GROUP 3_ PART 2 DISCUSSION OF MIDTERM TOPICS.pptx

GROUP 3: PART 2
DISCUSSION OF
MIDTERM TOPICS
PRESENTED BY: GROUP 3 BSN 2A
MEMBERS:
LEANDA LUCILA MENORCA PARONABLE
LEGASPI MAGAJES MILLAN PASCUAL
LEMA MADRAZO NACALABAN

Topic Outline
BLOOD
TRANSFUSION
CATHETERIZATION
URINALYSIS
URINE
COLLECTION
INTAKE AND
OUTPUT

DESCRIPTION
● A blood transfusion is a common medical
treatment that involves receiving donated blood
through a small tube inserted into a vein in your
arm.
● provides blood or blood components if you’ve lost
blood due to an injury, during surgery or have
certain medical conditions that affect blood or its
components (Cleveland Clinic, 2020)

PURPOSE:
When the body's blood supply is
insufficient, blood transfusions
are required. A person may
require a blood transfusion if
they have had a serious injury or
have lost blood during surgery,
for example.
Other cases include:
● Anemia
● Hemophilia
● Cancer
● Sickle cell disease
● Kidney disease
● Liver disease

PT
Personalize your
presentation by
customizing this
slide as much as
you want.
You can duplicate
this slide as much
as you want to
PREPARATION:
● Provide privacy: consent form will
be signed
● The nurse/doctor will explained
how the procedure will be done
● Perform hand hygiene
● Provide safety
● Assess allergy of the patient
● The health care professional
discussed the risk/benefits of
blood transfusion
● The blood will be tested if the
patient is O, B AB, Rh
negative/positive
● Assemble equipments and
materials
● The nurse will check the pt blood
pressure, pulse and temperature.
● The health care professional will
check the appropriate site for the
transfusion
● Ensure that the donor blood type
is a match for your blood type.
● Ensure the supplied blood is the
product ordered by your doctor
and is labeled with your name.

PROCEDURE
● An intravenous (IV) line with a
needle is inserted into one of
your blood vessels.
● The donated blood that's been
stored in a plastic bag enters
your bloodstream through the
IV.
● You'll be seated or lying down
for the procedure, which usually
takes one to four hours.
● A nurse will monitor you
throughout the procedure and
take measures of your blood
pressure, temperature and heart
rate.
Tell the nurse immediately if you
develop:
❖ Fever
❖ Shortness of breath
❖ Chills
❖ Unusual itching
❖ Chest or back pain
❖ A sense of uneasiness

DON’TS
NURSING CONSIDERATIONS
DO’S
● Make sure your doctor knows
your correct blood group before
a blood transfusion.
● If you have any other blood
conditions, make sure you
inform your doctor before
getting a blood transfusion.
● All medical history should be
given to your physician honestly
before you donate or receive
blood
● Eat a proper meal
● Hydrate yourself
● Have an iron-rich diet
● Enjoy your snack
● For a person who is donating
blood, make sure you don’t suffer
from any systemic disease such
as diabetes, or high cholesterol.
● Make sure you aren’t undergoing
a viral infection such as HIV,
Hepatitis and the likes.
● The donor should also be aware
of his present hemoglobin levels
as well as make sure you are not
underweight.
● Refrain from smoking, drinking or
consuming any intoxicating drugs
at least 48 hours before the day
of donating blood.

CLIENT HEALTH TEACHING:
● People can react in various ways to
blood transfusions. Reactions people
experience may include:
○ Breathing troubles.
○ Fevers, chills or rashes.
○ Hemolytic transfusion reaction
● If you experience unusual symptoms
during a transfusion, tell your
healthcare provider. Stopping the
transfusion or getting certain
medications can provide relief.
● After your transfusion, your
healthcare provider will
recommend that you rest for 24
to 48 hours.
● You’ll also need to call and
schedule a follow-up visit with
your healthcare provider.
● Blood is important.
● Blood and the components of blood
benefit the body in these ways:
○ Red blood cells carry oxygen
through your body to your heart
and brain. Adequate oxygen is
very important to maintain life.
○ Platelets help to prevent or control
bleeding due to low platelet count.
○ Plasma and cryoprecipitate also
help to prevent or control
bleeding.
● Reactions to a blood transfusion can happen at
unexpected times.
● Call your healthcare provider right away if you
experience:
○ Bleeding, pain or new bruising at the IV
site.
○ Cold and clammy skin, fever or chills.
○ Dark or reddish urine.
○ Fast heartbeat, chest pain, trouble
breathing or wheezing.
○ Headache, dizziness, nausea or
vomiting.
○ Rash, hives or itching.
○ Severe back pain.

