Ch.30 Urinary Elimination Flashcards
A(n) ____________ specimen is a sample of fresh urine collected in a clean container.
Voided
____________ means the absence of urine or a urinary volume of 100 mL or less in 24 hours.
Anuria
In ____________ the urine output is less than 400 mL per 24 hours, which indicates the inadequate elimination of urine.
Oliguria
____________ is difficult or uncomfortable voiding and a common symptom of trauma to the urethra or a bladder infection.
Dysuria
____________ refers to using a device inside the bladder or externally about the urinary meatus.
Catheterization
A(n) ____________ catheter is a urine drainage tube inserted, but not left in place; it drains urine temporarily or provides a sterile urine specimen.
Straight
A(n) ____________ irrigation instills irrigating solution into a catheter by gravity over a period of days.
Continuous
Age-related changes, such as diminished bladder capacity and relaxation of the pelvic floor muscle tone, increase the risk of ____________.
Incontinence
A(n) ____________ catheter is not inserted within the bladder; instead, it surrounds the urinary meatus.
External
A(n) ____________ is a seat-like container for elimination that is used to collect urine or stool.
Bedpan
Identify the labeled areas.
The figure shows major structures of the urinary system.
What are the functions of the various parts in the figure?
The urinary system consists of the
Kidneys
Ureter
Bladder
Urethra
These major components, along with some accessory structures such as the ring-shaped muscles called the internal and external sphincters, work together to produce urine, collect it, and excrete it from the body.
Process of releasing excess of fluid and metabolic waste
Urinary elimination
Voided sample of urine that is considered sterile
Clean catch
Greater-than-normal urinary volume and may accompany minor dietary variations
Polyuria
Cylindrical container for collecting urine
Urinal
Technique for restoring or maintaining catheter patency
Catheter irrigation
Presented here, in random order, are steps that occur when providing a continuous irrigation. Write the correct sequence in the boxes provided.
- Connect the tubing to the catheter port for irrigation.
- Monitor the appearance of the urine and volume of urinary drainage.
- Purge the air from the tubing.
- Regulate the rate of instillation according to the medical order.
- Hang the sterile irrigating solution from an intravenous pole.
- Hang the sterile irrigating solution from an intravenous pole.
- Purge the air from the tubing.
- Connect the tubing to the catheter port for irrigation.
- Regulate the rate of instillation according to the medical order.
- Monitor the appearance of the urine and volume of urinary drainage.
What are the common disorders associated with polyuria?
The common disorders associated with polyuria include the following:
Diabetes mellitus—an endocrine disorder caused by insufficient insulin
Diabetes insipidus—an endocrine disease caused by insufficient antidiuretic hormone
What is a urinary catheter used for?
A urinary catheter is used for various reasons:
To keep incontinent clients dry (catheterization is a last resort that is used only when all other continence measures have been exhausted)
To relieve bladder distention when clients cannot void
To assess fluid balance accurately
To keep the bladder from becoming distended during procedures such as surgery
To measure residual urine
To obtain sterile urine specimens
To instill medication within the bladder
What are the problems that may accompany the use of a condom catheter?
Application of the catheter correctly and managing care appropriately can prevent potential problems that may accompany the use of a condom catheter, such as the following:
Restriction of blood flow to the skin and tissues of the penis, resulting from a tight sheath
Skin breakdown resulting from the accumulation of moisture beneath the sheath Leakage
What physiologic changes could lead older adults to experience urinary urgency and frequency?
Older adults are likely to experience urinary urgency and frequency because of normal physiologic changes such as diminished bladder capacity and degenerative changes in the cerebral cortex.
What are the resources available to assist older adults in evaluating and treating incontinence?
Many resources are available to assist older adults in evaluating and treating incontinence, such as the following:
Health care facilities offer special incontinence clinics and physical therapy departments to teach pelvic muscle exercises.
The National Association for Continence (http://www.nafc.org) is an excellent source of information for products, resources, and continence programs.
Clients should be taught to compile a log of urinary elimination patterns.
Suggest that paralyzed clients with reflex incontinence use cutaneous triggering (lightly massaging or tapping the skin above the pubic area).
What are the problems that a client with oliguria is likely to face?
Oliguria indicates the inadequate elimination of urine.
Sometimes oliguria is a sign that the bladder is being only partially emptied during voiding.
Residual urine, or more than 50 mL urine that remains in the bladder after voiding, can support the growth of microorganisms, leading to infection.
In addition, urinary stasis or lack of movement can cause dissolved substances such as calcium to precipitate, leading to urinary calculi (stones).
What care should the nurse take when a closed drainage system is used to collect urine from the catheter?
When a closed drainage system is used to collect urine from the catheter, the nurse should do the following:
Coil excess tubing on the bed to keep the section from the bed to the collection bag vertical because dependent loops in the tubing interfere with gravity flow.
Ensure that the tubing is not compressed and the drainage is not obstructed.
The tubing may be placed over the client’s thigh.
Position the drainage system lower than the bladder to avoid a backflow of urine.
Suspend the drainage bag from the wheelchair below the level of the bladder.
Secure the drainage bag to the lower part of an intravenous pole, or allow the client to carry the bag by hand when ambulating.
How can the nurse prevent the drainage system from becoming a reservoir of pathogens?
To reduce the potential for the drainage system to become a reservoir of pathogens, the entire drainage system is replaced whenever the catheter is changed and is replaced at least every 2 weeks in clients with a urinary tract infection.
