TABLE 3.

NURSING IMPLICATIONS FOR ASSESSING AND MANAGING GROSS HEMATURIA

Obtain a detailed history and physical Understand etiology of hematuria to assess severity, impact and potential interventions Understand potential medical interventions to assess or intervene in gross hematuria at end of life Continuously assess severity of bleeding and urinary tract patency: obstruction is considered an end of life emergency Understand and perform nursing principles and practices of intermittent and continuous bladder irrigation Understand rationale behind various pharmacologic and topical measures to manage catheter related pain or discomfort, hemorrhage Consider the impact of changing the current care setting to obtain urologic consultation on patient comfort, quality of life, and goals of care Promote open communication and clarification of patient/family goals Coordinate with medical team and members of the interdisciplinary team to discuss and assess the impact of gross hematuria on patient quality of life, independence and terminal trajectory