8/2/2019 Concep Map Urinary

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CONCEPT MAP Urinary Elimination

outcome outcome

Outcomes met: Able to discus

the correlationbetween enlaprostate andurinary difficu

TURP scheduin 2 weeks

Impaired Urinary Elimination (Retention and Overflow Incontinence) r/t bladder neckobstruction by enlarged prostate gland (aeb dysuria, frequency, nocturia, dribblinghesitancy, and bladder distention)

JB68 y.o. maleBPH

assess

generate nursing diagnosis

evaluationevaluation

Shopkeeper, c/o urinaryfrequency 2 weeks,nocturia 23 X/night,difficulty starting stream,dribbles, c/o not feelinglike bladder is emptied

Height: 185.4 cm (6' 2") Weight: 85.7 kg (189 lb) Temperature: 38.1C (100.6F) 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 foglucose, protein, ketones, RBCand bacteria; IVP: enlargedprostate gland

Appraisecurrentlevel ofknowledgeaboutbenignprostatichypertrophy

Explain the

pathophysiologyof the diseaseand how itrelates to urinaryanatomy andfunction

Instruct owhich sigandsymptomreport to primary cprovider (burning ourination,hematuriaolliguria)

Catheterizefor residualurine, asappropriate

Provide enoughtime for bladderemptying

(10 min)

Instructclient orfamilymemberto recordurinaryoutput

Instructclient tolimit fluidsfor 2 to 3hoursbeforebedtime

Monitorurinaryelimination,includingodor,volume,and color

Help clientselectappropriateincontinencegarment orpad forshort-termmanagementwhile moredefinitivetreatment isdesigned

Instruct todrink aminimum of1,500 mL(six 8-ounceglasses fluids)per day

Limitingestionof bladderirritants

(e.g., colas,coffee, tea,andchocolate)

Implementintermittentcatheterization;as appropriate

Instruct in waysto avoidconstipation orstool impaction

Describe therationale behindmanagement,therapy, andtreatmentrecommendations

nursing intervention nursingintervention

nursing intervention

activity

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Urinary Incontinence Care

Teaching: Disease process

Knowledge:TreatmentRegimen aebsubstantial Description

of self-careresponsibilitiesfor ongoing care

Description ofself-monitoringtechniques

Urinary Continenceaeb Able to start and

stop stream Empties bladder

completely

Urinary Retention Care

Outcomes partially met: Following removal of

the Foley catheter,reported continueddifficulty initiating aurinary stream but lessdribbling and nocturia

Intermittentcatheterization notindicated

Intake is about200 mL > output Selected an acceptable

undergarment and hereports more confidence