URINARY CATHETERIZATION IHP Student's Name * First Middle Last Suffix This field is required. Please complete the following fields: First,Last. PhotoAccepted file types: jpg, gif, png, jpeg, Max. file size: 100 MB.DoB Month Incorrect Value for Month field Day Incorrect Value for Month field Year Incorrect Value for Month field Please enter a valid date. GR/LevelDaycareEEPKKN010203040506070809101112Post-GraduateWould you like to add the student's ID number? Yes No ID Campus/Building Would you like to add the student's homeroom number and teacher's name? Yes No Teacher Name Homeroom Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Emergency Contact List is attached to IHP. Yes No ContactContact Name Add RemoveRelationship Add RemoveContact Phone Number Add RemoveContact Phone Type Add RemoveContact Phone Number Add RemoveContact Phone Type Add RemoveContact Name RelationshipChoose one:ParentGuardianOtherContact Phone Number Contact Phone TypeChoose OneHomeMobileWorkFaxContact Phone Number Contact Phone TypeChoose OneHomeMobileWorkFax Add More Treating Physician Add RemovePhysician Phone Number Add RemovePhysician Fax Number Add RemoveTreating Physician Physician Phone Number Physician Fax Number Add More Preferred Hospital City MEDICAL DIAGNOSIS(ES)Add a medication or procedure? Yes No MEDICATIONS/PROCEDURES Medication/Procedure Strength Dose ModeChoose one:OralTopicalInhaledIntranasalSQNebulizerSublingualRectalIMIVSched/PRN?Choose OneScheduledPRNTime Frequency If PRN, administer for Medication/Procedure Add RemoveStrength Add RemoveDose Add RemoveMode Add RemoveSched/PRN? Add RemoveTime Add RemoveFrequency Add RemoveIf PRN, administer for Add Remove Add More MEDICAL HISTORYASSESSMENT NursingList InterventionList OutcomesList Nursing Diagnosis: Risk for Infection Related to presence of urinary catheter or the need for intermittent catheterization, which increases the risk of urinary tract infections (UTIs). Related to poor catheter care techniques or inadequate hand hygiene during catheter insertion or maintenance. Interventions The school nurse will teach and reinforce sterile techniques for catheter insertion and care, ensuring staff and the student (when appropriate) follow best practices. The school nurse will instruct the student and school staff to practice thorough hand washing before handling the catheter. The school nurse will regularly inspect the catheter insertion site for signs of infection such as redness, swelling, or discharge. Educate the student and caregivers about common signs of UTIs like fever, cloudy urine, or pain during urination. The school nurse will promote the importance of adequate hydration to help flush bacteria from the urinary tract. Expected Outcomes The student will remain free from urinary tract infections. The student and school staff will demonstrate proper catheter care techniques. The student will actively manage hydration to prevent UTIs. Nursing Diagnosis: Risk for Impaired Skin Integrity Related to prolonged catheter use or frequent catheterization can lead to irritation, pressure sores, or skin breakdown around the insertion site. Related to the presence of catheter tubing may cause friction or rubbing against the skin, leading to possible irritation. Interventions The school nurse will perform daily inspections of the catheter insertion site for any signs of irritation, redness, or skin breakdown. The school nurse will apply skin barriers or protective ointments as needed around the insertion site to prevent skin breakdown. The school nurse will ensure the catheter is appropriately secured to minimize tension on the skin and reduce friction from the tubing. The school nurse will educate the student and caregivers on daily skin care practices to keep the area clean and dry, avoiding moisture buildup that could cause irritation. Expected Outcomes The student will maintain intact skin around the catheter insertion site. The student and caregivers will follow proper skin care practices to prevent skin breakdown or irritation. Nursing Diagnosis: Impaired Urinary Elimination Related to inability to independently void urine due to the need for catheterization, leading to reliance on intermittent catheterization or indwelling catheter. Related to possible discomfort or anxiety about catheterization procedures. Interventions The school nurse will assist the student with the catheterization procedure as needed, ensuring privacy and comfort during intermittent catheterization. The school nurse will provide age-appropriate instruction on self-catheterization if applicable and ensure the student understands when and how to perform the procedure. The school nurse will ensure that the student has access to appropriate restroom facilities or a private space for catheterization during school hours. The school nurse will observe for any signs of incomplete bladder emptying, leakage, or difficulty with the catheterization process, and report concerns to caregivers. Expected Outcomes The student will perform intermittent catheterization independently or with minimal assistance, maintaining proper urinary elimination. The student will report no difficulties or complications related to urinary elimination. The student will demonstrate understanding of when and how to perform catheterization. Nursing Diagnosis: