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Intro to Nursing Exam 2 > Chapter 46 > Flashcards

Chapter 46 Flashcards

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1
Q

The last step in the removal & elimination of excess water and by-product of body metabolism

A

Urinary elimination

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2
Q

Protein in urine

A

Proteinuria

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3
Q

Blood in urine

A

hematuria

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4
Q

Normal range of urine production

A

1-2 L a day

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5
Q

Factors that influence the production of urine

A

fluid intake and temperature

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6
Q

Stimulates red blood cell production

A

erythropoietin

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7
Q

renin function

A

convert angiotensinogen into angiotensin ii

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8
Q

what does angiotensin ii cause

A

vasoconstriction

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9
Q

Patients with kidney impairment can have these medical problems

A

anemia, hypertension, and electrolyte balance

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10
Q

Areas of the brain involved in bladder control

A

cerebral cortex, thalamus, hypothalamus, and brainstem

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11
Q

Psychosocial conditions influencing urination

A

Social expectation (school, recesses, work breaks)

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12
Q

physiological factors influencing urination

A

Anxiety & stress (increase) and depression (decrease)

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13
Q

Medications affecting urination. Patients hold on to water

A

Diuretics (increase)

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14
Q

Urinary retention

A

The inability to partially or completely empty the bladder

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15
Q

Postvoid residual (PVR)

A

amount of urine left in the bladder after voiding and is measured by ultrasound or straight catheterization.

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16
Q

Most common cause of UTI

A

Escherichia coli

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17
Q

Cystitis symptoms

A

Urgency, frequency, incontinence, suprapubic tenderness, and foul-smelling cloudy urine.

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18
Q

sign of UTI in older adult

A

delirium

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19
Q

UTI in upper urinary tract

A

pyelonephritis

symptoms: fever, chills, diaphoresis, and flank pain

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20
Q

Urinary diversions

A

when patients have had the bladder removed b/c of cancer or bladder dysfunction, and the urine is diverted to the outside of the body through an opening of the abdominal wall called a stoma.

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21
Q

Two types of urinary diversions

A

Continent urinary diversion: distal part of the ilium and proximal part of the colon
orthotopic neobladder: uses an ileal pouch to replace the bladder.

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22
Q

6 month old infant who weighs 13-15lbs will excrete how much urine a day

A

400-500 ml a day

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23
Q

Best position to examine the female genitalia

A

dorsal recumbent position to provide full exposure to the genitalia

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24
Q

retracted foreskins can cause dangerous swelling called

A

Paraphimosis

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25
Q

Assessment of I&O is a way you assess

A

bladder emptying, renal function, and fluid and electrolyte balance

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26
Q

although I&O is often a written order, it can also be….

A

placed by the nursing judgement

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27
Q

Output measurement includes

A

Urine, vomitus, gastric drainage tubes, and wound drains

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28
Q

A change in urine can be an indicator of

A

fluid imbalance, kidney dysfunction, decreased blood volume.

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29
Q

if urinary output falls below 30 mL/hr, the nurse should do what first

A

assess for signs of blood loss and notify the health care provider.

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30
Q

How long should a nurse wait to evaluate for urinary retention if a client has had fluid and is not voiding urin

A

3-6 hr

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31
Q

Normal urine color

A

Pale straw color to amber, depending on its concentration

32
Q

Patients taking diuretics urine will look

A

diluted in color while medication is active.

33
Q

Bleeding from kidneys causes urine to look

A

dark red

34
Q

Bleeding from the bladder or urethra causes urine to look

A

bright red

35
Q

Urine will look bright orange if a patient is taking

A

Phenazopyridine

36
Q

What foods cause red urine

A

Beets, rhubarb and blackberries

37
Q

patients with liver disease could have what color urine

A

Dark amber, as a result of high concentrations of bilirubin.

38
Q

Clarity of urine should be

A

transparent

39
Q

Renal disease causes urine to appear (consistency)

A

cloudy because of protein concentration. Could also look thick because of bacteria and white blood cells

40
Q

Foods that change the odor of urine

A

asparagus and garlic

41
Q

proper label for all specimen collections

A

PT name, date, time, and type of collection

42
Q

To obtain urine that is fresh and up to policy, what must the patient do

A

PT must double void

second voided specimen is the one sent to the laboratory

43
Q

A patient with normal renal function who does not have heart disease or alterations requiring fluid restrictions should have an output of

A

30 ML/kg of weight or 0.5 ounces/lb/day

44
Q

Indwelling

A

remains in place over a period of time

45
Q

Intermittent

A

one-time cathertization for bladder emptying

46
Q

Indwelling catheterization can last as little or as long as?

