting the room and informing the patient that the nurse will return in 30 minutes to check on the patient's progress.
  b. Utilizing the power of suggestion by turning on the faucet and letting the water run.
  c. Obtaining an order for a Foley catheter.
  d. Administering diuretic medication.

Question 2

A nurse is evaluating a nursing assistive personnel's (NAP) care for a patient with an indwelling catheter. Which action by the NAP will cause the nurse to intervene?
 
  a. Emptying the drainage bag when half full
  b. Kinking the catheter tubing to obtain a urine specimen
  c. Placing the drainage bag on the side rail of the patient's bed
  d. Securing the catheter tubing to the patient's thigh

[taylorsonier]

Answer to Question 1

ANS: B
To stimulate micturition, the nurse should attempt noninvasive procedures first. Running warm water or stroking the inner aspect of the upper thigh promotes sensory perception that leads to urination. A patient should not be left alone on a bedpan for 30 minutes because this could cause skin breakdown. Catheterization places the patient at increased risk of infection and should not be the first intervention attempted. Diuretics are useful if the patient is not producing urine, but they do not stimulate micturition.

Answer to Question 2

ANS: C
Placing the drainage bag on the side rail of the bed could allow the bag to be raised above the level of the bladder and urine to flow back into the bladder. The urine in the drainage bag is a medium for bacteria; allowing it to reenter the bladder can cause infection. A key intervention to prevent catheter-associated urinary tract infections is prevention of urine back flow from the tubing and bag into the bladder. All the rest are correct procedures and do not require follow-up. The drainage bag should be emptied when half full; an overfull drainage bag can create tension and pulling on the catheter, resulting in trauma to the urethra and/or urinary meatus and increasing risk for urinary tract infections. Urine specimens are obtained by temporarily kinking the tubing; a prolonged kink could lead to bladder distention. Failure to secure the catheter to the patient's thigh places the patient at risk for tissue injury from catheter dislodgment.