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1、導(dǎo)尿管之選擇與護理慈濟技術(shù)學(xué)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(dǎo)尿管：在膀胱脹滿水之後由恥骨上正中央插入導(dǎo)引器然後插入導(dǎo)尿管suprapubiccatheterizationsuprapubiccatheterizationindicationsforsuprapubiccatheterizattionUrethratraumaClientswhorequirelong-termcatheterizationandwhoaresexuallyactiveFollowingpelvicorurologic
5、alsurgerySomegynaecologicalconditions,e.g.colposuspensionLong-termcatheterizationforincontinenceClientswhoareunabletotolerateurethralcatheterizationSomewheelchair-boundclientsConsidersuprapubicorurethralcatheterizationsuprapubicurethralLongterm（includingincontinence）ShorttermSex
6、uallyactiveclientsintermittentPost-specificsurgeryPost-specificsurgeryUrethratraumaDifficultieswithsuprapubicSomewheelchair-boundclientsDifficultieswithurethralcatheterConsidersuprapubicorurethralcatheterizationsuprapubicurethraspecificcareStrictasepsisoninsertionStrictasepsison
7、insertionspecificadvantagesReducedriskofinfectionNurseabletocarryoutprocedureEnablesexualintercourseConsidersuprapubicorurethralcatheterizationsuprapubicurethralSpecificdisadvantagesAlteredbodyimageAlteredbodyimagePotentialleakagefromandaroundsiteImpedessexualintercourseRequires
8、aregisteredmedicalpractitionertoinsertHigherris
