Editing Fundamentals of Nursing (section)

=== Urinary elimination ===

Average adult urine output is roughly 1,500 mL per day. A minimum acceptable output is about 30 mL per hour, or 0.5 mL per kilogram per hour. Output below that threshold, sustained, must be reported.

Terms: dysuria (painful voiding), oliguria (diminished output), anuria (essentially absent output), nocturia (voiding at night), polyuria (excessive output), urinary frequency, urgency, hesitancy, and retention. Incontinence types include stress, urge, overflow, functional, and reflex.

Interventions: offer toileting on a schedule, provide privacy and unhurried time, position the patient as normally as possible (women sitting, men standing when able), run water or pour warm water over the perineum to stimulate voiding, ensure adequate fluid intake unless restricted, and perform bladder scanning for suspected retention rather than immediately catheterizing.

'''Catheter care and infection prevention:''' insert only when clearly indicated and remove at the earliest opportunity, since duration of catheterization is the single largest risk factor for catheter associated urinary tract infection. Insert using sterile technique, maintain a closed drainage system, secure the tubing to the thigh or abdomen to prevent traction, keep the collection bag below the level of the bladder at all times and off the floor, keep tubing free of dependent loops and kinks, perform routine perineal care with soap and water, and empty the bag with a separate clean container for each patient. Do not routinely irrigate. Do not disconnect the system to obtain a specimen; use the sampling port.