Hello, this is a task from the Medical-Surgical Nursing Laboratory and the teacher wants a nursing note related to the care of a urinary catheter (no less than 10 sentences) Please create a real case in an unreal patient and you must complete the file attached with the notes of the nursing care of the patient with the urinary catheter. Bibliography: 1. Ignatavicius, D., & Workman, M. (2015). Medical-Surgical Nursing (8th ed.). St Louis, Missouri: Elsevier. ISBN: 9781455772551.

Title: Nursing Note: Care of Urinary Catheter in a Patient with Chronic Kidney Disease

Patient Identification:
Name: John Doe
Age: 65 years
Gender: Male
Diagnosis: Chronic Kidney Disease (Stage 3)

Date/Time: [Insert Date/Time]

Subjective:
The patient reports increased frequency of urination, occasional nocturia, and intermittent episodes of hematuria. The patient also complains of lower abdominal discomfort and occasional urge incontinence. These symptoms have been present for the past week.

Objective:

Physical Examination:
Upon examination, the patient appears pale and fatigued. Vital signs are within normal limits. Auscultation of the lungs reveals clear breath sounds. On abdominal examination, there is mild tenderness in the suprapubic region. The urinary catheter is in place and draining clear yellow urine. There are no signs of inflammation or discharge around the catheter insertion site.

Diagnostic Assessment:
Laboratory investigations show elevated blood urea nitrogen (BUN) and serum creatinine levels, indicating impaired renal function. Urinalysis indicates the presence of red blood cells and proteinuria.

Plan and Intervention:

1. Perform catheter care:
– Ensure proper hand hygiene and don gloves.
– Cleanse the urinary catheter site with a sterile solution and sterile gauze pads.
– Assess and document the condition of the urethral meatus and surrounding skin.
– Clean the catheter tubing with an antiseptic solution, using a clean cloth.
– Monitor and maintain a closed drainage system.
– Administer prescribed urinary catheter care solution per protocol (e.g., chlorhexidine solution).
– Document catheter care, including appearance, any changes, and patient’s tolerance.

2. Monitor and record urinary output:
– Measure urine output every 2 hours to ensure appropriate urine flow and identify any urinary obstruction or retention.
– Observe urine characteristics, such as color, odor, and consistency.
– Report any significant changes in urinary output or characteristics to the healthcare provider.

3. Ensure proper catheter placement:
– Verify that the catheter is properly secured in place to prevent accidental dislodgement.
– Assess for any signs of catheter migration or displacement.
– Assess for bladder distention by palpation and measure abdominal girth.
– Report any signs of catheter obstruction or dislodgement immediately to the charge nurse or healthcare provider.

4. Assess for complications and adverse events:
– Monitor the patient for signs of urinary tract infection (UTI) such as fever, chills, foul-smelling urine, or cloudy appearance.
– Observe for signs of catheter-associated urinary tract infection (CAUTI), such as increased urinary frequency, urgency, and tenderness in the suprapubic or lower back region.
– Document any signs of complications, and report them to the healthcare provider promptly.

5. Educate the patient and family:
– Explain the purpose, benefits, and potential risks associated with urinary catheterization to the patient and family.
– Encourage the patient to maintain adequate fluid intake to promote urine flow and prevent urinary stasis.
– Teach the patient and family about the importance of proper hand hygiene when handling the catheter.
– Emphasize the need for reporting any signs of infection promptly.
– Provide printed educational materials and contact information for further support and guidance.

6. Collaborate with the healthcare team:
– Communicate with the healthcare provider regarding the patient’s condition, any changes, and required interventions.
– Collaborate with the nursing team and other healthcare professionals to ensure optimal care and prevent complications associated with urinary catheterization.

Rationale:
Proper care of the urinary catheter is essential to prevent complications such as UTIs, catheter-associated urinary tract infections (CAUTIs), and catheter-related bloodstream infections (CRBSIs). Regular monitoring and assessment of the patient’s urinary output, as well as documentation of any changes or complications, are crucial for providing appropriate care and intervention. Education of the patient and family helps to ensure their understanding of the importance of adhering to infection prevention measures and reporting any abnormal symptoms promptly.

References:
Ignatavicius, D., & Workman, M. (2015). Medical-Surgical Nursing (8th ed.). St Louis, Missouri: Elsevier.