导尿管之选择与护理PPT课件

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1、導尿管之選擇與護理1Incidenceofcatheterization10%ofpatientsinhospital（Mulhalletal,1988）25%ofpatientsinhospital（Saintetal,1999）4%ofpatientsreceivingnursingservicesathome（GetliffeandMulhall,1991）2IndicationsforuseofurinarycathetersShort-termcatheterizationUrologicsurgerySurgeryoncon

2、tiguousstructuresCriticallyillpatientsrequiringaccuratemeasureofurinaryoutputAcuteurinaryretention3IndicationsforuseofurinarycathetersLong-termcatheterizationBladderoutletobstructionnotcorrectablemedicalorsurgicallyIntractableskinbreakdowncausedorexacerbatedbyincontinenc

3、eSomepatientswithneurogenicbladderandretentionPalliativecareforterminallyillorseverelyimpairedincontinentpatientsforwhombedandclothingchangesareuncomfortablePreferenceofapatientwhohasnotrespondedtospecificincontinencetreatments4途徑TransurethracatheterizationTransvesicalca

4、theterization（suprapubiccatheterization）5Whatissuprapubiccatheterization？恥骨上導尿管：在膀胱脹滿水之後由恥骨上正中央插入導引器然後插入導尿管6suprapubiccatheterization7suprapubiccatheterization8indicationsforsuprapubiccatheterizattionUrethratraumaClientswhorequirelong-termcatheterizationandwhoaresexually

5、activeFollowingpelvicorurologicalsurgerySomegynaecologicalconditions,e.g.colposuspensionLong-termcatheterizationforincontinenceClientswhoareunabletotolerateurethralcatheterizationSomewheelchair-boundclients9ConsidersuprapubicorurethralcatheterizationsuprapubicurethralLon

6、gterm（includingincontinence）ShorttermSexuallyactiveclientsintermittentPost-specificsurgeryPost-specificsurgeryUrethratraumaDifficultieswithsuprapubicSomewheelchair-boundclientsDifficultieswithurethralcatheter10Considersuprapubicorurethralcatheterizationsuprapubicurethras

7、pecificcareStrictasepsisoninsertionStrictasepsisoninsertionspecificadvantagesReducedriskofinfectionNurseabletocarryoutprocedureEnablesexualintercourse11ConsidersuprapubicorurethralcatheterizationsuprapubicurethralSpecificdisadvantagesAlteredbodyimageAlteredbodyimagePoten

8、tialleakagefromandaroundsiteImpedessexualintercourseRequiresaregisteredmedicalpractitionertoinsertHighe