A small compilation of nurse anesthesia care plans

These anesthesia care plans are meant to inspire nurse anesthesia residents when they are making their care plans. Always make sure you fully understand and "own" your care plan. Your plan must be specific for your patient and should always be with the most up-to-date information.

Meatoplasty

Meatal stenosis is a narrowing of the opening of the urethra

Persistent urinary problems can be complications resulting from meatal stenosis, including

  • Abnormal urine stream
  • Painful urination
  • Frequent urination
  • Urinary incontinence
  • Blood in the urine
  • Increased susceptibility to urinary tract infections

Meatoplasty is the alteration of the urethral external opening to enlarge it. It is usually required when the terminal part of the urinary passage narrows, producing an obstructed stream. Meatoplasty may be necessary for a variety of reasons. It is not uncommon to see this happen after a heart bypass surgery when a urethral catheter is usually kept for a couple of days.

In females, this condition is a birth abnormality that can cause urinary tract infections and bed-wetting. Although less common, this condition may also be seen in adult women. It may occur if multiple endoscopic procedures (cystoscopy) have been performed or if the person suffers from severe, long-term atrophic vaginitis

Symptoms

  • Abnormal strength and direction of urinary stream
  • Visible narrow opening in boys
  • Discomfort with urination
  • Incontinence (day or night)
  • Bleeding (hematuria) at the end of urination
  • Urinary tract infections

Diagnosis

In boys, history and physical exam are adequate to make the diagnosis

In girls, VCUG (voiding cystourethrogram) is usually diagnostic

Other tests may include

Urine analysis

Urine culture

CBC, basic metabolic panel

An overactive bladder is a condition in which the bladder squeezes at the wrong time. Nerve problems may cause the condition, or it may occur without any clear cause

Renal and bladder ultrasound

Procedure

In females, meatal stenosis can usually be treated in the physician's office. This is done using local anesthesia to numb the area and dilate (widening) the urethral opening with special instruments

In boys, meatoplasty, a minor outpatient surgical procedure, is the treatment of choice

Most people can expect normal urination after treatment

Anesthetic considerations

GA, mask, or LMA

Immobile patient

Pain medications