DESCRIPTION
A urinary catheter is a hollow, partially flexible tube that
collects urine from the bladder and leads to a drainage bag.
Urinary catheters come in many sizes and types.
They can either be inserted through the tube that carries
urine out of the bladder (urethral catheter) or through a
small opening made in your lower tummy (suprapubic
catheter).

intermittent catheters – these are temporarily inserted into the
bladder and removed once the bladder is empty
indwelling catheters – these remain in place for many days or
weeks, and are held in position by an inflated balloon in the
bladder
TYPES

intermittent catheters – these are temporarily inserted into
the bladder and removed once the bladder is empty
indwelling catheters – these remain in place for many days
or weeks, and are held in position by an inflated balloon in
the bladder
TYPES

PURPOSE:
A urinary catheter is usually used
when people have difficulty peeing
(urinating) naturally.
It can also be used to empty the
bladder before or after surgery and
to help perform certain tests.

PURPOSE:
It can be left in place for hours or
days to alleviate your need to go to
the bathroom or to use a bedpan if
you are restricted to bed or are
numb and can't feel the need to
urinate.
A full bladder in labor can become
distended and cause the baby to
have trouble moving down into the
pelvis. It may also prevent a baby
from being able to rotate into a
good position for birth.

PURPOSE:
In labor and delivery, such as when
you receive medications like
epidural anesthesia or have a c-
section.

PT
Personalize your
presentation by
customizing this
slide as much as
you want.
You can duplicate
this slide as much
as you want to
PREPARATION:
● Adequate exploration.
● Dorsal recumbent for the female and
supine for the male using a firm
mattress
● Ensure the patient’s privacy is
maintained throughout the procedure
and that they are kept warm.
For the child and family
● Gain patient/primary care givers
consent for procedure
● Families/primary care givers should
be given a thorough explanation of
the procedure.
● Consider the need for a referral to
play therapy to assist in explaining
and preparing the patient for the
procedure
Equipment
● Catheters are graded on the French
scale according to the size of the
lumen.
● For the female adult, No. 14 and No. 16
French catheters are usually used.
● For male adult, No.18 and No. 20
French catheters usually used, but if
this appears to be too large, smaller
catheter should be used
● No. 8 and No. 10 French catheters are
commonly used for children.
● Dressing trolley
● Sterile gloves
● Straps/tape to secure catheter to leg
● Drainage bag
● Waterproof sheet

PROCEDURE
● Inflate the balloon with the prefilled syringe
before inserting the catheter to check for
balloon patency.
● Hold the catheter with one hand and inflate the
balloon according to the manufacturer’s
instructions
● If the patient complains of pain after the
balloon is inflated, allow it to empty and replace
the catheter with another one.
● Exert slight tension on the catheter after the
balloon is inflated to assure its proper
placement in the bladder
● Connect the catheter to the drainage tubing
and drainage bag
● Tape the catheter along the anterior aspect of
the thigh for a female patient
● Hang the drainage bag on the frame of the bed
below the level of the bladder
Patient with an Indwelling Catheter
● Perform handwashing
● Clean the perineal area thoroughly,
especially around the meatus, twice a day
and after each bowel movement.
● Make sure that the patient maintains a
generous fluid intake.
● Note the volume and character of urine
and record observations carefully
● Report any signs of infection promptly.
These include a burning sensation and
irritation at the meatus, cloudy urine, a
strong odor to the urine, an elevated
temperature and chills
● Plan to change indwelling catheters only
as necessary. The usual length of time
between catheter changes varies and can
be anywhere from 5 days to 2 weeks.

DON’TS:
DO’S:
● Don’t change catheters or urine
collection bags at routine, fixed
intervals.
● Don't administer routine antimicrobial
prophylaxis.
● Don't use antiseptics to cleanse the
periurethral area while a catheter is in
place.
● Don't vigorously clean the periurethral
area.
● Don't irrigate the bladder with
antimicrobials.
● Don’t instill antiseptic or antimicrobial
solutions into urine collection bags.
● Don't routinely screen for asymptomatic
bacteriuria (ASB).
● Don't contaminate the catheter outlet
valve during urine collection bag
emptying.

NURSING RESPONSIBILITIES
Before care:
● Be sure to wash hands before and after caring
for a patient with a catheter.
● Clean the perineal area thoroughly, especially
around the meatus, twice a day and after each
bowel movement. This helps prevent
organisms for entering the bladder
● Use soap or detergent and water to clean the
perineal area and rinse the area well
● Make sure that the patient maintains a
generous fluid intake. This helps prevent
infection and irrigates the catheter naturally by
increasing urinary output
● Encourage the patient to be up and about as
ordered.
After care:
● Be sure the balloon is deflated before
attempting to remove the catheter.
● Have the patient take several deep breaths to
help relax while gently removing the catheter.
● Clean the area thoroughly with antiseptic
swabs after the catheter is removed
● See to it that the patient’s fluid intake is
generous and record the patient’s intake and
output.
● Instruct the patient to void into the bedpan or
urinal
● Observe the urine carefully for any signs of
abnormality
● Record and report any usual signs such as
discomfort, a burning sensation when voiding,
and changes in vital signs, especially the
patient’s temperature.
● Be alert to any signs of infection and report
them promptly

