43 - Urinary Elimination Flashcards
Micturition
Complex neural response that allows the bladder to contract, the urethral sphincter to relax, and urine to leave the body through the urethra
Hematuria or proteinuria
glomeria injury.
Hematuria is the presence of blood in a person’s urine
Proteinuria is increased levels of protein in the urine
Renin
controls blood pressure (released in low bp)
Urinary tract infections
commonly result from catheterization; may have other causes
an infection in any part of your urinary system — your kidneys, ureters, bladder and urethra
Urinary retention
an accumulation of urine caused by the inability of the bladder to empty
Urinary diversions
diversion of urine to external source
The stoma. Can be due to cancer or trauma, radiation fistulas chronic cystitis, and they can be temporary or they can be permanent
Cystitis
inflammation of the bladder. Causes frequesnt urgent senation of need to void. Look for cloudy foul smelling urine.
CAUTI
catheter associated UTI. Find out why the catheter was in. A lot of the time it was put in during surgery and then never taken out. You’re free to ask “why do they have this catherder” to check to see why it’s there. Ie. Prosate enlarged, bladder probelems.
Transient urinary incontinence
results from something that affects the urinary system, and resolves with treatment.
Urine loss resulting from causes outside of or affecting the urinary system, that resolves when the underlying causes are treated.
So transient gives you the clue that it kind of comes and goes. Acronym DISAPPEAR used to identify common causes.
Delirium, Intake of fluids, Stool impaction, Atrophic vaginitis, Psychological problems, Pharmacology, Excess urine output, Abnormal lab values, Restricted mobility
Urgency UI
when the urge to avoid cannot be postponed.
urine loss associated with or immediately preceded by a sudden an urgent need to void that cannot be postponed. Can be part of an overactive bladder syndrome
Stress UI
from something that causes extra abdominal pressure such as sneezing or coughing or laughing. And many times, women who have had children experience stress incontinence later. Later in life, or sometimes even when they’re younger, but they’ve given birth vaginally.
urine loss resulting from increased intra-abdominal pressure such as coughing and sneezing laughing lifting
Mixed UI
urgency and stress UI are combined.
UI associated with chronic urinary retention
the urine remaining in the bladder after voiding. perhaps due to poor contractility or bottom muscles, spinal cord injury or enlarged prostate.
involuntary loss of urine when the bladder does not completely empty with a high residual urine volume or palpable non painful bladder remaining after voiding
Functional UI
urine loss due to the inability to reach the toilet.
So that could be more from things blocking your way. Or your arthritis is so bad you can’t get there.
Multifactorial UI
urine loss due to multiple interacting factors both inside and outside the urinary tract
when there are external and internal factors causing the UI. Ee. the person has weak pelvic floor muscles combined with a body that has arthritis which makes it hard to move and they have lots of belongings in their house and those belongings are blocking a clear path to the toilet. All those factors contribute to urinary incontinence.
Peritoneal dialysis
occurs in the peritoneal cavity, where dialysate (sterile fluid) is put into the peritoneal cavity and it filters the waste.
Hemodialysis
though runs the blood through machine is essentially an external kidney, and it removes excess waste and fluid from the blood that way
Renal failure
Irreversible damage to the glomeruli or renal tubules. End stage renal failure the kidneys can no longer function well enough to adequately remove waste from the body or produce urine and you need something to replace the kidneys. Dialysis or organ transplant.
Random specimens
for routine analysis and testing electrolytes
Urinalysis
pH proteins, ketones blood (test within 2hrs of collection)
Specific gravity
weight of urine
Urine culture
a sterile or clean void sample needed
Cytology when do we get the sample
is the exam of a single cell
requires second void in the day (a lot in geriatrics):
RUG (retrograde urethrogram) precaution
need to know if they have a shellfish or idodine allergy
DTV
due to void
Straight catheters
just put in straight bladder and then take it out right away
Indwelling catheters
it stays in more permennatly
If people require long term catheterization, they often use a catheter that is designed to stay in place for up to three months
incontinence
involuntary loss of urine
urgency
sudden and compelling urge to void that cannot be postponed
dysuria
painful or difficult urination, burning during urination
frequency
voiding more than 8x in 24hrs
hesitancy
difficulty initiating urination
polyuria
voiding large amounts of urine
oliguria
diminished urinary output relative to intake (usually 400mL/24hrs)
nocturia
getting up to void one or more times at night
dribbling
leakage of urine despite voluntary control of urination
hematuria
blood in urine
superpubic catheter
involves the surgical placement of a catheter through the abdominal wall directly into the bladder
Condom catheters
are sometimes an appropriate option for males who have complete bladder emptying. They come off a lot and aren’t a great alternative. Don’t tape it to the penis, catherder cant expland
Continuous irrigation
is used to instill a sterile solution to prevent the formation of blood clots.
