POMOSCHAT urological disorder

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.

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