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Nursing 200 > Chapter 45 Urinary Elimination > Flashcards

Chapter 45 Urinary Elimination Flashcards

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1
Q

Kidneys:

A

remove wastes from the blood to form urine

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2
Q

Ureters:

A

transport urine from the kidneys to the bladder

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3
Q

Bladder:

A

holds urine until the urge to urinate develops

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4
Q

Urethra:

A

urine leaves the body through it

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5
Q

Efferent:

A

leaves

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6
Q

Afferent:

A

arrives

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7
Q

Urine should be released in a catheter how many mL/hr?

A

30 mL/hr

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8
Q

Nephron in kidneys:

A

functional unit that forms urine

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9
Q

Proteinuria:

A

presence of large proteins in the urine

-sign of glomerular injury

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10
Q

The normal adult urine output average:

A

1200-1500 mL/day

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11
Q

Eythropoietin:

A

Within bone marrow to stimulate RBC production and maturation and prolongs the life of mature RBCs

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12
Q

Renin:

A

released from juxtaglomerular cells

functions as a enzyme to convert angiotensinogen into angiotensin I

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13
Q

Kidneys affect:

A

calcium and phosphate regulation

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14
Q

Kidney functions:

A

Production of erythropoietin

Production of renin, prostagiandin E2, and prostacyclin affect BP

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15
Q

Voiding

A

Bladder contraction + Urethral sphincter and pelvic floor muscle relaxation

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16
Q

Act of Urination

A
  1. Stretching of bladder wall signals the micturition center in the sacral spinal cord.
  2. Impulses from the micturition center in the brain respond to or ignore this urge, thus making urination under voluntary control.
  3. When a person is ready to void, the external sphincter relaxes, the micturition reflex stimulates the detrusor muscle to contract, and the bladder empties.
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17
Q

Renal calculus:

A

obstruction within a ureter

-kidney stones

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18
Q

An adult normally voids every

A

2-4 hours

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19
Q

Reflex Incontinence:

A

damage to the spinal cord above the sacral region

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20
Q

Overflow incontinence:

A

when a bladder is overly full and bladder pressure exceeds sphincter pressure, resulting in involuntary leakage of urine

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21
Q

Factors influencing urination:

A
  • Disease conditions
  • Medications and medical procedures
  • Socioeconomic factors (need for privacy)
  • Psychological factors (anxiety, stress, privacy)
  • Fluid balance
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22
Q

Uremic syndrome:

A

increase in nitrogenous wastes in the blood, marked fluid and electrolyte abnormalities, nausea, vomiting, headache, coma, and convulsions characterize this syndrome

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23
Q

Renal replacement therapies:

A

treatment such as dialysis or organ transplantation

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24
Q

Peritoneal dialysis:

A

an indirect method of cleaning the blood of waste products using osmosis and diffusion

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25
Q

Sociocultural factors:

A
  • North Americans: bathrooms are private

- European cultures: accept communal toilet facilities

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26
Q

Nocturia:

A

awakening to void one or more times at night

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27
Q

Polyuria:

A

an excessive output of urine

28
Q

Oliguria:

A

a urine output that is decreased despite normal intake

29
Q

Anuria:

A

no urine is produced

30
Q

Diuresis:

A

coffee, tea, cocoa, and cola drinks that contain caffeine promote urine formation

31
Q

Fever:

A

excessive perspiration loss from fever decreases urine amount

32
Q

Amitriptyline causes a

A

green or blue discoloration

33
Q

Disease conditions affecting urination:

A
  • Prerenal, renal, postrenal classification
  • Conditions of the lower urinary tract
  • Diabetes mellitus and neuromuscular diseases such as multiple sclerosis
  • Benign prostatic hyperplasia
  • Cognitive impairments (e.g., Alzheimer’s)
  • Diseases that slow or hinder physical activity
  • Conditions that make it difficult to reach and use toilet facilities
  • End-stage renal disease, uremic syndrome
34
Q

Medical Interventions- Surgical procedures:

A
  • Restriction of fluid intake lowers urine output.

- Stress causes fluid retention

35
Q

Medical Interventions - Medications:

A
  • Some cause urinary retention and/or overflow incontinence.
  • Some cause urgency and incontinence.
  • Some change the color of urine
36
Q

Medical Interventions- Diagnostic examinations

A
  • Restriction of fluid intake lowers urine output.

- Direct visualization causes localized trauma and edema; patients may have difficulty voiding.

