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CNA > Chapter 16 > Flashcards

Chapter 16 Flashcards

Urinary Elimination

1
Q

Urination

A

AKA micturition or voiding. Passing urine from the bladder through the urethra to the outside of the body.

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2
Q

How many mL of urine should an adult produce per day?

A

1200 - 1500 mL

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3
Q

Name 5 urinary observations that should be reported to the nurse.

A

Cloudy , dark/rust-colored, strong-smelling, fruity-smelling, pain, burning, pressure while urinating, blood, pus, mucus, discharge in urine, protein or glucose in urine, and urinary incontinence.

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4
Q

What can cause urine to be an abnormal color?

A

Medications, food, food dyes, vitamins, and supplements.

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5
Q

How do urinary needs change as people age?

A

The elderly will need to urinate more frequently and the bladder may not empty completely. They are dehydrated more often, as they have decreased thirst. Illnesses and disorders can also affect urination.

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6
Q

Fracture Pan

A

A type of bedpan that is flatter than a regular bedpan and is used for residents who cannot assist in lifting their hips

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7
Q

Portable Commode

A

Used by residents who are able to get up, but are unable to walk to the bathroom.

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8
Q

Another name for a portable commode is:

A

Bedside commode

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9
Q

Where should bedpan wastes be disposed of? How?

A

The toilet. Wear gloves and do not spill the wastes and then wash the containers with a disinfectant. Finally, dry them and return them to storage. Do not dispose of wastes that need to be reported to the nurse, if a specimen is needed, or if intake/output monitoring is needed.

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10
Q

Urinary Incontinence

A

The person cannot control the muscles of their bladder, which leads to an involuntary loss of urine.

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11
Q

Urinary Tract Infection

A

UTI. Causes inflammation of the bladder and ureters that can cause burning during urination and frequent feeling of needing to urinate.

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12
Q

Cystitis

A

Inflammation of the bladder that may be cause by a bacterial infection. It is more common in women because the urethra is shorter in women.

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13
Q

How should females wipe during perineal care? Why?

A

From front to back. This helps to prevent infection.

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14
Q

Calculi

A

Kidney stone. Forms when urine crystallizes in the kidneys, which can block the ureters and kidneys and cause pain

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15
Q

What does urine straining do? How is it done?

A

It catches any fine particles to determine the presence of calculi. It is strained by pouring a collected specimen through a strainer or over a 4x4 piece of gauze into a specimen container. Any calculi found are sent to the lab.

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16
Q

How big are kidney stones?

A

They can be as small as grains of sand or as large as golf balls.

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17
Q

Nephritis

A

Inflammation of the kidneys. It can cause a decrease in urine, dark/rust-colored urine, and burning during urination. Another symptom is swollen hands, face, and eyelids because the person is retaining fluid. A chronic form can develop in the elderly.

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18
Q

Renovascular Hypertention

A

Blockage of arteries in the kidneys cause high blood pressure. Medications and surgery can be used to treat it.

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19
Q

Chronic Renal (Kidney) Failure

A

Kidneys are unable to eliminate certain wastes. Can be caused by chronic UTIs, nephritis, and diabetes. Can progress to ESRD.

20
Q

Excessive ____ in the diet can cause kidney damage.

A

Salt.

21
Q

Name 5 symptoms of kidney failure.

A

High BP, decreased/no urine output, dark urine, anemia, nausea, vomiting, loss of appetite, weight changes, fatigue, weakness, headaches, difficulty sleeping, back pain, edema, and stool that is bloody or black.

22
Q

Kidney Dialysis

A

Artificial means of removing wastes from the body that can improve and extend life for several years.

23
Q

Name 3 things that can cause calculi.

A

Vitamin deficiency, mineral imbalance, structural abnormalities of the urinary tract, or infection.

24
Q

Catheter

A

Thin tube inserted into the body that is used to drain or inject fluids. A urinary catheter is used to drain urine from the bladder.

25
Q

Straight Catheter

A

Removed immediately after the urine is drained.

26
Q

Indwelling Catheter

A

Remains inside the bladder for a long period of time; drains urine into a bag.

27
Q

Condom Catheter

A

AKA “Texas catheter.” Attachment at the end that fits onto the penis and is fastened with tape. It is changed daily or as needed.

28
Q

Specimen

A

A sample that is used for analysis in order to try and make a diagnosis

29
Q

What should you report when observing a catheter?

A

Blood in urine, abnormal appearance of urine, catheter bag does not fill after several hours, catheter bag fills suddenly, catheter out of place, urine leaks from catheter, odor, and patient complaints of pain or pressure.

30
Q

Hat

A

A plastic collection container that can be put into a toilet to collect and measure volumes of urine or stool

31
Q

Routine Urine Specimen

A

Collected anytime the patient voids. Can be collected via urinal, commode, bedpan, or hat.

32
Q

Clean Catch Specimen

A

“Midstream” catch; does not get the first and last urine in the sample. These are used to determine the presence of bacteria in the urine. The patient’s perineal area will need to be cleaned before collection.

33
Q

24-hour Urine Specimen

A

Tests for certain chemicals and hormones. All of the urine voided by the patient in a 24-hour period is collected. Usually begins at 7:00 a.m. and runs until 7:00 a.m. the next day. The first urine must be voided and discarded so that collection starts with an empty bladder. Collection is restarted if any is thrown away or improperly stored.

34
Q

Why should a sign be placed on the resident’s bed to indicate a 24-hour urine specimen is being collected?

A

To let other care team members know.

35
Q

What can reagent strips do?

A

Test for pH level, glucose, ketones, blood, and specific gravity. They change color when they react with urine to give test results.

36
Q

What is normal pH level for urine? What are abnormalities caused by?

A

A pH of 4.6 - 8.0 is normal. Disruption can be caused by medication, food, or illness.

37
Q

How are ketones produced?

A

They are produced when the body burns fat for energy or fuel; there is not enough insulin to help the body use sugar for energy.

38
Q

What can the presence of glucose and ketones in the urine indicate?

A

Diabetes: There is not enough insulin to convert sugar to energy, so sugar flows through the blood stream and sometimes, appears in urine.

39
Q

What can testing a double-voided urine specimen show? What is a double-voided specimen?

A

Test for glucose; it is a specimen that is collected after first emptying the bladder, then waiting until another specimen can be collected. Patient encouraged to drink fluids after first void and second void is collected about 30 minutes later.

40
Q

What is “occult blood” in urine?

A

Hidden blood that can be discovered through testing.

41
Q

Urine Specific Gravity Test

A

Tests to measure the concentration of particles in the urine and evaluates the body’s water balance and urine concentration (by showing how urine compares to water). Usually requires a clean-catch urine specimen.

42
Q

What are normal specific gravity test values?

A

Normal values are between 1.002 and 1.028 and usually require a clean-catch urine specimen

43
Q

What can cause loss of normal bladder function?

A

Injury, illness, or inactivity

44
Q

Bladder Retraining

A

Helping to decrease incontinence after bladder control has decreased or been lost

45
Q

How can an NA help with bladder retraining?

A
  • Encourage the patient to drink fluids (even in cases of incontinence)
  • Offer frequent trips to the bathroom
  • Keep a record of urination
  • Be patient and do not show anger or frustration
  • Wash or dispose of supplies as directed (e.g., discard of clothing protectors and incontinence briefs properly, wash bedpans)
  • Observe for skin changes and help with perineal care
  • Help encourage urination by running water in the sink or having the patient lean forward (to put pressure on the bladder)
  • Provide privacy for voiding

CNA (4 decks)

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