【医学ppt课件】導尿管之選擇與護理

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1、導尿管之選擇與護理慈濟技術學院江明珠Incidenceofcatheterization10%ofpatientsinhospital（Mulhalletal,1988）25%ofpatientsinhospital（Saintetal,1999）4%ofpatientsreceivingnursingservicesathome（GetliffeandMulhall,1991）IndicationsforuseofurinarycathetersShort-termcatheterizationUrologicsurgerySurgeryoncont

2、iguousstructuresCriticallyillpatientsrequiringaccuratemeasureofurinaryoutputAcuteurinaryretentionIndicationsforuseofurinarycathetersLong-termcatheterizationBladderoutletobstructionnotcorrectablemedicalorsurgicallyIntractableskinbreakdowncausedorexacerbatedbyincontinenceSomepatie

3、ntswithneurogenicbladderandretentionPalliativecareforterminallyillorseverelyimpairedincontinentpatientsforwhombedandclothingchangesareuncomfortablePreferenceofapatientwhohasnotrespondedtospecificincontinencetreatments途徑TransurethracatheterizationTransvesicalcatheterization（supra

4、pubiccatheterization）Whatissuprapubiccatheterization？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suprapubiccatheterizationsuprapubiccatheterizationindicationsforsuprapubiccatheterizattionUrethratraumaClientswhorequirelong-termcatheterizationandwhoaresexuallyactiveFollowingpelvicorurologic

5、alsurgerySomegynaecologicalconditions,e.g.colposuspensionLong-termcatheterizationforincontinenceClientswhoareunabletotolerateurethralcatheterizationSomewheelchair-boundclientsConsidersuprapubicorurethralcatheterizationsuprapubicurethralLongterm（includingincontinence）ShorttermSex

6、uallyactiveclientsintermittentPost-specificsurgeryPost-specificsurgeryUrethratraumaDifficultieswithsuprapubicSomewheelchair-boundclientsDifficultieswithurethralcatheterConsidersuprapubicorurethralcatheterizationsuprapubicurethraspecificcareStrictasepsisoninsertionStrictasepsison

7、insertionspecificadvantagesReducedriskofinfectionNurseabletocarryoutprocedureEnablesexualintercourseConsidersuprapubicorurethralcatheterizationsuprapubicurethralSpecificdisadvantagesAlteredbodyimageAlteredbodyimagePotentialleakagefromandaroundsiteImpedessexualintercourseRequires

8、aregisteredmedicalpractitionertoinsertHigherris