chapter 37, urinary Elimination

Question 1

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…

Answer 1

incontinence

Question 2

what are some factors affecting urination

Answer 2

age
food and fluid intake
psychological variables (stress)
activity and muscle tone (indwelling urinary catheters)
pathologic conditions (renal failure, diabetes mellitus etc)
medications

Question 3

24 hour urine output is less than 50 mL; synonyms are complete kidney shutdown or renal failure.

Answer 3

Anuria

Question 4

presence of sugar in the urine

Answer 4

glycosuria

Question 5

painful or difficult urination

Answer 5

dysuria

Question 6

The surgical creation of an alternate route for excretion of urine.

Answer 6

urinary diversion

Question 7

what should the nurse do when a patient reports a problem with voiding?

Answer 7

explore its duration, severity and precipitating factors.

Question 8

where can the bladder be palpated when its distended

Answer 8

above the symphysis pubis and may reach just below the umbilicus.

Question 9

what should the nurse do first before palpating the bladder.

Answer 9

always ask the patient when he or she voided last

Question 10

what is a safer alternative to catheterization to determine bladder urine volume?

Answer 10

the bedside scanner

results are most accurate when the patient is in the supine position.

Question 11

what position should the nurse place a female patients for good visualization of the meatus?

Answer 11

dorsal recumbent position

Question 12

abnormal constituents of urine

Answer 12

protein
blood
glucose
ketone bodies
bacteria

Question 13

what is the best way for the nurse to use when measuring I & O of a continent patient

Answer 13

placing a specimen hat under the toilet seat.

Question 14

what is the normal urine specific gravity

Answer 14

1.015 to 1.025

Question 15

A high specific gravity indicates?

Answer 15

dehydration

Question 16

A low specific gravity indicates

Answer 16

overhydration

Question 17

how can the nurse measure the I & O in patients who are incontinent?

Answer 17

note the number of times the patient is incontinent and any urine characteristics.
use of scheduled toileting, assisting the patient to the toilet q2h.

Question 18

A type of urinary incontinence that appears suddenly and lasts for 6 months or less.

Answer 18

Transient incontinence

usually caused by factors such as illness, infection, medications.

Question 19

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?

Answer 19

urge incontinence

Question 20

urine loss caused by the inability to reach the toilet because of environmental barriers, physical limitations loss of memory or disorientation.

Answer 20

functional incontinence

Question 21

The amount of urine remaining in the bladder immediately after voiding

Answer 21

postvoid residual (PVR)
less than 50 mL indicates adequate bladder emptying
greater than 150 mL is guideline for catheterization

Question 22

what action should the nurse take when a condom catheter leaks with every voiding?

Answer 22

check the size of condom catheter.

check space between tip of penis and end of condom sheath.

Question 23

when assessing the penis of a patient with condom catheter, the nurse finds break in skin integrity.

Answer 23

Do not reapply condom catheter.
Allow skin to be open to air as much as possible.
consult wound care nurse.

Question 24

patient complains of extreme pain when nurse is inflating balloon during catheterization

Answer 24

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.

Question 25

No urine flow is obtained, nurse notes that catheter is in vaginal orifice.

Answer 25

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.

Question 26

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..

Answer 26

notify primary care provider.

A Coude catheter may be ordered

Question 27

urine flow is initially well established and urine is clear, but after several hours, urine flow dwindles

Answer 27

check tubing for kinking