Ch.30 Urinary Elimination

Question 1

A(n) ____________ specimen is a sample of fresh urine collected in a clean container.

Answer 1

Voided

Question 2

____________ means the absence of urine or a urinary volume of 100 mL or less in 24 hours.

Answer 2

Anuria

Question 3

In ____________ the urine output is less than 400 mL per 24 hours, which indicates the inadequate elimination of urine.

Answer 3

Oliguria

Question 4

____________ is difficult or uncomfortable voiding and a common symptom of trauma to the urethra or a bladder infection.

Answer 4

Dysuria

Question 5

____________ refers to using a device inside the bladder or externally about the urinary meatus.

Answer 5

Catheterization

Question 6

A(n) ____________ catheter is a urine drainage tube inserted, but not left in place; it drains urine temporarily or provides a sterile urine specimen.

Answer 6

Straight

Question 7

A(n) ____________ irrigation instills irrigating solution into a catheter by gravity over a period of days.

Answer 7

Continuous

Question 8

Age-related changes, such as diminished bladder capacity and relaxation of the pelvic floor muscle tone, increase the risk of ____________.

Answer 8

Incontinence

Question 9

A(n) ____________ catheter is not inserted within the bladder; instead, it surrounds the urinary meatus.

Answer 9

External

Question 10

A(n) ____________ is a seat-like container for elimination that is used to collect urine or stool.

Answer 10

Bedpan

Question 11

Identify the labeled areas.

Answer 11

The figure shows major structures of the urinary system.

Question 12

What are the functions of the various parts in the figure?

Answer 12

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.

Question 13

Process of releasing excess of fluid and metabolic waste

Answer 13

Urinary elimination

Question 14

Voided sample of urine that is considered sterile

Answer 14

Clean catch

Question 15

Greater-than-normal urinary volume and may accompany minor dietary variations

Answer 15

Polyuria

Question 16

Cylindrical container for collecting urine

Answer 16

Urinal

Question 17

Technique for restoring or maintaining catheter patency

Answer 17

Catheter irrigation

Question 18

Presented here, in random order, are steps that occur when providing a continuous irrigation. Write the correct sequence in the boxes provided.

1. Connect the tubing to the catheter port for irrigation.
2. Monitor the appearance of the urine and volume of urinary drainage.
3. Purge the air from the tubing.
4. Regulate the rate of instillation according to the medical order.
5. Hang the sterile irrigating solution from an intravenous pole.

Answer 18

5. Hang the sterile irrigating solution from an intravenous pole.
6. Purge the air from the tubing.
7. Connect the tubing to the catheter port for irrigation.
8. Regulate the rate of instillation according to the medical order.
9. Monitor the appearance of the urine and volume of urinary drainage.

Question 19

What are the common disorders associated with polyuria?

Answer 19

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

Question 20

What is a urinary catheter used for?

Answer 20

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

Question 21

What are the problems that may accompany the use of a condom catheter?

Answer 21

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

Question 22

What physiologic changes could lead older adults to experience urinary urgency and frequency?

Answer 22

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.

Question 23

What are the resources available to assist older adults in evaluating and treating incontinence?

Answer 23

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).

Question 24

What are the problems that a client with oliguria is likely to face?

Answer 24

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).

Question 25

What care should the nurse take when a closed drainage system is used to collect urine from the catheter?

Answer 25

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.

Question 26

How can the nurse prevent the drainage system from becoming a reservoir of pathogens?

Answer 26

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.