CH 44 urinary elimination Flashcards
Urinary elimination is a precise system of
filtration, reabsorption, and exertion
Urinary system, process help maintain
fluid and electrolyte balance while glittering and excreting water soluble wat=sted
The primary organs of the urinary elimination system are
the kidney
The nephrons perform most of the functions of
filtration and elimination
most adults produce
1,000-2,000 ml a day of urine
After filtration
the urine passes through the ureters into the bladder
the bladder
the storage reservoir for urine
urine passes from the bladder through the
urethra and exits the body
urinary diversions
are created to reroute urine and are temporary or permanent
Surgeons create urinary diversions for clients who
have bladder cancer or injury
Ureterostomy (lead conduit)
incontinet urinary diversion in which the surgeon attaches one or both ureters via a stoma to the abdominal wall
Nephrostomy
incontinent urinary diversion in which the surgeon attaches a tube from the renal pelvis via a stoma to the surface of the abdominal wall
kock pouch (content lead bladder conduit)
a continent urinary diversion in which the surgeon forms a reservoir from the ileum. The pouch is emptied by clean straight catheter every 2 - 3 hours.
neurobladder
a new bladder created by the surgeon using the ileum that attaches to the ureters and urethra. It asllows the client to maintain continence. The client learns to void by straing the abdominal muscles
Factors that affect urinary elimination
poor abdominal and pelvic muscle tone, acute and chronic disorders, spinal cord injury, age, pregnancy, diet, immobility, psychosocial factors, pain, surgical procedures, medications.
Children receive full bladder control by age
4 to 5 years
An enlarged prostate can obstruct
the bladder outlet which leads to retention and urgency
childbirth and gravity
weaken the pelvic floor
A growing fetus can compromises bladder space and
compress the bladderi
in pregnancy their is a 30 to 50 percent increase in circulatory volume which increases
renal workload and output
An increase in sodium leads to a
decrease in urination
Caffeine and alcohol lead to an
increase in urination
Phenazophyridine medication causes
orange or red urine color
Amitrityline medication causes
green or blue urine color
levodopa medication causes
dark urine color
riboflavin medication causes
bright yellow urine color
Urinary tract infections risk factors
females-because of close location of urethral meatus and anus
indwelling urinary catheters
UTI symptoms
urgency, frequency, fever, during
older adult clients utilize symptoms
confusion, incontinence, falls, fatigue, anorexia
Client edu for Otis
2,000-3000 ml water daily, complete Course of antibiotics, avoid tight fitting clothing’s,
bladder scanner
non-invasive portable ultrasound scanner for measuring bladder volume and residual after urination
xray
uses to determine size shape and position of kidneys ureters and bladder
Intravenous pyelogram
injection of contrast media(iodine) for viewing ducts, renal pelvis, ureters, bladder, and urethra
Contrast media(iodine) is not always contraindicated in clients who have
selfish allergy
Renal scan
view of renal blood flow and anatomy of the kidneys without contrast
Renal Ultrasound
View of gross renal structures and structural abnormalities using high frequency sound wavesCy
Cystoscopy
use of lighted instrument to visualize treat and obtain specimens from the bladder and urethra
urodynamic testing
test for bladder muscle function by filling the bladder with CO or 0.9% sodium chloride and comparing pressure reading with reported sensations
Normal amount of urine appt an hour
30mL/ hr
Less than 30 mL/ hour urine output for more than 2 hour
should be reported to the provider
Urinalysis
random non-sterile specimens
clean catch midstream for c&s
catch midstream
Catheter urine specimen for c&s
obtain a sterile specimen from straight or indwelling catheter using surgical asepsis (sterile technique)
Timed urine specimen
collect for 24 hours or duration prescribed, discard first void, urine in fridge
Stress incontinence
Loss of small amounts of urine farm increased abdominal pressure without bladder muscle contraction. laughing, sneezing, or lifting. Weak pelvic floor muscle following childbirth or menopause.
urge incontinence
inability to stop urine flow long enough to reach bathroom. bladder irritation, overactive bladder,
overflow incontience
frequent loss of small amounts of urine due to urinary retention from bladder dissection obstruction etc
reflex incontience
involuntary loss of moderate amount of urine usually without warning due to hyperflexia of detrusor muscle, usually from spinal cord injury
Function incotinence
Loss of urine due to factors that interfere with responding to the need to urinate
transient incontinence
reversible due to inflammation or irritation, temporary cognitive impairments
Urinalysis and urine culture & sensitivity
to identify the present of uti showng rbs wbcs micro organisms
Blood creatine and BUN
assess renal function
ultrasound
detect bladder abnormalities or residual urine
voiding cystourethrography
identifies the size, shape, support, and function of the urinary bladder, prostate obstruction
urodynamic testing
cystourethroscopy and uroflowmetry
Cystourethroscpy
visualizes the inside of the bladder
Uroflowmetry
measure the rate and degree of bladder emptying
Electromyography
measures the strength of pelvic muscle contractions
bladder retraining programs
increases the bladders ability to hold urine
urinary habit training
helps clients who have limited cognitive ability to establish a predictable pattern on bladder emptying
intermittent urinary cauterization
periodic use to empty the bladder, urine output 400ml or less
suprapubic catheter
inserted into abdomen above pubic bone and in the bladder
