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NUR 333 > E4 Urinary Elimination > Flashcards

E4 Urinary Elimination Flashcards

1
Q

Bacteremia

A

Bacteria in the bloodstream

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2
Q

Bacteriuria

A

Bacteria in urine

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3
Q

Cystitis

A

an infection of the bladder that almost always follows (is secondary to) bacterial infection in the urine

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4
Q

Dysuria

A

pain and/or burning when urinating

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5
Q

Hematuria

A

Blood in urine

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6
Q

Micturition

A

the action of urinating

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7
Q

Nephrostomy

A

a procedure to drain urine from your kidney using a catheter (tube)

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8
Q

Pelvic floor muscle training

A

Begin by emptying your bladder. · Tighten the pelvic floor muscles and hold for a count of 10. · Relax the muscles completely for a count of 10.

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9
Q

Proteninuria

A

elevated protein in the urine

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10
Q

Pyelonephritis

A

a bacterial infection causing inflammation of the kidneys

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11
Q

Ureterostomy

A

a surgery that redirects your ureters, the tubes that carry pee from your kidneys to your bladder, to carry your pee to a new, surgical opening in your skin instead.

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12
Q

Voiding

A

Bladder contraction
Urethral sphincter relaxes
Pelvic floor muscles relax

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13
Q

Factors influencing urinary elimination

A

-Growth & development
-Sociocultural factors
-Psychological factors
-Personal habits
-Fluid intake
-Pathological conditions
-Surgical procedures
-Diagnostic examinations

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14
Q

Decreased urinary changes in older adults

A

-Decreased amount of nephrons
-Decreased bladder muscle tone
-Decreased bladder capacity
-Decreased time between initial desire to void and urgent need to void

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15
Q

Increased urinary changes in older adults

A

-Increased bladder irritability
-Increased bladder contractions during bladder filling
-Increased risk of urinary incontinence

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16
Q

Common urinary elimination problems

A

-Urinary retention
-UTI
-Urinary incontinence

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17
Q

Urinary retention

A

-Inability to partially or completely empty the bladder
-Can be acute or chronic
-Diagnose with Post-Void residual (PVR)

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18
Q

Bladder scanning is a ________ nursing action

A

independent

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19
Q

What is the most common type of UTI?

A

E.Coli

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20
Q

What does a upper vs lower UTI?

A

Upper: kidney infection
Lower: bladder or urethra infection

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21
Q

UTI risk factors

A

-Presence of indwelling catheter
-Any instrumentation of urinary tract
-Urinary retention
-Urinary or fecal incontinence
-Poor perineal hygiene
-Females
-Frequent sexual intercourse
-Uncircumcised patients

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22
Q

Older adults UTI symptoms

A

-Confusion
-Decreased functional status
-Delirium
-Increased falls
-Fever

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23
Q

Upper UTI symptoms

A

Flank tenderness

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24
Q

Lower UTI symptoms

A

-Burning
-Pain w/ urination
-Irritated bladder
-Urgency
-Frequency
-Incontinence
-Maybe superpubic tenderness
-Foul smell
-Cloudy urine

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25
Q

How to prevent CAUTI

A

-Good hand hygiene
-Correct way to get sample from foley
-Secured properly
-Sterile insertion
-Castile wipes
-CHG wipes

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26
Q

Overflow urinary incontinence

A

-Poor bladder emptying
-Bladder obstruction
-Males w/ BPH

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27
Q

Stress urinary incontinence

A

-Usually from effort or exertion
-laughing, coughing, sneezing
-Injury to sphincter
-Childbirth

28
Q

Urgency urinary incontinence

A

-Older adults
-Idiopathic
-Really gotta go

29
Q

Functional

A

-Inability to get to bathroom
-Older adults with assistive devices
-Broke leg need assistance

30
Q

Incontinence risk factors

A

-More common in women & elderly
-Obesity
-Multiple pregnancies/ vaginal births
-Neurological disorders: Parkinson’s, CVA, Spinal cord injury, MS
-Medication therapy
-Confusion
-Dementia
-Immobility
-Depression

31
Q

What Medications are risk factors for incontinence?

A

-Diuretics
-Opioids
-Anticholinergics
-Calcium channel blockers
-Sedatives
-Hypnotics

32
Q

Assessing someone with urinary issues

A
  1. Assess understanding and expectations of treatment
  2. Be professional
  3. Assess ability to perform necessary behaviors associated with voiding
  4. Culture or personal considerations
  5. Past medical hx
  6. Medication use
  7. Normal bowel and urine patterns
  8. Sleep, activity, nutrition
33
Q

Hesitancy

A

difficulty starting the stream of urine or keeping it flowing, or your flow may stop before your bladder is empty

34
Q

Polyuria

A

Excessive urination volume- occurs when you urinate more than normal.

