chapter 37, urinary Elimination Flashcards
what will be the result if an individual view themselves as old, powerless and neglected and cease to value voluntary control over urination and simply find toileting too much bother no matter what the setting…
incontinence
what are some factors affecting urination
age
food and fluid intake
psychological variables (stress)
activity and muscle tone (indwelling urinary catheters)
pathologic conditions (renal failure, diabetes mellitus etc)
medications
24 hour urine output is less than 50 mL; synonyms are complete kidney shutdown or renal failure.
Anuria
presence of sugar in the urine
glycosuria
painful or difficult urination
dysuria
The surgical creation of an alternate route for excretion of urine.
urinary diversion
what should the nurse do when a patient reports a problem with voiding?
explore its duration, severity and precipitating factors.
where can the bladder be palpated when its distended
above the symphysis pubis and may reach just below the umbilicus.
what should the nurse do first before palpating the bladder.
always ask the patient when he or she voided last
what is a safer alternative to catheterization to determine bladder urine volume?
the bedside scanner
results are most accurate when the patient is in the supine position.
what position should the nurse place a female patients for good visualization of the meatus?
dorsal recumbent position
abnormal constituents of urine
protein blood glucose ketone bodies bacteria
what is the best way for the nurse to use when measuring I & O of a continent patient
placing a specimen hat under the toilet seat.
what is the normal urine specific gravity
1.015 to 1.025
A high specific gravity indicates?
dehydration
A low specific gravity indicates
overhydration
how can the nurse measure the I & O in patients who are incontinent?
note the number of times the patient is incontinent and any urine characteristics.
use of scheduled toileting, assisting the patient to the toilet q2h.
A type of urinary incontinence that appears suddenly and lasts for 6 months or less.
Transient incontinence
usually caused by factors such as illness, infection, medications.
what type of urinary incontinence is a patient experiencing when he or she have a loss of urine before getting to the toilet and an inability to suppress the need to urinate?
urge incontinence
urine loss caused by the inability to reach the toilet because of environmental barriers, physical limitations loss of memory or disorientation.
functional incontinence
The amount of urine remaining in the bladder immediately after voiding
postvoid residual (PVR) less than 50 mL indicates adequate bladder emptying greater than 150 mL is guideline for catheterization
what action should the nurse take when a condom catheter leaks with every voiding?
check the size of condom catheter.
check space between tip of penis and end of condom sheath.
when assessing the penis of a patient with condom catheter, the nurse finds break in skin integrity.
Do not reapply condom catheter.
Allow skin to be open to air as much as possible.
consult wound care nurse.
patient complains of extreme pain when nurse is inflating balloon during catheterization
stop inflation of balloon.
Balloon is most likely still in urethra.
Withdraw the solution from the balloon
insert catheter an additional 1/2 to 1” and slowly attempt to inflate balloon again.
No urine flow is obtained, nurse notes that catheter is in vaginal orifice.
leave catheter in place as a marker.
obtain new sterile gloves and catheter kit.
start the procedure over and attempt to place new catheter directly above misplace catheter.
Nurse cannot insert a catheter for a male patient past 3” to 4”; rotating the catheter and having patient breathe deeply are of no help..
notify primary care provider.
A Coude catheter may be ordered
urine flow is initially well established and urine is clear, but after several hours, urine flow dwindles
check tubing for kinking
