Pain, dysuria (frequent or painful urination), incontinence or urinary retention, bladder spasm, and similar symptoms in patients with advanced forms of cancer can be Obuscatching both primary tumor process so and metastatic lesions. The reasons for the similarityGOVERNMENTAL violations are also malignant OPUCholewa growth, causing pain, mechanical timeDrazhenom or spasms of the bladder, spinal cord compression, plexopathy, hypercalcemia, and more. As a result of cancer treatment are developing post-radiation or drug cisTitus, post-radiation fibrosis, asthenia (infectious complications, inability to selfmu bowel). It also includesXia side effects of diuretics, as well as comorbidities: prostate adenoma, urolithiasis, hemorrhagic diAmes, diseases of the central nervous system.
Urological complications can be prevented by the following measures:
- provide the patient with an opportunity at an optionallygo to retire;
conduct a thorough hygiene of the skin in the area
genitals;
- using regular diaper pinrolirovat their purity (every 2 chasa kruglosutochbut);
- monitor the regularity patients bladder emptying (every 2 – 3 hours);
- ensure as far as possible, the process mocheisblowing in women in a sitting position, and men – standing (it promotes complete emptying of the mochevogo bladder);
- control the reception of a sufficient quantity of liquid.
With extensive local spread swellingWhether bladder catheterization. Some patients even temporary catheterizationtion of the bladder may become intractable psychological problem. Therefore, you must patiently and clearly explain that the purpose of procefools – provide maximum comfort patsienthe. When atony of the bladder, its constant obstruction or incontinence, bedsores, wounds perineal shows prolonged bladder catheterization.
The patient should follow the recommendations for the catheter and drainage bag care, connectyuschimsya catheter. In order to reduce the riskof infection should be used twice a day and after each act of urination process catheter and the surrounding genital area:
- Prepare a container of warm water, wipes, liquid soap;
- Wash your hands and treat them doubly anti-septic solution (70-degree alcohol solution, 0.5-percent solution of chlorhexidine
bigluconate); - napkin soak in warm water with a liquid soap;
- treat the tissue by the catheter into the urethral opening direction (to prevent ascending infection);
- change the cloth and handle the catheter adjacent to the genital area;
- wash your hands;
- observe and promptly report to your doctor about the appearance of secretions around the catheter.
A similar sanitization is performed and as filling the drain bag, which is attached to the patient’s femur or tibia or on the fixed bed frame seriously ill Pacicient. The catheter and the drainage bag may be withUniform for 5 – 7 days. To ensure a good flow of urine, the receiver should be crucifiedfalse below the bladder. This is especially important at night. We can not allow the tube twist, for which the outflow, as this could lead to disruption of the flow of urine through the catheter.
Emptying of the urinary drainage bag:
- wash hands, wear gloves;
- put the container for collecting the urine at the discharge pipe of the drainage bag;
- free outlet tube from the holder;
- open the tube clamp, drain urine into the container (branch tube does not touch the wall of the container for collecting urine);
- close the clamp;
- wipe the end of the outlet tube swab dipped 70-degree alcohol (twice);
- consolidate the branch pipe in the holder;
- off the gloves;
- make sure that the tube connecting the catheter and drainage bag is not kinked (see. fig.).
Remember!
- The patient should drink more often to the urine was less concentrated. Recommended juices, preferably cranberry helps to prevent infection.
- Exercise regularly care for the perineum, from front to back, followed by drying of the skin.
- Observe the condition of the skin of the perineum, for the amount of urine, its color, abouttransparency, scent
- Inform your doctor about any pain in catheter site, about changes in the urine.
Intermittent catheterisation is performed for regular and effective voidingof the bubble in disorders caused by attenuationeating or lack of muscle tone, as well as in the case of obstruction of urine outflow. frequency cathetertion depends on the function of the urinary puZira and 6-12 times per day for 1 – 2 times a week. Patients can learn to performmanipulation for the catheter itself-sustaining (self-catheterization). The procedure is performed aseptically. periodic kateterizatsiya Nelatona performed using the catheter, which is a cylindrical tube with drainage holes (Fig. 46). Women self-catheterization, “wash your hands, to retire;
- undercut front to back in the direction of the anus, to avoid the risk of infection;
- wet genital area dry with a clean cloth;
- sit on the edge of the hard bed or on a chair;
- put in front of the bed or chair mirror so that you can see the opening of the urethra and surrounding area (you can determine the presence Ureta ry to the touch);
- placed between the legs of the capacity for the collection of urine;
- handle hands twice with 70-degree SpeerTom;
- open the package the catheter by atRonchi;
- take the catheter in the area of the funnel and put on He gel (if the catheter has no lubricant oncovered), without touching the catheter;
- with his left hand to breed big lips in the genital area, right – enter slowly into the urethra katater to a depth of 4 – 5 cm;
- lower end of the catheter into the vessel for collecting urine;
- after reducing the outflow of urine slow startbut withdraw the catheter from the urethra;
- Wash and dry your hands, get dressed.
Men self-catheterization:
- wash your hands, to retire;
- wash the glans penis, slightly pulling the foreskin of the urethra down;
- wet penis dry with a clean cloth;
- sit on the edge of the hard bed or a chair (WMSbut to carry out the manipulation of standing);
- placed between the legs of the capacity for the collection of urine;
handle hands twice with 70 gradusnymspirtom;
- open the package the catheter by atRonchi;
- take the catheter in the area of the funnel and put on He gel (if the catheter has no lubricant oncovered), without touching the catheter;
- with his left hand to take the penis, right – a catheter;
- gently, slowly introduce a catheter through the urethra into the bladder;
- forward end of the catheter into the vessel for collecting urine;
- slowly withdraw the catheter when the urine flow is reduced, stopping the renewal of urine – ensuring complete emptying of the bladder;
- tightly close the funnel opening pointernym right thumb until complete removal of the catheter from the urethra (urine to prevent falling
on clothes); - without removing your finger from the funnel to the container to bring the catheter for urine collection and release the funnel to collect urine in the catheter completely youflowed;
- Wash and dry your hands, get dressed.
If it is impossible transurethral cathetertion bladder patient superimposed epitsistostoma.