Chapter 8 Flashcards
Lack of urine output
<100mL/ 24 hours
Anuria
A behavioral therapy designed to help patients control bothersome urinary urgency and frequency
Bladder training program
Irritation or imflammation of the bladder
Cystitus
Overfilling of the bladder resulting in muscle stretching- verified by physical assessment of the bladder
Distention
Caused by factors that prohibit or interfere with a patients access to the toilet or other acceptable recepticle for urine
Functional incontinence
Abnormal presence of blood in the urine
Hematuria
Urination; act of passing or expelling urine voluntarily through the urethra
Micturation
Diminished urinary output in relation to fluid intake <500mL / 24 hours or < 30mL / hour
Oliguria
Voiding excessive amounts of urine
Polyuria
Volume of urine remaining in the bladder after a normal voiding; the bladder normally is almost completely empty after micturation
Residual urine
Dribbling incontinence or urinary frequency with a full bladder- caused by chronic urinary retention
Inability to respond adequately to urge to void
Retention with overflow
What are factors that
Affect the volume of urine and the voiding process
1) growth and development
2) sociocultural factors
3) psychological factors
4) medication
5) daignostic examinations
6) muscle tone
7) interruption of flow
Ability to meet urinary needs and level of development- infant
1) lack of bladder control
2) immature kidneys and small bladder
3) unable to concentrate urine effectively
( Specific gravity around 1.008)
4) output 250-500mL q day
5) urinary control development age 2-5
Ability to meet urinary needs according to developmental level- preschooler
1) cognitive ability to respond to urge to void
2) accidents occur
3) girls should be taught to wipe front to back
Ability to meet urinary needs according to developmental level- school age children
1) kidneys double in size between ,5-10 years
2) larger bladder
3) urinate 6-8 times q day
4) Enuresis- involuntary passing of urine when control should have been established ( about 5 years old)
5) Noctura- bed wetting; involuntary passing of urine during sleep, not a problem until after age 6
Specific gravity of infant urine
1.008
Kidneys double in size between ages ?
5-10
Involuntary passing of urine when control should have been established
Enuresis
Control should be established by age 5
Bed wetting; involuntary passing of urine during sleep; not a problem until
NOCTURIA
NOT. A problem until age 6
Effect of age and developmental level on ability to meet urinary elimination need- eldery
1) decreased bladder capacity
2) 30% of nephrons lost by age 80
3) renal blood flow decreases
4) ability to concentrate urine decreases
5) bladder muscle tone decreases
6) risk for incontinence
30% of nephrons are lost by age _____?
80
Normal urine volume in 24hr
1500-2500mL
Composition of normal urine
94% water, 4% solutes
Normal urine pH
4.5-8
Alkaline urine common with _____
UTI
Normal.amount of acetone( ketones) in urine
0 none
Normal.amount of protien in urine?
0- none, albumen in the urine is a sensitive indicator of kidney function
( Damage to glomerular membrane)
Normal RBC in urine
0 ( except during menstruation )
Acidic urine is common in diseases dealing with _______?
Metabolism
Normal glucose in the urine
0
WBC in the urine, normal value?
0-5 only present during infection or inflammation
Compressed protien, cells, debris formed in the kidney tubules
Casts, normally 0 casts in the urine
Normal.specific gravity of urine
1.010 - 1.025
Identify essential data to be collected for a patient for a patient to meet the basic need of urinary elimination
1) through the patients eyes
2) self-care-ability
3) cultural considerations
4) pattern urination
5) symptoms of urinary alternations
6) physical assessment
7) intake and output
8) laboratory and diagnostic testing
9) diagnostic examinations
Health promotion strategies relationship related to the basic need of urinary elimination
1) maintain adequate hydration
2) keep good voiding habits
3) prevent urinary tract infections
4) quit smoking
5) report changes in bladder habbits
6) keep your bowels regular
Common problems with urinary elimination
1) dysuria
2) enuresis
3) frequency
4) NOCTURIA
5) retention
6) urgency
7) urinary incontinence
Causes of dysuria
UTI, inflammation of prostate, urethritis, trauma, to the lower urinary tract, urinary tract tumors.
Common causes of NOCTURIA (nocturnal anuresis)
Excess intake of fluids, bladder outlet obstruction, over reactive bladder, medication, cardiovascular disease, UTI
Suddenly unable to void when bladder is adequately full or overfull
Acute retention
Bladder doe not empty completely during voiding and urine is retained in the bladder ( happens all the time)
Chronic rentention
Repeated involuntary urination in children beyond the age when voluntary bladder control is normally aquired
Enuresis
Voiding more than 8 times during waking hours and or/ at decreased intervals such as less than every two hours
Frequency
Inflammation of the urethra
Urethritis
Common cuases of urinary frequency problems
High fluid intake, Bladder irritants UTI Increased pressure on bladder( pregnancy) Bladder outlet obstruction Over reactive bladder
Common cuases of urinary urgency
Full bladder, UTI, inflammation, or irritation of the vladder, overreactive bladder
Common causes of rentention
Bladder outlet obstruction, absent or weak bladder contractility, side effects of medications
Data which indicates the presence of urinary retention and imlaired urinary elimination
Distention, discomfort, feeling of pressure, tenderness over symphasis pubis, restlessness, diaphoresis
Small volume voiding, incontinence of small volumes of urine, no urinary output over several hour
Chronic- decrease in voiding vol. Straining to void, fequency, urgency, incontinence and sensation of incomplete emptying
Incomplete emptying of the bladder
Urinary retention
Defining characteristics of urinary retention
Absent urinary output, bladder distention, dribbling of urine, dysuria, frequent voiding overflow incontinence, residual urine, sensation of bladder fullness, small voiding
Definition of impaired urinary elimination
Dysfunction in urine elimination
Defining characteristics of impaired urinary elimination
Anatomic obstruction, multiple causality; sensory motor impairment; urinary tract infection
Residual volume more that 150-250mL
Urinary retention
Interventions for urinary retention
PMH ( past medical history)
Pain assessment
Physical assessment
Recognize retention as medical emergency
Review medications
Bladder scam
Attempt non-invasive methods of encouraging voiding
Insert catheter using CDC recommendations
Interventions to promote comfort and maintain skin integrity
1) containment of urine
2) gentle skin cleansing with no-rinse pH balance cleanser
3) use of moisturizer
4) apply moisture barrier product
A toilet schedule based on the patients usual voiding pattern
Habit training
A program of toileting designed for patients with mild or moderate cognitive impairment
Prompted voiding
Involves teaching patients how to indentify and contact pelvic floor muscles
Pelvic muscle exersizes
Behavioral therapy designed to help patients control bothersome urinary urgency and frequency
Bladder training
Nursing interventions in prevention or treatment of cystitis and UTI
A) EDUCATION
Maintain adequate fluid intake
Void when urge is felt before and after sex
Proper Peri care ( avoid bubble baths, harsh soaps and powder)
Avoid synthetic underwear
Avoid tight fitting clothes that restrict urethra
When to empty the catheter drainage bag
1/2 full
Keep the urinary drainage bag _______ the level of the bladder
Below
Patients in acute care should have urinary catheters inserted useing ________ technique and _________ equipment
Aseptic technique
Sterile equipment
Obtain urine samples from an indwelling catheter using the…..
Sample port
Clean the port with disinfectant
Use a sterile syringe/ cannula
