37 Urinary Elimination

Question 1

male vs female urinary tract

Answer 1

• male urethra functions for excretion + reproduction
• male urethra has 3 parts (prostatic, membraneous, + cavernous)
• male length is 5.5-6.2inches
• female length is 1.5-2.5 in

Question 2

detrusor muscle

Answer 2

3 layered bladder muscle

Question 3

innervation of bladder muscle

Answer 3

auto ns-innervates
sym ns-inhibit bladder + motor impulse to internal sphincter
para ns-motor impulse to bladder + inhibit internal sphincter

Question 4

symp ns on bladder

Answer 4

• inhibits bladder
• motors internal sphincter
• causes detrusor muscle to relax + expand and sphincter to constrict
• hold more urine

Question 5

parasym ns on bladder

Answer 5

• motors bladder
• inhibits internal sphincter
• causes detrusor muscle to constrict + internal sphincter to relax
• for voiding

Question 6

stretch receptors

Answer 6

in bladder wall

-when pressure becomes sufficient to stim nerves, the person feels the desire to empty

Question 7

external sphincter is under ____ control

Answer 7

voluntary control

Question 8

person feels a desire to void when the bladder fills to….

Answer 8

150-250mL

Question 9

urination process

Answer 9

1 voiding is initiated
2 detrusor muscle contracts
3 internal sphincter relax
4 urine enters posterior urethra
5 perineum + external sphincter relax
6 abs contract slightly, diaphragm lowers
7 urination occurs

Question 10

incontinence

Answer 10

involuntary loss of urine that causes a problem

Question 11

retention

Answer 11

urine is produced NORMALLY but is NOT excreted completely

Question 12

enuresis

Answer 12

continued incontinence of urine past the age of toilet training

Question 13

nocturia

Answer 13

awakening at night to urinate

-may be due to diminished ability of the kidney to concentrate urine

Question 14

urge incontinence

Answer 14

involuntary loss of urine that OCCURS SOON AFTER FEELING AN URGENT NEED TO VOID

Question 15

anuria

Answer 15

24 hr urine output is less than 50mL

Question 16

dysuria

Answer 16

painful or difficult urination

Question 17

frequency

Answer 17

increased incidence of voiding

Question 18

glycosuria

Answer 18

presence of glucose in the urine

Question 19

oliguria

Answer 19

24 hr urine output is less than 400mL

Question 20

polyuria

Answer 20

aka diuresis

-excessive output of urine

Question 21

proteinuria

Answer 21

protein in urine

Question 22

pyuria

Answer 22

pus in urine

Question 23

urgency

Answer 23

strong desire to void

Question 24

urinary incontinence

Answer 24

involuntary loss of urine

Question 25

continence

Answer 25

patients who have self-control over urination

Question 26

UTI

Answer 26

2nd most common type of infection in the body
Women are especially vulnerable bc of shorter urethra + close proximity of vagina and rectum
E. coli is the most common causal microbe

Question 27

UTI analysis

Answer 27

Clean-catch or sterile specimen findings:

• 100,000 organisms/mL (lower counts may be considered positive if s+s are present)
• RBC + nitrate may also be present

Question 28

Post-void residual

Answer 28

amount of urine remaining in bladder immediately after voiding

• PVR of less than 50mL indicates adequate bladder emptying
• More than 100mL means the bladder is not emptying correctly

Question 29

Stress Incontinence

Answer 29

involuntary loss of urine R/T an increase in intra-abdominal pressure
-Commonly occurs when coughing, sneezing, laughing, or other physical activities

Question 30

Transient Incontinence

Answer 30

appears suddenly + last for 6 months or less
-Usually caused by treatable factors like confusion secondary to acute illness, infection, or result of medical treatment (diuretics or IV administration)

Question 31

Overflow Incontinence aka chronic retention of urine

Answer 31

Involuntary loss of urine associated w overdistention and overflow of bladder

• Bladder fills then dribbling occurs
• The signal to empty bladder may be underactive or absent

Question 32

Functional Incontinence

Answer 32

urine loss caused by inability to reach the toilet bc of environmental barriers, physical limitations, loss of memory, or disorientation

Question 33

Reflex Incontinence

Answer 33

experience emptying of the bladder without the sensation of the need to void
-May be r/t spinal cord injury

Question 34

Total Incontinence

Answer 34

continuous + unpredictable loss of urine due to anatomic abnormality
-Resulting from surgery, trauma, or physical malformation

Question 35

Nursing diagnosis for fluid overload or decreased fluid intake

Answer 35

Impaired urinary elimination

• R/T
• –Sensory motor impairment
• –UTI
• –Anatomic obstruction

Question 36

Anatomy of main urinary structure + flow of urine

Answer 36

nephrons> pelvis of kidneys> ureters> urinary bladder

Question 37

Obtaining a clean-catch or midstream urine specimen

Answer 37

Wear gloves> clean the area w soap and water> the patient voids and discards a small amount of urine (30mL)> Continues voiding in a sterile specimen container to collect urine (10mL)> Stops voiding into container> Remove container and continues voiding> Discard the last amount of urine in the bladder

Question 38

clean-catch midstream urine is considered a ____ specimen

Answer 38

sterile

Question 39

What is likely to lead to hyponatremia?

Answer 39

Frequent nasogastric tube irrigation with water

Question 40

HYPERcalcemia and HYPERmagnesemia cause

Answer 40

decreased neuromuscular excitability

Question 41

A patient has a positive Chvostek sign. The nurse interprets this as a sign of

Answer 41

neuromuscular excitability

-can be caused by HYPOcalcemia, HYPOmagnesemia