GI/GU: Assisting with urinary elimination

Urination is the process of expelling urine outside the body via the urethra. In the medical field, it’s also called voiding or micturition. Your client might have problems with urinating, so it’s important that you recognize them and be able to assist them.

Typically, this process starts when you decide to urinate, the brain sends a signal down to the bladder causing it to contract. The sphincter relaxes, and the urine passes through the urethra and outside the body.

The amount of urine a person passes depends on their age and size, but generally, an adult should pass around 2,200 ml to 2,700 ml per day. If they pass under 300 ml per day, it’s called oliguria. If it’s less than 100ml per day, it’s called anuria. Both often indicate a serious medical condition!

Frequency of urination can also be an issue. Needing to urinate more than once every 2-3 hours is called urinary frequency, and having to urinate often at night is called nocturia. If there’s pain when urinating, it’s called dysuria. If they leak urine involuntarily, it’s called incontinence. If they feel the urge to urinate but can’t, it’s urinary retention; if they feel sudden, strong urges, it's called urinary urgency.

Now typical urine can range from clear to a light yellow or an amber color, and it should be free of particles . A darker “tea” color could be due to dehydration but also other medical problems. Red urine could be due to hematuria or blood in the urine, but some food, like beets, can also cause this.

Now, some people might have trouble with urination simply because they are too weak or have other medical conditions that prevent them from getting to the bathroom or using the toilet, so whatever the cause, you’ll need to know how to assist people with voiding.

Now, before we go into each procedure, some common care tips include: Making sure the path to the toilet is lit before the client goes to the bathroom. Answer call lights promptly, especially if they are elderly or have a history of incontinence.

Keep note of their normal urinary habits, so you can recognize any changes. Remember to close the room’s door and bedside curtain and respect their privacy. Warm bedpans and urinals are more comfortable; and close the curtain for privacy when using them.

A person might be too embarrassed to urinate when you’re there, so leaving the room or looking away might help, but stay nearby in case they need aid. You might be asked to provide perineal care, or “peri-care,” where you clean the genitals and anal region.

Use disposable cloth and wipe from the front to the back where the anus is located. Finally, when you finish assisting, check their clothing, gown, and bedsheet to ensure they’re dry and not soiled.

Let’s look at ways you can assist the client with urination. If a biological female can’t get out of bed, we can use a bedpan. This device is also used for bowel movements for both biological male and female clients.

To use a bedpan for voiding, put on gloves, raise the bed to a comfortable level for you to work with, and lower the head of the bed so it’s flat. Roll them onto their side in the lateral position and place down the bed protector.

Move the gown, so the buttocks are exposed. Ask them to bend their knees and place the bedpan firmly against their buttocks. Next, help roll them onto their back with the bedpan under the buttocks. Tell them you’re ready and give them time to void.

Some people have difficulty urinating in this position, so in these cases, you might need to help them into a sitting position. For some clients, you can leave the room until they’re finished if they can hold the bedpan themselves.