.
Catheter Care
To take care of your catheter, you’ll need to do the ff:
● Clean your catheter
● Change your drainage bag,
● Wash your drainage bags every day, and lastly drink
water every 2 hours while you’re awake.
Flush your catheter if it is clogged.
1) Prepare a syringe with 60 cc of sterile saline solution.
2) Connect the syringe to the port on the catheter tubing.
3) Push the fluid into the catheter.
4) If you cannot push the fluid in, adjust your catheter and try
again.
5) If you still have trouble, call your nurse or doctor.
Changing your urinary catheter bag
You may change your drainage bag once a week. You may reuse
this bag if you clean it:
1) Use a solution of 1/2 vinegar and 1/2 water.
2) Rinse the bag out with the solution.
3) Let the bag air-dry.
Changing your catheter.
- When you have a catheter, you are at risk for having a bladder
infection. Bladder infections can be serious. For this reason, it is important to
take great care of your catheter.
- Always follow the instructions your doctor or home health nurse gave
you.
- If the tubing and catheter do come apart, you must clean both ends
carefully. Use alcohol to clean the ends. Then, put them back together.

DESCRIPTION
According from Cleveland Clinic, a urine
test also known as urinalysis is a test
that examines the visual, chemical and
microscopic aspects of your urine (pee).
It include a variety of tests that detect
and measure various compounds that
pass through your urine using a single
sample of urine.

DESCRIPTION
There are three ways to analyze urine, and
your test might use all of them.
● Color and appearance. It’s how the urine
sample looks to the “naked eye”
● Microscopic findings. Checks for tiny
substances in the urine
● Chemical findings. Uses dipsticks to test
for certain chemical substances in the
urine sample.

DESCRIPTION
Common types of tests that use a dipstick in a
urinalysis include:
● Urine pH level test
● Protein urine test
● Glucose urine test
● Nitrite urine test
● Bilirubin urine test

PURPOSE OF URINALYSIS IN
PREGNANCY:
● Urinalysis every prenatal check up gives
the practitioner a sign that the pregnant
woman is potentially have a condition
requires for further treatment.
● Urine test during pregnancy looks for the
following factors:
A.) Diabetes = High level of glucose may
indicate pre- existing type 1 and type 2
diabetes or later on, gestational diabetes.
B.) Preeclampsia = protein in urine may
be a sign of pre eclampsia or PIH.

PURPOSE OF URINALYSIS IN
PREGNANCY:
C.) Urinary tract Infection (UTI)
=Red or white blood cell in the urine may be a
signs of UTI.
D.) Dehydration
= Dark, tea-colored urine usually signals that
a pregnant mother needs to drink more water.

PT
PREPARATION:
Before your test, make sure
to drink plenty of water so
you can give an adequate
urine sample. However,
drinking excessive amounts
of water may cause
inaccurate results.
One or two extra glasses of
fluid, which can include juice
or milk if your diet allows, is
all you need the day of the
test. You don’t have to fast
or change your diet for the
test.
Also, tell your doctor about any
medications or supplements you’re
taking. Some of these that can affect
the results of your urinalysis include:
● vitamin C supplements
● metronidazole
● riboflavin
● anthraquinone laxatives
● methocarbamol
● nitrofurantoin

PROCEDURE
Initial assessment of urine:
1. Wash your hands and don PPE.
2. Confirm the patient’s details on the
sample bottle are correct including their
name, date of birth and hospital number.
3. Inspect the colour of the urine:
• Straw-coloured urine: this is the
normal colour of urine in a healthy, hydrated
individual.
• Dark concentrated urine: suggests
STEP BY STEP PROCEDURE ON HOW TO PERFORM
URINALYSIS FOR A PREGNANT WOMAN
How prenatal urine tests are
done?
1. Wash your hands and
wipe the labia clean from
front to back (usually
with a wipe provided by
the doctor).
2. Start peeing in the toilet.
1. Catch the urine
midstream with the
collection cup.
1. Continue filling to the
mark indicated by your
practitioner (usually
about 1 to 2 ounces).
● A nurse or technician will
insert a dipstick into the
sample or place a few drops
of urine onto testing strips to
check for sugar, protein or
blood cells. A color change
indicates a positive test.

