MEADOWLARK HOSPICE PALLIATIVE PLAN OF CARE URINARY ELIMINATION: No. 41 PATIENT: ID No: FREQUENCY: Each POC problem marked will be addressed at each visit by each discipline. GOALS/EXPECTED DATE DATE PLAN/APPROACH ORG DIS OUTCOMES RESOLVED 1. Instruct patient/caregiver on signs and H, NF RN, SW, VC, 1. Patient will have symptoms of altered urinary elimination: C, NFS optimal comfort. a. Increase anxiety or agitation b. Lower abdomen appears swollen and tender to pressure 2. Patient/caregiver c. Small amounts of urine when voiding understands signs d. No urine x 8-10 hours and e. Patient does not feel empty after voiding symptoms/causes of urinary retention in 2. Explain to patient/caregiver causes of urinary disease process. symptoms. H, NF RN, SW, VC, a. Decreased output secondary to decreased C, NFS intake 3. Patient/caregiver b. Medications understands signs, c. Disease process symptoms/causes of urinary incontinence 3. Instruct on medications as prescribed in disease process. including side effects. Monitor effectiveness H, NF RN, SW, VC, (analgesics, medications for bladder spasms). C, NFS 4. The catheter will 4. Assist and instruct with general hygiene and remain patent and comfort measures as needed (adult briefs, functional between Chux, peri-care). H, NF RN, SW, VC, regularly schedule C, NFS changes. 5. Insert Foley catheter as ordered: a. Irrigate PRN with 30-50cc NS or as 5. Patient/caregiver ordered. H, NF RN, SW, VC, will properly b. Change Foley catheter q month or as C, NFS perform all care ordered by physician. required, including cleaning the site, 6. Asses the urinary system including: changing the bags, a. Assessment for bladder spasms and maintaining b. Any discomfort H, NF RN, SW, VC, patency of the c. Patency C, NFS catheter. d. Color and consistency of urine e. Urine output f. Signs of infection 7. Instruct the patient/caregiver in care of the catheter, including: a. Catheter irrigation H, NF RN, SW, VC, b. Changing the collection bag C, NFS c. Care of insertion site d. Signs of dysfunction, infection EVALUATION 41. urinary elimination.doc Revised 09/05 Page 1 of 1 .