A

2 weeks to more than a month

47
Q

Difference in catheters

A
  • number of catheter lumens
  • the presence of a balloon to keep the catheter in place
  • the shape of the catheter
  • a closed drainage system
48
Q

Single-lumen catheters are used for

A

intermittent/straight catheterization

49
Q

Double-lumen catheters are used for

A

indwelling catheters

one lumen for the urinary drainage and one used to inflate the balloon to keep the catheter in place.

50
Q

Triple-lumen catheters

A

continuous bladder irrigation or when it is necessary to instill medication into the bladder.

51
Q

A health care provider chooses a catheter based on

A
  • latex allergy
  • history of catheter encrustation
  • anatomical factors
  • susceptibility to infection
52
Q

indwelling catheters are made of

A

latex or silicone (good for patients who require a lot of changes, due to encrustation

53
Q

Intermittent/straight catheters are made of

A

rubber or polyvinyl chloride

54
Q

Most common adult size of indwelling catheter

A

14-16 Fr

55
Q

Infant indwelling catheter size

A

5-6 Fr

56
Q

Children indwelling catheter size

A

8-10 Fr

57
Q

young girls indwelling catheter size

A

12Fr

58
Q

Indwelling catheter balloon sizes

A

3mL (children)
10 mL (adult)
30 mL

59
Q

Why should the drainage system never be separated?

A

It can introduce the system to pathogens

60
Q

When a patient ambulates, it is important to

A

carry the bag below the level of the patients bladder, and use a leg bag if necessary.

61
Q

The only drainage bag that does not need to be kept dependent to the bladder is a

A

Specially designed drainage bag (belly bag)

62
Q

Patients should receive catheter care how often?

A

Every 8 hours

63
Q

What can an overfull drainage bag do?

A

create tension and pulling on the catheter, resulting in trauma to the urethra and/or urinary meatus.

64
Q

In the presence of no urine drainage, what should the nurse assess first?

A

Check to make sure there are no kinks or obvious occlusions of the drainage tubing or catheter.

65
Q

How long should all patients have their voiding monitored after catheter removal?

A

For at least 24-48 hours

66
Q

Symptoms requiring intervention after a catheter has been removed and the first few urinary voids are complete

A
  • Abdominal pain & distention
  • A sensation of incomplete emptying
  • Incontinence
  • Constant dribbling of urine
  • Voiding in very small amounts
67
Q

What catheter increases the risk of a UTI

A

Indwelling catheter

68
Q

After catheter is removed, how many days until symptoms of infection develop?

A

2-3 or more

69
Q

What are the 2 alternatives to urethral catheters

A

Suprapubic catheterization & External catheter (condom catheter)

70
Q

Suprapubic catheter is

A

A urinary drainage tube inserted surgically into the bladder through the abdominal wall above the symphysis pubis.

71
Q

How does a suprapubic catheter stay in place

A
  • sutured to the skin
  • secured with adhesive material
  • retained in the bladder with a fluid-filled balloon
72
Q

External catheter is

A

A condom-like sheath that fits over the penis, providing a safe noninvasive way to contain urine.

73
Q

Medications to treat urgency, frequency, nocturia and urgency UI

A

Antimuscarinics

  • derifenacin
  • oxybutynin
  • solifenacin
  • fesoterodine
  • tolterodine
  • tropsium
74
Q

Adverse effects of antimuscarinics

A

dry mouth, constipation and blurred vision

75
Q

Common irritants that increase symptoms of frequency, urgency, and incontinence

A

artificial sweeteners, spicy food, citrus products, and caffeine.

76
Q

Pelvic floor muscle training

A

kegels

77
Q

Factors influencing urination

A

growth and development, sociocultural factors, psychological factors, personal factors, personal habits, fluid intake, pathological conditions, surgical procedures, medications, diagnostic examinations

Intro to Nursing Exam 2 (6 decks)

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