PROCEDURE
● Red urine: can be caused by the
presence of blood in the urine
(macroscopic haematuria),
porphyria, drugs such as rifampicin
and certain foods (e.g. beetroot).
● Brown urine: can be caused by the
presence of bile pigments (e.g.
jaundice) or myoglobin (e.g.
rhabdomyolysis) in the urine.
Some antimalarial medication,
such as chloroquine, also cause
brown discolouration of the urine.
4. Inspect the clarity of the urine:
• Clear urine: this is normal for healthy,
well-hydrated individuals.
• Cloudy urine with sediment: may
indicate urinary tract infection, renal stones, high
protein content (e.g. nephrotic syndrome).
• Frothy urine: typically associated with
significant proteinuria (e.g. nephrotic syndrome).
5. Consider opening the sample pot’s cap and
assessing the urine’s odour:
• Offensive odour: suggestive of urinary
tract infection.
• Sweet odour: suggestive of glycosuria
(e.g. diabetes mellitus).
• Assessment of urinary odour is rarely

PROCEDURE
DIPSTICK TESTING
Procedure:
1. Check the expiry date of the urinalysis dipstick.
2. Remove a dipstick from the container whilst
avoiding touching the reagent squares.
3. Replace the container lid to prevent oxidation of
the remaining dipsticks.
4. Insert the dipstick into the urine sample, ensuring
all reagent squares are fully immersed.
5. Remove the dipstick immediately and tap off any
residual urine using the edge of the container,
making sure to hold the dipstick horizontally to avoid
cross-contamination of the reagent squares.
6. Lay the dipstick flat on a paper towel.
7. Use the urinalysis guide on the side of the
testing strip container to interpret the findings.
Different reagent squares on the strip need to be
interpreted at different times, so ensure you
interpret the correct test at the appropriate time
interval (e.g. 60 seconds for protein).
8. Once you have interpreted all of the tests,
discard the strip into the clinical waste bin along
with your PPE.
9. Wash your hands.

DO’S
● Don't touch the rim of
the container
● Feces, discharges,
vaginal secretions and
menstrual blood
shouldn’t be included
as this will contaminate
the urine specimen.
Instruct the patient to void directly
into a clean, dry container. Sterile,
disposable containers are
recommended. Women should always
have a clean-catch specimen if a
microscopic examination is ordered.
Collect specimens form infants and
young children into a disposable
collection apparatus consisting of a
plastic bag with an adhesive
backing around the opening that
can be fastened to the perineal area
or around the penis to permit
voiding directly to the bag.
DON’TS

DURING
BEFORE ● Instruct the patient to use the
cotton ball or towelette to clean
urethral area thoroughly to
prevent external bacteria from
entering the specimen.
● Let the patient void into the
container.
● Label the specimen container
with patient identifying
information, and send to the lab
immediately. A delay in
examining the specimen may
cause a false result when
bacterial determinations are to
be made.
● Wash your hands and instruct
the patient to do it as well.
● Note that the sample was
collected.
Do void before the
procedure.
Eat and drink
before the
procedure.

● Cover all specimens tightly, label properly and send
immediately to the laboratory.
● If a urine sample is obtained from an indwelling catheter, it
may be necessary to clamp the catheter for about 15-30
minutes before obtaining the sample. Clean the specimen port
with antiseptic before aspirating the urine sample with a needle
and a syringe.
● Observe standard precautions when handling urine specimens.
● If the specimen cannot be delivered to the laboratory or tested
within an hour, it should be refrigerated or have an appropriate
preservative added.
AFTER

● Cleanse the urinary opening. Women should spread the labia and
clean from front to back.
● Begin to urinate into the toilet.
● Pass the collection container into your urine stream.
● Urinate at least 1 to 2 ounces (30 to 60 milliliters) into the
collection container.
● Finish urinating into the toilet.
● Deliver the sample as directed by your healthcare provider.
● If you can't deliver the sample to the designated area within 60
minutes of collection, refrigerate the sample, unless your provider
has told you otherwise.

SAMPLE VIDEO PRESENTATION ON HOW TO
PERFORM URINALYSIS TEST

DESCRIPTION
A simple lab test that measures what’s in
your urine.
The urine specimen collection is a
procedure used to obtain a sample of
urine from a patient. The sample is used
for diagnostic tests (Urinalysis).

PURPOSE:
The client’s GP or another healthcare
professional may ask for a urine sample
to help them diagnose or rule out certain
health conditions. Urine contains waste
products that are filtered out of the body.
If the sample contains anything unusual,
it may indicate an underlying health
problem.
Urine tests are most commonly done to
check:
- for infections – such as a urinary
tract infection (UTI) or some
sexually transmitted infections
- if they are passing any protein in
the urine that indicates damaged
kidneys or kidney disease

PURPOSE: (In Pregnancy)
- Urine HCG tests are a common
method of determining if a woman
is pregnant. The best time to test
for pregnancy is after the woman
miss her period.
- A urine test is used to assess
bladder or kidney infections,
diabetes, dehydration, and
Preeclampsia by screening for
high levels of sugars, proteins,
ketones, and bacteria. High levels
of sugars may suggest
Gestational Diabetes, which may
develop around the 20th week of
pregnancy.

