koz74686_ch48.

qxd 11/8/06 5:59 PM Page 1318

1318 UNIT X / Promoting Physiologic Health

CONCEPT MAP Urinary Elimination

• Shopkeeper, c/o urinary
frequency 2 weeks,
JB nocturia 2–3 X/night,
68 y.o. male assess difficulty starting stream,
BPH dribbles, c/o not feeling
like bladder is emptied
• Height: 185.4 cm (6' 2")
• Weight: 85.7 kg (189 lb)
• Temperature: 38.1°C (100.6°F)
• Pulse: 88
• Respirations: 20/min
• BP: 146/86
• Catheterization for residual:
300mL amber urine
• Foley left in place for 2 days
• CBC normal; UA: amber, clear,
ph 6.5, SpGr 1.025, negative for
glucose, protein, ketones, RBCs,
and bacteria; IVP: enlarged
prostate gland

generate nursing diagnosis

Outcomes partially met: Impaired Urinary Elimination (Retention and Overflow Incontinence) r/t bladder neck
• Following removal of obstruction by enlarged prostate gland (aeb dysuria, frequency, nocturia, dribbling,
the Foley catheter, hesitancy, and bladder distention)
reported continued
difficulty initiating a
urinary stream but less outcome outcome
dribbling and nocturia
• Intermittent
catheterization not Urinary Continence Knowledge: Outcomes met:
indicated aeb Treatment • Able to discuss
• Intake is about • Able to start and Regimen aeb the correlation
evaluation
200 mL > output stop stream substantial between enlarged
• Empties bladder • Description evaluation prostate and
• Selected an acceptable
undergarment and he completely of self-care urinary difficulties
reports more confidence responsibilities • TURP scheduled
for ongoing care in 2 weeks
• Description of
nursing intervention nursing self-monitoring
intervention techniques nursing intervention
Urinary Incontinence Care
Urinary Retention Care Teaching: Disease process
activity
activity activity
activity
Monitor activity
activity activity
urinary Instruct
elimination, client or
including family Appraise
Instruct odor, activity current
member
client to volume, level of activity
to record
limit fluids and color knowledge
urinary
for 2 to 3 about
output
hours activity benign Instruct on
before prostatic which signs
Limit
bedtime hypertrophy and
ingestion Provide enough activity
symptoms to
of bladder time for bladder
activity report to the
irritants emptying Explain the primary care
(e.g., colas, (10 min) pathophysiology provider (e.g.,
coffee, tea, of the disease
Help client burning on
activity and and how it
select urination,
chocolate) relates to urinary
appropriate Implement hematuria,
intermittent anatomy and olliguria)
incontinence
catheterization; function
garment or
Instruct to as appropriate
pad for
drink a Catheterize
short-term Describe the
minimum of for residual
management rationale behind
1,500 mL urine, as
while more Instruct in ways management,
(six 8-ounce appropriate
definitive to avoid therapy, and
glasses fluids)
treatment is constipation or treatment
per day
designed stool impaction recommendations