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Urinary Tract Calculi V: Nursing Management01:28

Urinary Tract Calculi V: Nursing Management

61
AssessmentSubjective Data: Obtain a detailed health history, including any recent or chronic urinary tract infections, periods of immobilization, previous episodes of renal calculi, and medical conditions such as gout, benign prostatic hyperplasia, or hyperparathyroidism. Review the medication history for drugs that may influence stone formation, including allopurinol, analgesics, loop diuretics, or thiazide diuretics. Document the use of long-term indwelling catheters and any past surgical...
61
Imaging Studies VI: Voiding Cystourethrography and Cystography01:22

Imaging Studies VI: Voiding Cystourethrography and Cystography

199
Voiding Cystourethrography (VCUG) and Cystography are specialized radiographic procedures used to examine the structure and function of the bladder and urethra.Voiding Cystourethrography (VCUG)A Voiding Cystourethrogram (VCUG) is a diagnostic imaging procedure that assesses the anatomy and function of the lower urinary tract. It focuses on the bladder, bladder neck, and urethra, helping detect abnormalities such as vesicoureteral reflux (VUR)—the backward or reverse flow of urine into the...
199
Urinary Tract Infection IV: Nursing Management01:17

Urinary Tract Infection IV: Nursing Management

117
In managing urinary tract infections (UTIs) in nursing, a comprehensive assessment is essential. Begin by gathering subjective data, such as the patient’s complaints of dysuria (painful urination), urinary frequency, urgency, suprapubic pain, and any lower abdominal discomfort. This information can be complemented by questions regarding previous UTIs, sexual activity, and personal hygiene practices, which can provide insight into risk factors. Objective assessment should focus on signs...
117
Urinary Tract Calculi VI: Surgical Management01:25

Urinary Tract Calculi VI: Surgical Management

66
Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
66
Urodynamic Studies: Uroflowmetry01:19

Urodynamic Studies: Uroflowmetry

872
Uroflowmetry is a non-invasive urodynamic test designed to measure various aspects of urination, including volume, flow rate, and the time to void. This test is crucial for diagnosing and assessing conditions such as bladder outlet obstruction, bladder dysfunction, incomplete bladder emptying, incontinence, and urinary tract blockages caused by benign prostatic hyperplasia (BPH) and urethral strictures.Pre-Test Instructions:Before a uroflowmetry test, patients are typically advised to drink...
872
Nursing Assessment of the Genitourinary System II: Inspection and Palpation01:26

Nursing Assessment of the Genitourinary System II: Inspection and Palpation

273
The nursing assessment of the genitourinary (GU) system involves a systematic inspection and palpation to identify abnormalities in the kidneys, bladder, and surrounding structures.InspectionMouth: Inspect for signs of kidney dysfunction, such as stomatitis (inflammation of the mouth) and ammonia breath, which may occur in advanced kidney disease due to the buildup of urea, breaking down into ammonia.Skin: Check for pallor, which could indicate anemia caused by kidney disease. Look for...
273

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Related Experiment Video

Updated: Oct 5, 2025

Transcorporal Artificial Urinary Sphincter Cuff Placement in a Case Requiring Revision for Urethral Atrophy
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A Nurse-Led Voiding Algorithm for Managing Urinary Retention After General Thoracic Surgery.

Mary Pierson1, Brittany Cretella2, Maureen Roussel3

  • 1Mary Pierson is the assistant nurse manager of the medical intensive care stepdown unit, Yale New Haven Hospital. At the time this article was written, she was the assistant nurse manager of the 5-4 thoracic stepdown unit, Heart and Vascular Center, Yale New Haven Hospital, New Haven, Connecticut.

Critical Care Nurse
|January 31, 2022
PubMed
Summary

A new nurse-led algorithm significantly reduced postoperative urinary retention (POUR) after lobectomy, lowering the incidence from 21% to 3%. This approach helps prevent complications associated with urinary catheterization.

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Area of Science:

  • Thoracic Surgery
  • Urology
  • Nursing Research

Background:

  • Untreated postoperative urinary retention (POUR) can lead to bladder overdistension and necessitates urinary catheterization, increasing infection risk.
  • The hospital's POUR rate after lobectomy was 21%, significantly exceeding the STS benchmark of 6.4%.
  • A revised urinary catheter protocol appeared to increase catheterization rates.

Purpose of the Study:

  • To decrease the incidence of POUR in thoracic surgery patients.
  • Implementation of a thoracic surgery-specific, nurse-led voiding algorithm.

Main Methods:

  • A validated voiding algorithm standardized postoperative assessment for 179 general thoracic surgery patients.
  • Nurses collected patient data and followed the algorithm, documenting voided amounts and bladder scan results.
  • Statistical analyses (t test, χ2 test) identified factors associated with POUR.

Main Results:

  • The overall POUR rate decreased to 8%.
  • After implementation, the hospital's POUR rate following lobectomy dropped from 21% to 3%.
  • The nurse-led algorithm effectively reduced and sustained POUR rates.

Conclusions:

  • A nurse-led voiding algorithm successfully reduced postoperative urinary retention rates in thoracic surgery.
  • This standardized approach offers a sustainable method for improving patient outcomes and reducing catheter-associated complications.