PT
Personalize your
presentation by
customizing this
slide as much as
you want.
You can duplicate
this slide as much
as you want to
Different types of
urine collection
Random Urine Sample:
A sample of urine collected at
any time of the day. This
type of specimen is most
convenient to obtain.
Midstream “Clean-Catch”
Urine Specimen:
the most common method of
obtaining urine specimens
from adults, particularly men.
This method allows a
specimen, which is not
contaminated from external
sources to be obtained
without catheterization.
Timed Urine Specimens:
A 24-hour urine collection is
performed by collecting a
person’s urine in a special
container over a 24-hour
period. It always begins with
an empty bladder so that the
urine collected is not “left
over” from previous hours.
This specimen shows the
total amounts of wastes the
kidneys are eliminating and
the amount of each.

PT
Personalize your
presentation by
customizing this
slide as much as
you want.
You can duplicate
this slide as much
as you want to
Different types of
urine collection
Pregnancy Urine
Test:
Urine HCG tests are a common
method of determining if a
woman is pregnant. The best
time to test for pregnancy is
after the woman miss her
period.

PT
Personalize your
presentation by
customizing this
slide as much as
you want.
You can duplicate
this slide as much
as you want to
Midstream “Clean-Catch” Urine
Specimen collection:
Explain to the patient that this kind of
urine collection involves first voiding
approximately one half of the urine into
the toilet, urinal, or bedpan, then
collecting a portion of midstream urine
in a sterile container, and allowing the
rest to be pass into the toilet. Discuss
that this is done to detect the presence
or absence of infecting organisms and,
therefore, must be free from
contaminating matter that may be
present on the external genital areas.
Timed Urine Specimens :
The test does not require anything other
than normal urination. There are no
risks involved. Generally, the patient will
be given one or more containers to
collect and store urine over a 24-hour
time period.
PREPARATION:
Random Urine Sample:
The client’s urine for urinalysis may be
collected at any time, at the lab or in their
home. they do not need to schedule an
appointment at the lab. It is preferred that
they collect a specimen first thing in the
morning, because the first morning urination is
more concentrated and likely to yield the best
results.
Pregnancy Urine Test:
Allows patient to wait one to two weeks after
her first missed period to get the most
accurate results. Note: Irregular periods or
miscalculations of when a period is due can
affect the test. According to the FDA, 10 to 20
percent of pregnant women may not detect
their pregnancy by testing on what they
believe to be the first day of their first missed
period.

PROCEDURE
Timed Urine Specimens
collection
● Label the bottle with patient
identifying information, the date, and
time the collection begins and ends.
● Instruct the patient to urinate, flush
down the urine down the toilet when
she gets up in the morning.
● Afterward, tell the patient to collect
the rest of her urine in the special
bottle for the next 24 hours, storing
it in a cool environment. It can be
kept cool in the refrigerator or on ice
in a cooler.
● Instruct the patient to drink
adequate fluids during the
collection period.
● Emphasize proper hand hygiene
before and after each collection.
Record each amount on the intake
and output (I&O) sheet.
● Exactly 24-hours after beginning
the collection, ask the patient to
void. This will complete the
specimen collection.
● Instruct the patient to continue to
keep the collection container
refrigerated until transfer to
laboratory.
● Send the bottle and laboratory
request form to the lab.

PROCEDURE
Midstream “Clean-Catch” Urine
Specimen collection
For female patients
● Wash hands with soap and water.
● Instruct the client to clean perineal
area with towelettes or cotton balls.
● Instruct the patient to separate folds
of urinary opening with thumb and
forefinger and clean inside with
towelettes or cotton balls, using
downward strokes only; keep labia
separated during urination.
● Instruct the patient to void a small
amount of urine into the toilet to rinse out
the urethra, void the midstream urine into
the specimen cup, and the last of the
stream into the toilet. The midstream
urine is considered to be bladder and
kidney washings; the portion that the
physician wants tested.
● Label the specimen container with patient
identifying information, and send to the
lab immediately. A delay in examining the
specimen may cause a false result when
bacterial determinations are to be made.
● Note that the specimen was collected.
Record any difficulties the patient had or
if the urine had an abnormal appearance.

PROCEDURE
Random Urine Sample
● The patient will be instructed to
use the cotton ball or towelette to
clean urethral area thoroughly to
prevent external bacteria from
entering the specimen.
● Let the patient void into the
container.
● Label the specimen container with
patient identifying information,
and send to the lab immediately. A
delay in examining the specimen
may cause a false result when
bacterial determinations are to be
made.
● Wash your hands and instruct the
patient to do it
● Note that the sample would be
collected as well
PROCEDURE
Pregnancy Urine Test:
● Advise the patient to use the test the first
time she urinate after waking up. As this
urine is the most concentrated, it will contain
the highest hCG levels of the day. Urine will
become more diluted as the patient drink
liquids, so hCG levels may be harder to
measure later in the day.
● Label the specimen cup with the patient’s
identifying information, complete a
laboratory request form requesting an HCG
test and send both to the lab.
● Only the physician or a registered nurse
should tell the patient the results of the test.

