!! Chapter 37 Urinary Elimination Flashcards
___ helps to rid the body of waste products and materials that exceed bodily needs.
Elimination
The urinary system is responsible for:
absorption of nutrients and fluids from the body’s intake.
The urinary system controls the composition of blood by:
removing waste products known as urea and conserving useful substances.
__ is produced when protein-rich foods are digested.
Urea
The urinary system helps to control ___.
Blood pressure
The urinary system plays a crucial role in:
acid-base balance
The human makes ___ of urine every 24 hours.
1.5L
What are the 7 functions of the kidneys?
- major excretory organs of the body
- filter liquid waste from the blood
- balance salts and electrolytes in the blood
- regulate blood volume and pressure
- produce erythropoietin for RBC formation
- synthesize vitamin D to help with calcium levels
- maintains acid-base balance or extracellular fluid
How is urine formed?
by tiny filtering units called nephrons, which are the functional unit of the kidney.
Each nephron consists of: (2)
-the renal corpuscle and a small tube called the renal tube.
The renal corpuscle is comprised of a network of blood capillaries called the ___.
Glomerulus
___ occurs in the glomerulus as fluid moves across a membrane as the result of a pressure difference.
Filtration
___ occurs in the renal tubule as most of the filtrate moves back into the blood.
Reabsorption
As ___ takes place, urine is produced.
Secretion
After exiting the kidneys, the urine goes where and through what?
to the bladder through the ureters (narrow tubes)
The ureter wall muscles continually tighten and relax to:
force urine downward
What can make a patient susceptible to kidney infections?
if urine is retained in the kidney or back flows from the bladder toward the kidneys
The bladder walls relax and expand to ___, and they they relax and extend to ___.
- store urine
- empty urine through the urethra
What do sphincter muscles at the base of the bladder do?
they help keep urine from leaking
What transports urine from the bladder to outside the body?
the urethra
What is it called when the bladder signals that it is time to urinate and empty the bladder?
urgency or urge
When all the signals occur in the correct order for urination, ___ occurs.
Micturition or urination.
What is urinary retention?
Can’t release the urine, and it is instead stuck in the bladder.
What is urinary incontinence?
Loss of ability to control voiding
What are the 5 factors that affect the structure or function of the urinary system?
- psychosocial factors
- food and fluid intake
- surgical and diagnostic procedures
- pathologic conditions (arteriosclerosis)
- UTI’s
Anuria
No urine or less than 50-100ml
Oliguria
little urine, 100-400 ml in 24 hours (adults: less than 400.)
Polyuria
excessive urination , over 2,500 ml per day.
Nocturia
excessive urination at night
Dysuria
painful urination
Hematuria
blood in the urine
Anuria can be caused by:
a tumor, obstruction, blood clots, etc.
Dialysis
fluids and molecules pass through an artificial semipermeable membrane and are filtered via osmosis.
Hemodialysis
the patients blood is continually flowing through a machine that filters it.
What does hemodialysis take place of?
the kidneys if they aren’t working right
Peritoneal dialysis
instilling dialysis solution into the patients abdominal cavity through an external catheter. put the fluid in, they sleep, it gets drained in the morning.
Oliguria classifications: (3)
prerenal: from reduced blood flow to kidneys
renal: from actual renal damage
postrenal: failure from abstraction of urine flow
Does urine color reflect degree of blood loss?
NO, some blood could be microscopic.
What is tea colored urine?
blood is in it.
Urinary incontinence
The inability to control the passage of urine
Stress incontinence
Loss of urine when sneezing, laughing, exercising, etc.
-lots of women after childbirth have this
Urge incontinence
a sudden STRONG need to void or urinate, follow day rapid bladder contraction
Mixed incontinence
urge and stress incontinence mixed.
Functional incontinence
occurs despite the fact that the urinary tract is functioning appropriately. their is some other type of issue going on that is causing this.
Overflow incontinence
Patient is unable to fully empty bladder, so it results in a constant dribbling.
Urinary incontinence is caused by:
- obstruction in the urinary bladder
- neurologic disorder
Enuresis
The involuntary passing of urine
5 medications causing urine changes?
- diuretics
- anticoagulants
- phenazopyridine: Pyridium
- antidepressant-amitriptyline
- levodopa
what are anticoagulants and what change can they cause in the urine?
- blood thinners
- blood in urine (hematuria)
What are diuretics and what change can they cause in the urine?
- water pills
- dehydrates you by making your body get rid of all the excess water
- lighten color or urine
What is phenazopyridine and what change can they cause in the urine?
- PYRIDIAM
- urinary tract analgesic
- cause urine to be orange
What can antidepressants-amitriptyline change in the urine?
-can cause urine to be green or blue
What is levodopa and what change can they cause in the urine?
- Seizure medication
- can lead to brown or black urine
What is the single most common hospital-acquired infection?
UTI
What is a urinary diversion?
When bladder function is not working correctly so they do a ureterostomy on the abdomen and either both ureters stick outside the skin attached to a bag, or they’re connected inside and one sticks out.
What does the BUN and creatinine test?
kidney function
__ is a measure of the urea level in the blood.
BUN
What is urea?
waste, the end product of protein metabolism
What is a waste product that is produced in the blood as a byproduct of muscle metabolism?
Creatinine
A patient with kidney damage has decreased ___ but increased ___.
- urinary creatinine
- serum levels
What is the balance of water and solutes?
specific gravity
Normal urine characteristics:
no protein, no ketones, and little to no glucose.
increased __ levels show a UTI.
nitrate
What organs does a diagnostic x-ray that shows GI conditions such as bowel obstruction and gallstones involve?
Kidney, ureter, and bladder x-ray (KUB)
What is an x-ray with contrast that shows the size, shape, and position of the urinary tract?
Intravenous pyelogram (IVP)
What is used to diagnose kidney stones, bladder stones, or blockage, and also looks for growths, infections, or other disease of the urinary tract?
-Computed tomography (CT) of the KUB.
What is an examination of the bladder and urethra via a camera that is inserted into the urethra and then advanced into the bladder?
cystoscopy
Medications such as diuretics may cause frequency or urgency, potentially compromising which patients?
fall risks
What are 5 ways to promote normal urinary patterns in a healthcare facility?
- integrate the patient’s habits into daily care
- safe practice (diuretics and fall risks)
- privacy !!!
- toileting schedule
- fluid intake (increase)
What do Kegel exercises do?
help to tone the female pelvic floor which reduces risk of incontinence.
-helps keep it tight so urine doesn’t come out unexpectedly.
___% of UTIS are the result of catheterizations?
about 80
What is a primary method for UTI prevention?
avoiding use of indwelling catheters
4 different catheters and what do they do?
- straight: one time and used to get the urine out, or for a measurement.
- foley: balloon is used to keep it in the bladder, one tube used to irrigate ht ballon, other to release urine.
- Triple-Lumen: used to irrigate or put medicine is AS WELL as let urine come out
- Coude: bent for older men bc their prostates enlarge as they age
__ is used for bladder irrigation?
-saline
What are suprapubic catheters?
- inserted directly into the bladder just above the pubic bone.
- used if the urethra is not working.
What are the documentation concerns for urinary tract:
- I & O
- Note stoma condition and skin appearance
- record color, odor, consistency, and amount of urine
