Need help with careplan on Impaired urinary elimination

[Kaysmom8]

Hello,

I'm struggling with this one, my pt is a 61 yr old man who is 3 days postop following a prostatectomy with radical dissection of pelvic node. History of BPH and prostate cancer, he has a foley in place. My instructor suggested I do my careplan on Impaired urinary elimination but she said to be careful and not use certain interventions from the book because he has a foley in place. This is my first pt with a foley.

Assess foley patency, check for urine leakage and swelling around the urethra

Intervention 1: Keep tubing free from kinks and keep drainage bag below bladder level and ensure the cath is secured to pt's leg to prevent pulling/inflammation

#2 ??? I'm stuck- what else can I possible do to help this pt with his impaired elimination, from my understanding this is a common problem postop, my interventions must help the problem of his impaired elimination.

Should I encourage fluids

clean the area well

encourage pt to void every 2-4 hours

Monitor I&O

check urine output for clots or odor

Administer meds to help reduce bladder spasms

What about a good goal my book gives things that seem to be out of his control

I don't understand how these things will help him void considering he just had major surgery to remove his prostate?

Thanks Any help is appreciated

[Esme12, ASN, BSN, RN]

Your instructor wants an entire careplan on impaired urinary elimination? or to include "impaired urinary elimination" on the care plan.

[phuretrotr]

You could look for signs/symptoms of infection: redness, odor, temperature, cloudy urine, check skin integrity. Since he had BPH and prostate cancer, he may have had difficulty urinating before the surgery, so you could do some teaching regarding him able to recognize the urge to void and getting to the toilet in time after you remove the catheter. I think acute term catheters are only suppose to be in for 3-4 days, so if he is 3 days post-op, it may be soon to take the catheter out. Sorry if I'm not much help, but this one stumped me too.

[NurseMaybeBaby]

Education: teach s/s, ways to prevent, encourage questions, provide written material.

Monitor labs if applicable

Encourage fluids

Good cath care to prevent infection

If the cath is taped to him, watch for skin breakdown in the area

[nurseprnRN, BSN, RN]

what does he know about his diagnosis, medical plan of care, and expected course of care when he is dischaged? teaching him about this should be a huge part of your nursing plan of care. look up info on postop prostatectomy and long term effects -- it's not as easy as "foley out, now you can pee."