DO’S
DO’S & DON’TS
For collecting samples, don’t use improper
collection instruments such as non sterile
containers and containers that can produce
leaks from the specimen.
Label the specimen container properly.
Ensure that the female patient is not
experiencing menstruation or vaginal
discharge, as these will contaminate
the urine sample.
Don't delay the transfer of the urine
sample to the lab.
● Do not leave samples standing out on
work surfaces overnight, refrigerate in a
specimen fridge. When possible, collect
specimen in the morning, if in the
community, get transport to the hospital
the same day.
● Maintain an appropriate time between
collection of the specimen and delivery
to the lab.
● It's important to note that irregular
periods or miscalculations of when a
period is due can throw the test off.
According to the FDA, 10 to 20% of
pregnant women may miss their period
because they test on what they
● To maintain the integrity of the urine
sample, it must be collected in a sterile
and dust-free environment.
● Do not perform a pregnancy urine
test later in the day since HcG
levels will be more difficult to detect.

BEFORE
● Instruct the patient to void directly into a
clean, dry container.
● Observe proper hand hygiene prior to the test.
● Label the specimen container with patient
identifying information
● Fill out the laboratory request form completely
● Instruct the patient to completely retract
foreskin and cleanse penis with towelettes or
cotton balls. (For male patients)
● Advise the patient to use the test the first time
she urinate after waking up. (Pregnancy Urine
Test)
BEFORE
DURING
● Provide privacy for the adult patients
● the clean-catch kit consists of a plastic bag
with a sticky strip on one end that fits over the
baby’s genital area, as well as a sterile
container. Use the same cleaning methods and
the plastic bags for collecting the urine. Pour
the urine into the sterile container. (For infant
patients)
AFTER
● Wash your hands and instruct the patient to do
it as well.
● Note that the specimen was collected. Record
any difficulties the patient had or if the urine had
an abnormal appearance.
● Send the bottle and laboratory request form to
the lab.
● Urine samples and used test devices are potentially
infectious, so please keep them away from direct
contact with objects. Proper handling, hand
washing, and immediate disposal is recommended.

Inform the patients the
normal values of the
urine when the results
are up.
Advise the pregnant
patient that urine
collection for testing is
recommended at every
prenatal visit in order to
detect disease early.
If possible, inform the
patient the purpose of
the urine collection.
Instruct the patient to
continue to keep the
collection container
refrigerated until transfer to
laboratory. (For timed urine
specimens)

DESCRIPTION
● Input and output monitoring can also be called
as fluid management in the body which is
essential as it allows the metabolic activities of
the body to function in a normal manner.
● This is important for certain groups of clients,
like those on special fluid order, those who are
at risk of developing dehydration and those who
might develop edema.

PURPOSE:
● Monitoring of intake help to
ensure that the patient has
proper intake of fluid and other
nutrients. Monitoring of output
helps determine whether there is
adequate output of urine as well
as normal defecation.
● Intake and output (I&O) indicate
the fluid balance for a patient.
The goal is to have equal input
and output. Too much input can
lead to fluid overload. Too much
output can cause dehydration.
Both situations can put the
patient at risk for complications.

PT
Personalize your
presentation by
customizing this
slide as much as
you want.
You can duplicate
this slide as much
as you want to c
PREPARATION:
● Prepare I&O sheet
● Know what fluid output to include
● Keep in mind any necessary conversion
● Prepare Gloves
● Prepare a Graduated measuring container
● If there is a possibility of splashing, prepare personal
protective equipment such as gown, goggles, or face
shield and mask
● Provide client with urine receptacles specifically labelled
with their name an bed location

PROCEDURE
MEASURING FLUID INTAKE:
For fluid intake, you’ll need to count:
● anything the client drinks, including water and
beverages
● all foods that are liquid at room temperature,
like ice cream, gelatin, sherbert, pudding,
custard, ice chips, and popsicles
● the fluids provided through intravenous
therapy, enteral, or total parenteral nutrition
Keeping in mind any necessary conversions, gather
the supplies you’ll need, including:
● gloves
● a graduated measuring container
1. Add all fluid volumes served to that client.
For example, during your shift, the client
could have been served with 200 mL of
water, 360 mL of soda, and 140 mL of
milk. All together, these equal 700 mL .
2. Put on your gloves and transfer whatever
has remained from each liquid into a
graduated measuring container.
Remember to keep the graduate even and
at eye level to ensure precise
measurements
3. Subtract the volume in the graduate from
the total volume of fluid served to the
client. For example, if the volume left in the
graduate is 80 mL, this is subtracted from
the full serving amount of 700 mL, giving
us a total fluid intake of 620 mL.
4. Remove your gloves and practice hand
hygiene.

