Chap 37 Flashcards
function of kidneys
remove waste from blood to form urine
function of ureters
transport urine from kidneys to bladder
function of urethra
urine travels from bladder and exits through urethra
function of bladder
reservoir for urine until urge to urinate
anuria
24 hr urine output is less than 50 mL
dysuria
painful/difficult urination
frequency
increased incidence of voiding
glycosuria
presence of glucose in urine
nocturia
awakening @ night to pee
oliguria
24 hr output less than 400 mL
polyuria
excessive output
proteinuria
protein in urine
pyuria
pus in urine
urgency
strong desire to void
urinary incontinence
involuntary loss of urine
micturition/voiding
emptying bladder
factors influencing urination
- disease conditions
- medications/medical procedures
- activity/muscle tone
- developmental
- psychological factors
- food/fluid intake
anticoagulants (color)
red urine
diuretics (color)
pale yellow
pyridium (color)
orange to orange-red
amitriptyline/B-complex vitamin (color)
green to blue-green
levodopa
brown/black
urinary retention
accumulation of urine due to inability to void
urinary tract infection
bacteria in urinary tract
urinary diversion
diversion of urine to external source
causes of urinary retention
- medications
- edema/infection/tumor of prostate in males
- urethral obstruction
- anesthesia/paralysis/neurological
assessments for urinary retention
- medications
- how long since last void
- is bladder palpable?
- previous diagnoses
- any trauma/injury to urethra?
- any change in color/consistency of urine?
interventions for urinary retention
- catheterization
- surgery
- medication
risk factors/causes of UTI
- catheter insertion
- urinary stasis
- improper hygiene
- invasive procedures
interventions for UTI
- increase fluid intake/water/cranberry juice
- anti-infectives
- education
patients @ risk for UTI
- sexually active women
- women using diaphragms for contraception
- postmenopausal women
- indwelling catheter pt
- diabetes mellitus
- older adults
transient incontinence
appears suddenly and lasts 6 months or less
mixed incontinence
void w/ features of 2 or more other types
overflow incontinence
overdistention & overflow of bladder
functional incontinence
caused by factors outside urinary tract
reflex incontinence
emptying bladder w/out sensation of need to void
total incontinence
continuous/unpredictable loss of urine
stress incontinence
involuntary loss of urine related to an increase in intra-abdominal pressure
interventions for overflow incontinence
- intermittent catheterization
- condom catheter
interventions for functional incontinence
- schedule toileting
- absorbent products
- clothing modifications
- environmental alteration
interventions for stress incontinence
- pelvic floor exercises
- surgical intervention
interventions for urge incontinence
- medication/lifestyle changes
- pelvic floor exercises
- bladder retraining
- absorbent products
interventions for hyperactive/overactive bladder
- pelvic floor exercises
- fluid intake 1.5-2 L a day
- limit carbonation & caffeine
- bladder training
assessment for urinary
- history of urination pattern & symptoms
- physical assessment
- characteristics of urine
- patient’s perception of problems
- lab/diagnostic testing
skin and mucosal membrane assessment
assess hydration
kidneys assessment
flank pain may occur w/ infection or inflammation
bladder assessment
distended bladder rises above symphysis pubis
urethral meatus assessment
observe for discharge, inflammation, and lesions
assessment of urine
- intake/output
- color
- clarity
- odor
- urine testing
types of urine specimens
- routine analysis
- clean-catch/midstream
- sterile specimens w/ indwelling cath
- from urinary diversion
- 24-hr specimen
CDC indwelling catheter reasons
- pt has acute urinary retention/bladder output obstruction
- need accurate urine output measurements
- selected surgical procedure
- assist in healing open sacral/perineal wound
- requires prolonged immoblization
- end of life care
straight/intermittent/in-and-out caths
used to empty bladder and then removed
when should you perform cath care?
every 8 hrs & PRN
cath care
- wash w/ soap and warm water
- check for kinks/leakage
- keep drainage bag below level of bladder
surgical asepsis
- sterile touches sterile only
- only sterile on sterile field
- once out of range of vision and an object is below waist line, it is contaminated
- sterile object is contaminated by prolonged air exposure
- when sterile gets wet, contaminated
- fluid flows in direction of gravity
- edges of field are contaminated