35
Q

Oliguria

A

urinary output less than 400 ml per day or less than 20 ml per hour

36
Q

Nocturia

A

Frequent nighttime urination

37
Q

Might assess ____ for kidney infection/ tenderness

A

Costovertebral Angle (CVA)

38
Q

Normal urine output and concerning urine output

A

N: output >30mls/hr
C: output <30mls/hr for 2 hours

39
Q

The first of the day is more

A

concentrated

40
Q

Urine that sits becomes more

A

cloudy & stinky

41
Q

What does Thick and Cloudy urine mean?

A

Bacteria and WBCs

42
Q

What does normal urine smell like?

A

-Ammonia
-Odorless

43
Q

How do you get a urine sample from someone with a catheter?

A

Clamp catheter and get it up close to insertion site

44
Q

Normal urine pH

A

4.6-8.0
Alkaline: loss of acid
Acidotic: urine that sits for hours

45
Q

Specific gravity normal range

A

1.005-1.030
High: dehydrated
Low: Overhydrated

46
Q

Culture & Sensitivity

A

-Obtained to determine presence of pathogenic bacteria
-Obtain before antibiotic administration
-Only done if urinalysis suggest infection
-Send to lab within 3o mins
-Preliminary report should be available within 24 hrs
-Sterile specimen cup

47
Q

Why would you take abdominal x-ray: Kidney Urether Bladder(KUB)

A

-Determines size, shape, symmetry, location of structures of the urinary tract
-Detect and measure urinary calculi (kidney stones)
-Don’t have to be NPO

48
Q

Patient education for urinary elimination

A

-Promote selfcare practices
-Maintain normal routine
-Promote healthy nutrition and fluid intake
-Avoid constipation & smoking
-Strengthen pelvic floor muscles
-Men be vigilant about your prostate health (routine check ups)
-Report any changes in urinary tract

49
Q

How much fluid should you consume in a day?

A

2300mls/day if renal function is ok, no heart disease & no need for fluid restriction
-helps flush solutes to limit bladder irritability

50
Q

If fluid needs to be increased:

A
  1. Schedule times to drink
  2. Identify fluid preferences
  3. High fluid foods (fruits)
  4. Stop drinking 2 hours before bedtime
51
Q

Urinary retention Nursing care

A

-Assess & monitor urine output
-Assess for bladder distention
-Assist pt to normal position for urination
-Run water or flush commoade
-Apply cold compress to abdomen
-Encourage double voiding
-If bladder does not empty fully, try around the clock voiding
-Crede method is not recommended
-Intermittent catheterization or catheterization

52
Q

What is the crede method

A

exerting manual pressure on the abdomen at location of bladder

53
Q

What are things that can be done to prevent infection?

A

-Follow hospital protocol
-Assess for s/s of infection
-Perform perineal hygiene
-Void at regular intervals
-Adequate fluid intake
-Female considerations (wipe front to back)

54
Q

1st line therapy Incontinence care

A

-Be respectful of pts feeling
-Pelvic floor muscle training
-Lifestyle changes
-Bladder retraining
-Toileting schedule
-Intermittent catherization
-Meticulous skin care
-Absorbent pads & catheters

55
Q

2nd line therapy incontinence care

A

-Electrical stimulation
-Meds: anticholinergics
-Bulking material injections
-Botox
-Nerve stimulation
-Surgery: Sling, bladder neck suspension, prolapse surgery, artificial urinary sphincter

56
Q

Do’s of meticulous skin care

A

-Identify & treat early
-Use skin risk assessment tools
-Use appropriate skin barrier products
-Ensure hydration
-Consult WOCN if needed

57
Q

Don’ts of meticulous skin care

A

-Don’t use traditional soap & water
-Don’t double pad the bed
-Don’t leave soiled pads

58
Q

What type of catheter is used for an enlarged prostate?

A

Coude tip

59
Q

Suprapubic catheter

A

-Placed in bladder through abdominal wall
-Sutured in place
-Used when blockage of urethra or when indwelling catheter causes irritation
-Long term cath

60
Q

Empty drainage bag when it is _____ full

A

half

61
Q

Nursing catheter care

A

-Peri care
-Catheter care
-Secure catheter to prevent movement or pulling
-Ensure no kinks
-Keep below bladder
-Do not allow bag to touch floor
-Maintain closed drainage system
-Accurate monitoring og output
-Timely removal

62
Q

Peri care, CHG, and Castille wipes can be delegated to

A

nursing assistant or patient but job of nurse to ensure it gets done

63
Q

How soon should a pt void post removal?

A

6-8 hours

64
Q

What should you educate pt on post removal?

A

First urine may cause discomfort

65
Q

Catheter must be removed ______ after order written

A

4 hours

66
Q

If you bladder scan and volume <400 mLs then

A

ensure adequate hydration and rescan in 2 hours

67
Q

If you bladder scan and volume >400 mLs then

A

perform in and out cath

NUR 333 (15 decks)

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