PROCEDURE
MEASURING FLUID OUTPUT
Fluid output includes:
● urine
● vomitus
● wound drainage
● diarrhea
● blood
Once again, your supplies include:
● gloves
● a graduated container
● if there’s a possibility of splashing, personal
protective equipment, such as a gown,
goggles or face shield, and a mask
1. Provide these clients with urine
receptacles specifically labeled with
their name and bed location. Tell
them to only urinate in these
receptacles and notify you when
they are finished before discarding
the contents.
● Commonly used urine
receptacles are specimen
“hats” that can be positioned
under the toilet seat or a
bedside commode to collect
urine.

PROCEDURE
2. Collect all forms of the client's fluid output
into a receptacle with volume marks. Most
receptacles already have volume marks, but
not all of them
● If the client is using a bedpan or
catheter drainage bag, empty their
contents into a graduated container.
● If the client vomits, collect it in an
emesis basin. Blood and wound
drainage might be collected in
drainage pouches. If the emesis basin
and drainage pouch don’t have
volume marks, pour the contents of
both receptacles into a graduate.
3. Hold the receptacle or graduate at eye
level to measure the fluid volume.
4. Empty the contents into the toilet and
clean, rinse, and disinfect both the
receptacle or graduate as well as the
toilet.
5. You may also have to assess the
volume of fluid losses outside of
containers. This could be the case if a
client has vomited out of the emesis basin,
if there’s blood or wound drainage not
contained in a drainage pouch, as well as
in the case of diarrhea.
6. Remove your gloves and practice hand
hygiene.

DO’S
● Identify whether your patient has
undergone surgery of if he has medical
condition or takes medication that can
affect fluid intake or loss
● Measure record all intake and output at
least every 8 hours
● Record type and amount of fluid the
patient received and lost, describe the
route
● Describe them either as urine. Liquid
stool, vomitus, tube drainage and any fluid
aspirated from the body.
● Measure and observe input and output at
eye level
● Keep in mind the typical 24-hour intake
and output
● Empty the containers into the toilet and
clean and disinfect both the receptacles as
well as the toilet
DONT’S
● Don't delegate the task of
recording intake and output until
you’re sure the person who’s
going to do it understand its
importance
● Don’t assess output by amount
only, consider the color, color
changes and odor too.
● Don’t use the same graduated
container for more than one
patient

Teach and provide the rationale
for monitoring fluid intake and
output to the client and family as
appropriate. Include how to use a
commode or collection device
(“hat”) in the toilet, how to empty
and measure urinary catheter
drainage, and how to count or wet
diapers
Instruct and provide the
rationale for regular weight
monitoring to the client and
family. Weigh at the same time
of day, using the same scale
and with the client wearing the
same amount of clothing.
Educate and provide the
rationale to the client and
family on when to contact a
healthcare professional, such
as in the cases of a significant
change in urine output; any
change of 5 pounds or more in
a 1- to 2-week period;
prolonged episodes of
vomiting, diarrhea, or inability
to eat or drink; dry, sticky
mucous membranes; extreme
thirst; swollen fingers, feet,
ankles, or legs; difficulty
breathing, shortness of breath,
or rapid heartbeat; and
changes in behavior or mental
status.

REFERENCES:
BLOOD TRANSFUSION:
Blood transfusion . (2017). Retrieved 7 April 2022, from https://www.nhs.uk/conditions/blood-
transfusion/
Blood transfusion - Mayo Clinic. (2022). Retrieved 7 April 2022, from
https://www.mayoclinic.org/tests-procedures/blood-transfusion/about/pac-20385168
Blood Transfusion: What is it, Benefits, Risks & Reactions, Time. (2022). Retrieved 7 April 2022,
from https://my.clevelandclinic.org/health/treatments/14755-blood-transfusion
Blood transfusion: Types, purpose, procedure, and recovery. (2022). Retrieved 7 April 2022, from
https://www.medicalnewstoday.com/articles/327513#what-to-expect
Melbourne, T. (2022). Blood Transfusion : Blood administration . Retrieved 7 April 2022, from
https://www.rch.org.au/bloodtrans/blood_administration/Blood_administration/
Step-by-Step Master's Guide to Blood Transfusions | Unitek College. (2021). Retrieved 7 April 2022,
from https://www.unitekcollege.edu/blog/a-step-by-step-guide-to-blood-transfusion/
Clevelandclinic.org. (2022). Cleveland Clinic. Retrieved from Blood Transfusion:
https://my.clevelandclinic.org/health/treatments/14755-blood-transfusion
Health, R. (2019, July 30). Regency Health. Retrieved from Blood Donation:
https://regencyhealthcare.in/general/blood-donation-dos-and-donts/
Vitality, H. T. (2022). HTV. Retrieved from The do's and don'ts of blood transfusion:
https://htv.com.pk/health/the-dos-and-donts-of-blood-transfusion

