Bandaging of urological patients

For dressing of urological patients, in addition to the standard set of instruments, the dressing nurse should have the following:

• straight and curved bougies No. 16-28 in Sharjer;

• mother probes, button probes, gaunt probes;

• set of catheters - Nelaton, Maleko, Peccera, Foley catheter. The larger the assortment of catheters, the easier it is to select them according to the required circumstances;

• several vessels with a capacity of 100,150 ml with 20 ml syringes attached( for washing loaches);

• Glass lugs( at least 20 pcs.) For washing the bladder.

Each workstation should have a rack with a 2000 ml reservoir filled with a 3% solution of boric acid to wash the bladder.

Three categories of patients pass through the dressing room.

1. Dressings after surgery on the kidney without sensing.

The nurse gives the doctor a tweezer, with which the surgeon removes the bandage, then she gives two more tweezers, 3% peroxide to remove the crusts, then a solution of antiseptics to process the seam line. In the absence of complications, cellophane-gauze strips are removed on the second day, while the sister feeds the uterine probe and the rubber strip. Using a master probe, the rubber strip is inserted into the lumen of the stroke. This course is retained for 2-3 days, after which the rubber strip is removed. Sutures are removed on the 8th-9th day.

2. Dressings of patients with nephro- or pyelostoma.

The initial stages are standard. After treating the wound, the sister gives a glass with a 0.1% solution of chlorhexidine or another antiseptic to wash the nephrostomy drainage. After washing, the nurse gives a 5% iodine solution, then medium-sized napkins with a cut for the seam in the drainage area and large wipes to close the rest of the seam. When changing the drainage tube, a roller is placed under the opposite side of the patient. The nurse prepares a replacement tube and a uterine tube in case you have to probe the fistulous course in order to determine its direction. After the drainage tube is installed, the nurse gives a solution for rinsing the pelvis. Further all manipulations take place in the order indicated above. To fix the drainage tubes( nephrostomy or cystostomy), the nurse should have 1.5 m long ribbons. To make them, take a narrow bandage, cut it in half and twist it. Sterilize as a normal dressing.

3. Ligation of patients with a cystostomy tube.

After removing the bandage, the nurse gives two tweezers and a tampon moistened with an antiseptic to treat the seam. After that, she provides a sterile glass tip that is attached to the end of the tube connected to a reservoir filled with a disinfectant solution and placed above the dressing table by 100 cm. The doctor rinses the bladder. Then the nurse gives napkins with a cut to cover the seam near the drainage tube. The drainage tube is changed in the same way as nephrostomy drainage. Cushion under the patient is not put, because the fistulous course is shorter and straight.

4. Change of the catheter of Pezzer.

Before removing it, the nurse gives a large napkin. This napkin is covered with the area of ​​the external foramen of the fistulous course, after which the catheter is removed. This measure is necessary to prevent the splashing of urine when the head of the catheter leaves. Then the sister submits a new Pétzzer catheter and a metal conductor. In this state, it is injected into the bladder cavity. After the introduction of the catheter, it is not fastened with ribbons, as it is well retained in the bladder by the head. When the urethra is bougied, the sisters' actions are limited to the delivery of the boulevard number requested by the doctor.