Chapter 21: Urinary Elimination Flashcards
Involuntary loss of urine that can have an abrupt or sudden onset and is chronic
Established incontinence
Loss of voluntary control of urine due to disabilities that prevent independent toileting, sedation, inaccessible bathroom, medications that impair cognition, or any other factor interfering with the ability to reach a bathroom
Functional incontinence
Condition in which there is inflammation of the glomeruli, which filter blood as it passes through the kidneys
Glomerulonephritis
Involuntary loss of urine due to a combination of factors
Mixed incontinence
Loss of control of voiding due to inability to SENSE the urge to void or control urine flow
Neurogenic (reflex) incontinence
Voiding at least once during the night
Nocturia
Involuntary loss of urine due to an excessive accumulation of urine in the bladder
Overflow incontinence
Involuntary loss of urine when pressure is placed on the PELVIC FLOOR (e.g., from laughing, sneezing, or coughing)
Stress incontinence
Involuntary loss of urine that is acute in onset and usually reversible
Transient incontinence
Involuntary loss of urine due to irritation or SPASMS of the bladder wall that cause a sudden elimination of urine
Urgency incontinence
Involuntary loss of urine
Urinary incontinence
One of the greatest annoyances of the changes of the urinary tract is __ __.
urinary frequency
Urinary frequency is caused by:
hypertrophy and thickening of the bladder
What does hypertrophy of the bladder muscle and thickening of the bladder cause?
Decreases the ability of the bladder to expand and reduces storage capacity.
Kidney circulation __ when an individual lays down, which causes voiding to be required more often.
improves
Is incontinence a normal consequence of aging?
No
Age-related changes in cortical control of micturition also contribute to __. This is common with ___.
nocturia
dementia
Most common cause of urinary retention in women? In men?
Women: fecal impaction
Men: prostatic hypertrophy
Symptoms of retention include:
urinary frequency, straining, dribbling, palpable bladder, and the sensation that the bladder has not been emptied.
The filtration efficiency of the kidneys decreases with age, affecting the body’s ability to eliminate __
drugs
Decreased tubular function may cause problems in the ___.
concentration of urine in response to water and/or sodium excess/depletion
The maximum specific gravity at 80 years of age is ___ whereas at younger ages, it is __.
- 024
1. 032
An increase in the renal threshold for glucose is a serious concern, because older individuals can be:
hyperglycemic without evidence of glycosuria
The nurse can teach older adults specific efforts to enhance voiding and prevent retention by:
Voiding in upright position Massaging bladder area Rocking back and forth Running water Soaking hands in warm water
What things can prevent a urinary tract problem?
- good fluid intake
- Vitamin C
- activity
- frequent toileting
What can enhance acidic urine (which is beneficial to prevent infection)?
Vitamin C and foods such as cranberries, prunes, plums, eggs, cheese, yogurt, fish, and grains
the most common infection of older adults and increase in prevalence with age
UTI’s
Organisms primarily responsible for UTIs are __ in women and __ species in men
Escherichia coli
Proteus
UTIs can result from:
poor hygienic practices, prostate problems, catheterization, dehydration, diabetes, arteriosclerosis, neurogenic bladders, and general debilitated states.
Early symptoms of a UTI:
burning, urgency, and fever
Bacteriuria greater than ___ CFU/mL confirms the diagnosis of UTI
105
Some older adults develop __ and __ with UTIs.
incontinence and delirium
___ (septicemia secondary to UTI) is a common complication of persons with indwelling catheters.
Urosepsis
Severe UTIs leading to ___ occur more frequently among older persons than among the young, as do recurrent UTIs.
septicemia
___ is the most common UTI among older men.
Prostatitis
Although nonbacterial prostatitis is responsible for some cases, most infections are ___ in origin.
bacterial
Acute bacterial prostatitis is characterized by the systemic symptoms of:
fever, chills, and malaise
___ incontinence is acute and reversible and can be caused by infections, delirium, medication reactions, excessive urine production, fecal impaction, mood disorders, or the inability to reach a commode or urinal
Transient
__ incontinence is chronic and persistent with either an abrupt or gradual onset
Established
The initial goal for incontinent individuals is to:
identify the cause of incontinence
Older men (55yrs+) have more than ___ times the rate of older to develop bladder cancer.
3
A painless hematuria is the primary sign and characterizes ___
cancer of the bladder.
Renal calculi can also cause __
hematuria
T/F: Glomerulonephritis may exist in older persons without being diagnosed because of its nonspecific symptoms.
True
__ and __ can lead to urinary retention. (#1 cause in men and #1 cause in women)
prostatic hypertrophy and fecal impactions
__ occurs when sepsis impacts structures of the urinary tract.
Urosepsis
__ is a serious bloodstream infection.
Septicemia
___ is swelling and inflammation of the prostate gland.
Prostatitis
Kidney filtration ability decrease leads to :
a potential for adverse drug reactions.
An Increase in renal threshold for glucose can lead to:
False-negative results for glucose in the urine without symptoms
Is ESBL specific to male/female?
No
___ is an enzyme made by some bacteria. The enzyme prevents certain antibiotics from being able to kill the bacteria. The bacteria then become resistant to the antibiotics.
ESBL Extended Spectrum Beta Lactamase
___ ___ is associated with bladder neck obstructions and certain medications (adrenergic, anticholinergics, and calcium channel blockers).
overflow incontinence
What are some Signs & Symptoms for a UTI?
Fever or low temperature (hypothermic) Urgency Burning Incontinence (Transient/temporary) Delirium (decreased level in consciousness or onset of confusion)
Irritation of bladder, exposure to dyes, and cigarette smoking are all risk factors for ___ ___
bladder cancer
Bladder cancer: Observe patients for signs of ____
metastasis
___, ___, and ___ are the most common causes of renal calculi
Dehydration, hypercalcemia, and excessive elimination of uric acid