REFERENCES:
Types of Catheters & Complications. (2022). Retrieved 7 April 2022, from
https://www.webmd.com/urinary-incontinence-oab/catheter-
types#:~:text=A%20catheter%20is%20a%20thin,rid%20of%20urine%20for%20you.
Urinary Catheters: Uses, Types, and Complications. (2022). Retrieved 7 April 2022, from
https://www.healthline.com/health/urinary-catheters
Urinary catheters . (2017). Retrieved 7 April 2022, from https://www.nhs.uk/conditions/urinary-
catheters/#:~:text=A%20urinary%20catheter%20is%20a,by%20a%20doctor%20or%20nurse.
Why Urinary Catheters Are Used in Labor and Delivery. (2022). Retrieved 7 April 2022, from
https://www.verywellfamily.com/urinary-catheter-2759013
Agency for Healthcare Research and Quality. (2017, March) Catheter care do's and don'ts. Retrieved
April 7, 2022, from https://www.ahrq.gov/hai/quality/tools/cauti-
ltc/modules/resources/tools/prevent/do-dont.html
Cott, M. (2022, February). Patient Teaching Guides for Foley Catheter Care. Retrieved April 7, 2022,
from https://go.myhomecarebiz.com/blog/teaching-guides-for-home-health-foley-catheter-care
CATHETERIZATION:

REFERENCES:
URINALYSIS:
● , S., & says:, M. C. (2016, May 10). Nurses' guide to specimen
collection, preparation, and handling procedures. Nurseslabs.
Retrieved April 7, 2022, from https://nurseslabs.com/nurses-guide-
specimen-collection-preparation-handling-procedures/
● Cleveland Clinic. (2021). Urinalysis. Retrieved April 7, 2022, from
https://my.clevelandclinic.org/health/diagnostics/17893-urinalysis
● RNpedia. (N.D.). Routine Urinalysis. Retrieved April 7, 2022, from
https://www.rnpedia.com/nursing-notes/fundamentals-in-nursing-notes/routine-
urinalysis/#:~:text=Nursing%20Considerations%20for%20Routine%20Urinalysis,
a%20microscopic%20examination%20is%20ordered.
● https://www.youtube.com/watch?v=TbTRq6WpmgE

REFERENCES:
INTAKE & OUTPUT:
● FAQ, C., Care, B., & output?, W. (2022). CNA Frequently Asked Questions | CNA Plus Academy.
Retrieved 7 April 2022, from https://cna.plus/faq/basic-cna-aide-care/intake-output-purpose/
● The Intake-Output Chart. (2017). Retrieved 7 April 2022, from https://drdollah.com/monitoring/the-intake-
output-chart/#:~:text=Importance%20of%20M
● https://www.osmosis.org/learn/Monitoring_fluid_intake_and_output:_Clinical_skills_notes
● (2022). Retrieved 7 April 2022, from https://wps.prenhall.com/wps/media/obje

REFERENCES:
URINE COLLECTION:
● 24-hour urine collection. 24-Hour Urine Collection - Health Encyclopedia - University of
Rochester Medical Center. (n.d.). Retrieved April 7, 2022, from
https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=92&ContentID=P
08955
● Getting a pregnancy urinalysis: About prenatal urine tests. American Pregnancy Association.
(2021, December 9). Retrieved April 11, 2022, from https://americanpregnancy.org/prenatal-
testing/urine-test-
urinalysis/#:~:text=Why%20is%20a%20urine%20analysis,proteins%2C%20ketones%2C%20a
nd%20bacteria.
● Getting a pregnancy urinalysis: About prenatal urine tests. American Pregnancy Association.
(2021, December 9). Retrieved April 11, 2022, from https://americanpregnancy.org/prenatal-
testing/urine-test-
urinalysis/#:~:text=Why%20is%20a%20urine%20analysis,proteins%2C%20ketones%2C%20a
nd%20bacteria.
● Pregnancy test instructions. Time to Conceive. (n.d.). Retrieved April 11, 2022, from
https://www.med.unc.edu/timetoconceive/study-participant-resources/pregnancy-test-
instructions/#:~:text=Instructions%3A,collected%20by%20the%20testing%20device.
● Gil Wayne graduated in 2008 with a bachelor of science in nursing. He earned his license to
practice as a registered nurse during the same year. His drive for educating people stemmed
from working as a community health nurse. He conducted first aid traini, Says:, S., & says:, M.
C. (2016, May 10). Nurses' guide to specimen collection, preparation, and handling
procedures. Nurseslabs. Retrieved April 11, 2022, from https://nurseslabs.com/nurses-guide-
specimen-collection-preparation-handling-procedures/#44_pregnancy_urine_test

Thank you
for listening!
Don't hesitate to ask any
questions!

GROUP 3_ PART 2 DISCUSSION OF MIDTERM TOPICS.pptx

Recommended

Recommended

More Related Content

Similar to GROUP 3_ PART 2 DISCUSSION OF MIDTERM TOPICS.pptx

Similar to GROUP 3_ PART 2 DISCUSSION OF MIDTERM TOPICS.pptx (20)

Recently uploaded

Recently uploaded (20)

GROUP 3_ PART 2 DISCUSSION OF MIDTERM TOPICS.pptx