Risk for Anxiety Related to emotional distress about the need for catheterization or potential accidents at school. Related to fear of social stigma or embarrassment due to the visible catheter or procedure. Interventions The school nurse will offer a safe and supportive environment for the student to express concerns about their catheterization or related anxiety. The school nurse will ensure that the student can perform intermittent catheterization in private and with dignity, minimizing exposure and maintaining confidentiality. The school nurse will, if appropriate, educate the student’s peers about the need for catheterization to promote understanding and reduce stigma. The school nurse will teach relaxation techniques, such as deep breathing or mindfulness, to help the student manage anxiety around the procedure or social interactions. Expected Outcomes The student will demonstrate reduced anxiety and greater comfort with the catheterization process. The student will participate in school activities with confidence and feel supported by peers and staff. The student will use learned coping strategies to manage anxiety. Nursing Diagnosis: Deficient Knowledge Related to lack of understanding about proper catheter care, potential complications, and when to seek help. Related to misunderstanding of the need for frequent catheterization or the importance of hygiene. Interventions The school nurse will teach the student and caregivers about the proper techniques for catheter care, hygiene, and signs of complications such as infection or blockage. The school nurse will develop a care plan outlining the student's catheter care routine, including the timing of catheterization, hygiene practices, and when to seek assistance. The school nurse will, if the student is able to, self-catheterize, provide hands-on training and practice under supervision. The school nurse will offer periodic education sessions to ensure that the student and family continue to follow best practices for catheter care. Expected Outcomes The student and caregivers will demonstrate understanding and competence in catheter care, including proper hygiene and infection prevention techniques. The student will be able to manage their own catheterization with minimal assistance, if age-appropriate. The student will report fewer complications related to improper catheter care. Nursing Diagnosis: Risk for Social Isolation Related to physical limitations and the need for frequent catheterization may lead the student to avoid social or school activities. Related to fear of judgment or embarrassment from peers regarding the visible catheter or catheterization process. Interventions The school nurse will work with the student and school staff to ensure that the student can participate in all appropriate school activities, including physical education, with modifications as necessary. The school nurse will, with the family's consent, educate classmates about the student's condition and the need for catheterization to foster empathy and reduce stigma. The school nurse will be alert for signs of social withdrawal or avoidance and encourage the student to engage in social activities with peers. The school nurse will, if necessary, refer the student to a school counselor for support in managing any emotional challenges or self-esteem issues related to their condition. Expected Outcomes The student will actively participate in social and school activities. The student will report feeling included and supported by peers and staff. Nursing Diagnosis: Risk for Impaired Self-Esteem Related to embarrassment or self-consciousness about the catheter or catheterization process. Related to the need for ongoing medical intervention may affect the student’s self-perception, particularly if they feel different from peers. Interventions The school nurse will offer emotional support and counseling to help the student manage feelings of self-consciousness or frustration. The school nurse will help the student focus on their strengths and abilities, reinforcing a positive sense of self beyond the catheterization process. The school nurse will, with the family’s consent, educate peers about the condition to reduce stigma and foster an inclusive environment. The school nurse will encourage participation in activities or hobbies where the student excels, allowing them to feel valued for their abilities rather than focusing on their medical condition. Expected Outcomes The student will demonstrate improved self-esteem and positive body image. The student will feel comfortable participating in social and school activities without feeling self-conscious about their catheter. Would you like to add another nursing diagnosis? Yes No Nursing DiagnosisNursing DiagnosisAdd your own nursing diagnosisInterventionsAdd your own nursing interventionsExpected OutcomesAdd your own expected outcomesNursing Diagnosis Add RemoveInterventions Add RemoveExpected Outcomes Add Remove Add More EVALUATIONNOTESIHP Developed ByName First Last Title Date Month Day Year Please enter a valid date. Do you want to include physician and parent signature lines? Yes Download IHP Clicking this button will download this IHP to your computer and return you to the blank IHP. Return Clicking this button will return you to the IHP to make changes.