37
Q

Urinary retention:

A

An accumulation of urine due to the inability of the bladder to empty

38
Q

Urinary tract infection

A

Results from catheterization or procedure

39
Q

Urinary incontinence

A

Involuntary leakage of urine

40
Q

Urinary diversion

A

Diversion of urine to external source

41
Q

Older Adults - Promote:

A
  • Provide frequent opportunities to void. Older adults have a smaller bladder capacity than younger adults.
  • Encourage older adults to empty the bladder completely before and after meals and at bedtime.
  • Encourage patients to increase fluid intake to at least six to eight glasses a day unless medically contraindicated
42
Q

A health care provider may suspect that an older patient is experiencing urinary retention when the patient has

A

Small amounts of urine voided 2 to 3 times per hour.

43
Q

Nursing Knowledge Base:

A
  • Infection control and hygiene
  • Growth and development
  • Muscle tone
  • Psychosocial considerations
  • Cultural considerations
44
Q

Urine Collection in Children:

A

-Difficult
-Preschool children and toddlers have difficulty voiding on request.
Ex. running water, hat, bag

45
Q

A young girl is having problems urinating postoperatively. You remember that children may have trouble voiding

A

In the presence of a person other than their parents

46
Q

Physical Assessment:

A
  • Gather nursing history for the patient’s urination pattern and symptoms, and factors affecting urination.
  • Conduct physical assessment of the patient’s body systems potentially affected by urinary change.
  • Assess characteristics of urine.
  • Assess the patient’s perception of urinary problems as it affects self-concept and sexuality.
  • Gather relevant laboratory and diagnostic test data.
47
Q

Skin and mucosal membranes:

A

Assess hydration.

48
Q

Kidneys

A

Flank pain may occur with infection or inflammation.

49
Q

Bladder

A

Distended bladder rises above symphysis pubis

50
Q

Urethral meatus

A

Observe for discharge, inflammation, and lesions.

51
Q

Assessment of Urine:

A
  • Intake and output
  • Color, clarity, odor
  • Urine testing (specimen collection)
52
Q

Color of urine:

A

Pale-straw to amber color

53
Q

Clarity of urine:

A

Transparent unless pathology is present

54
Q

Odor of urine

A

Ammonia in nature

55
Q

Urine tests and diagnostic examinations:

A 
Urinalysis
Specific gravity 
Culture
Noninvasive procedures
Invasive procedures
56
Q

Stimulating micturition reflex:

A
  • Maintaining elimination habits
  • Maintaining adequate fluid intake
  • Promoting complete bladder emptying
  • Preventing infection
57
Q

Catheterization:

A
  • Insertion
  • Closed drainage systems
  • Care
  • Peri hygiene
  • Fluid intake
58
Q

Catheter is what kind of environment?

A

Sterile

59
Q

Restorative care:

A
  • Strengthening pelvic floor muscles
  • Bladder retraining
  • Habit training
  • Self-catheterization
  • Maintenance of skin integrity
  • Promotion of comfort
60
Q

Safety Guidelines:

A

Follow principles of surgical and medical asepsis as indicated when performing catheterizations, handling urine specimens, or helping patients with their toileting needs.
Identify patients at risk for latex allergy (i.e., patients with history of hay fever; asthma; and allergies to certain foods such as bananas, grapes, apricots, kiwi fruit, and hazelnuts).
Identify patients with allergies to povidone-iodine (Betadine). Provide alternatives such as chlorhexidine.

61
Q

The nurse directs NAP to:

A
  • Adjust for any special needs or adaptations
  • Provide personal hygiene
  • Report any urine changes
  • Explain procedures
62
Q

Intake:

A

Oral liquids, enteral feedings, parenterally

63
Q

Output:

A

Urine, diarrhea, vomitus, gastric suction and drainage from surgical tubes

64
Q

Monitoring Intake and Output:

A
  • Educate patient and family
  • Delegation to NAP
  • Record and report any changes in I&O
65
Q

Intermittent catheterization is used when

A

evaluating the residual urine following urination. The investigation requires measurement of urine remaining in the bladder after voiding. Intermittent catheterization prevents the risk of infection.

66
Q

Long-term catheterization is done in clients with

A

urinary retention. It may also be done for clients with recurrent episodes of urinary infections, skin breakdown, and terminal illness.

67
Q

Short-term catheterization is required for

A

obstructive conditions, surgical repair of bladder and urethra, prevention of urethral obstruction, and bladder irrigation.

Nursing 200 (23 decks)

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