Chapter 30: Urinary Elimination

Question 1

Describe the physical characteristics of urine.

Answer 1

Volume, color, clarity, odor

Question 2

Identify factors that can affect urination & their effect on urination.

Answer 2

• the degree of neuromuscular development & the integrity of the spinal cord
• the volume of fluid intake & the amt of fluid loss, including those from other sources
• the amt of food consumed
• the person’s Circadian rhythm, habits, opportunities for urination, & anxiety

Question 3

Voided specimen

Answer 3

Sample of fresh urine collected in a clean container; 1st voided specimen is preferred b/c it is most likely to contain substantial urinary components that have accumulated; transferred to a specimen container & delivered to the lab for testing & analysis; if cannot be examined in less than one hour, label & refrigerate

Question 4

Clean-catch specimen

Answer 4

Voided sample considered sterile; to avoid contamination, external structures are cleansed; urine us collected after the initial stream; preferred to random specimens; also preferred if a woman is on her period; after collection, is labeled and taken to the lab; refrigerate if analysis will be delayed more than 1 hr

Question 5

Catheter specimen

Answer 5

Urine specimen collected under sterile conditions; for clients who are already catheterized, nurse can aspirate a sample through the lumen of a latex catheter or from a self-sealing port that has been cleansed with an alcohol pad

Question 6

25-hr specimen

Answer 6

Collection of all urine produced in a full 24-hr period; nurse places the collected urine in a container with a chemical preservative or outs the container in a basin of ice or refrigerator; client must urinate just before & discard; label & take to lab

Question 7

Hematuria

Answer 7

Bloody urine

Question 8

Puris

Answer 8

Pus in urine

Question 9

Proteinuria

Answer 9

Protein in urine

Question 10

Albuminuria

Answer 10

Albumin in urine

Question 11

Glycosuria

Answer 11

Glucose in urine

Question 12

Ketonuria

Answer 12

Ketones in urine

Question 13

absence of urine or a volume of 100 mL or less in 24 hrs; indicates that kidneys are not forming sufficient urine

Answer 13

Anuria

Question 14

Oliguria

Answer 14

Urine output

Question 15

Nocturia

Answer 15

Nighttime urination; unusual b/c rate of urination is normally reduced at night

Question 16

Polyuria

Answer 16

> normal urinary elimination & may accompany minor dietary variations; common disorders associated with this includes diabetes mellitus & diabetes insipidus

Question 17

Urinary retention

Answer 17

Client produces urine but does not release it from the bladder; s/s = progressively distending bladder

Question 18

Dysuria

Answer 18

Difficult or uncomfortable voiding; common Sx of trauma to the urethra or a bladder infection; often accompanied by frequency & urgency

Question 19

Incontinence

Answer 19

The inability to control either urinary or bowel elimination; abnormal after a person is potty trained

Question 20

Discuss three ways to assist clients with urinary elimination.

Answer 20

• commode - chair with an opening in the seat under which a receptacle is placed; located near/beside the bed; cleaned immediately after use
• urinal - cylindrical container for collecting urine; more easily used by males; should be empty when given to client; clean/empty immediately after use
• bedpan - seatlike container or elimination; used for urine & stool; made of plastic, several inches deep

Question 21

Stress incontinence

Answer 21

Loss of small amts of urine when intra-abdominal pressure rises

Question 22

Urge incontinence

Answer 22

Need to void perceived frequently, with short-lived ability to sustain control of the flow

Question 23

Reflex incontinence

Answer 23

Spontaneous loss of urine when the bladder is stretched with urine, but w/o prior perception of a need to void

Question 24

Functional incontinence

Answer 24

Control over urination lost b/c of inaccessibility to a toilet or a compromised ability to use one

Question 25

Total incontinence

Answer 25

Loss of urine w/o any identifiable pattern/warning

Question 26

Overflow incontinence

Answer 26

Urine leakage b/c the bladder is not completely emptied; bladder distended with retained urine

Question 27

Discuss some ways to help clients manage incontinence

Answer 27

• modify clothing to make elimination easier
• continence training
• catheter (last resort)

Question 28

Catheterization

Answer 28

The act of applying or inserting a hollow tube

Question 29

List several reasons why a urinary catheter is used.

Answer 29

• keeping incontinent clients dry (last resort)
• relieving bladder distention when clients cannot void
• assessing fluid balance accurately
• keeping the bladder from becoming distended during surgery
• measuring residual urine
• obtaining sterile urine specimens
• instilling medications within the bladder

Question 30

External catheter

Answer 30

Urine collecting device applied to the skin; not inserted within bladder; more effective for male clients

Question 31

Straight catheters

Answer 31

Urine tube inserted but not left in place; drains urine temporarily and/or provides a sterile specimen

Question 32

Retention catheter

Answer 32

A.K.A. Indwelling or Foley catheters; secured with a balloon that is inflated after distal tip is inserted into the bladde

Question 33

Nursing guidelines for providing catheter care

Answer 33

• plan to cleanse the meatus & a nearby section of the catheter at least 1x day
• gather clean gloves, soap, water, washcloth, towel, & a disposable pad
• perform hand hygiene
• place a disposable pad beneath the hips of a female & beneath the penis of a male
• don clean gloves & wash the meatus, the catheter where it meats the meatus, the genitalia, & the perineum (in that order)with warm soapy water
• remove soiled materials & gloves, repeat hand hygiene

Question 34

Discuss the purpose for irrigating a catheter & methods for performing this skill.

Answer 34

Technique for restoring or maintaining catheter patency; open system; closed system; continuous irrigation

Question 35

Urinary diversion

Answer 35

One or both ureters are surgically implanted elsewhere

Question 36

Identify the functions of the urinary system.

Answer 36

• produce urine
• collect urine
• excrete urine from the body