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N1180 > Genitourinary and Fluid Balance > Flashcards

Genitourinary and Fluid Balance Flashcards

1
Q

What are the functions of the kidney:

A
  • regulates water volume, concentration of solutes in water, blood pH, and production of erythropoietin
  • filters blood stream
  • removing toxins and waste
  • returning necessary components back to blood
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2
Q

What does the urinary system consist of:

A
  • ureters
  • bladder
  • urethra
  • Kidneys
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3
Q

Micturition VS. Urination

A

Micturition: the physiologic process of eliminating urine

Urination: the act of expelling urine from the body

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4
Q

What is Hematuria?

A
  • blood in urine - can be microscopic (not visible to the naked eye) or macroscopic (visible to the naked eye)
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5
Q

What is Dysuria?

A
  • painful urination (subjective symptom)
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6
Q

What is Fluid Volume?

A
  • Can be a deficit status (dehydration) or overload (retaining fluid)
  • Patient should be in a fluid balance (input = output)
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7
Q

What is the purpose of diuretic medications?

A
  • help the body increase urination output (ie. Used when a patient is retaining fluid)
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8
Q

What is an Expected Urine Output?

A
  • Amount of urine a healthy individual produces each hour = 0.5mL/Kg/hour
  • Ex. Clients weighs 82kg - 22 Kg x 0.5mL/Kg/hr = 41 mL/hour
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9
Q

What are the 4 Factors that affect Micturition?

A

1) Disease/Disability
2) Pelvic Floor/ Muscle Tone
3) Psychologic Factors
4) Medications

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10
Q

How is urine output affected by disease/dsiability?

A
  1. Infection
  2. Disease of the kidneys (can lead to decreased secretion, filtration, or reabsorption)
  3. Continence/retention factors
  4. Immobility
  5. Neurological Changes
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11
Q

How is urine output affected by Pelvic Floor/Muscle Tone?

A
  1. Pregnancy and childbirth
  2. Chronic constipation/straining
  3. Heavy lifting
  4. Obesity
  • these factors can weaken pelvic muscles (which provide voluntary control of when we urinate)
  • A weak pelvic floor can lead to involuntary loss of urine (ex. Peeing when coughing or sneezing)
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12
Q

How is urine output affected by Psychologic Factors?

A
  1. Lack of privacy
  2. Aversion to public restrooms
  3. Anxiety
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13
Q

How is urine output affected by Medication?

A
  • some medications can increase urine output or cause urinary retention
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14
Q

What are the 3 steps in taking a Focused History of the Genitourinary tract?

A
  1. Specific Questions
    ○ What are your normal urinary patterns and habits?
    ○ Frequency, urgency, dysuria?
    ○ Associated symptoms?
    ○ Functional impact?
  2. Background Information
    ○ Family history
    ○ Past medical history
    ○ Medications
  3. Anatomical Variations
    ○ Any anatomical changes along upper and lower urinary tract can change urinary habits
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15
Q

Physical Examination

A
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16
Q

What affects urine colour?

A
  • Urine colour varies based on how much fluid is in your body and how much filtering your kidney is doing
  • Urine gets its yellow colour from urobilin/urochrome - compound excreted by kidneys
  • The more water you drink, the more clear your pee is - because you are diluting the other substances that are being excreted
17
Q

What different colours of pee mean?

A

Darker shade of yellow (honey) - not consuming enough water

Yellow or Orange
- Some medications can turn pee colour
- ie. Phenazopyridine - treatment for painful UTIs
- ie. Sulfasalazine - treatment for colitis

Dark brown
- Can be a result of eating rhubarb, aloe, or fava beens
- can be a sign of severe dehydration
- Can indicate rhabdomyolysis: dangerous condition in which muscles break down (Other symptoms - muscle cramps, severe pains, feeling weak or tired after exercise)
- Poor liver function can result in extra bilirubin (extra component of bile) in urine
- if you have a history of melanoma - brown urine can be a sign that this cancer is progressing

Urine is pink/red tint
- Could be a result of eating rhubarb, blueberries, or beets
- Medications (ie. Rifampin) causes red pee
- Could be a tint of blood in urine (resulting from UTI or infection)

Blue/green urine
- Usually not an issue
- could be a result of something you ate
- Asparagus can make pee green
- Medications - muscle relaxers and heartburn reducers
- Fungus/yeast
- Pseudomonas
- Other signs of infections: burning, odor, pain, fever
- Could be a sign of familial hypocalciuric hypercalcemia - genetic disorder

18
Q

Clear VS. Cloudy Urine

A

Clear Urine
Clarity: The urinary system is sterile - there should be no sediment, mucous, or visible blood floating in a urine sample
- Normal urine is clear, or see through.

Cloudy Urine
- Odor: Urine may smell strong if a patient is dehydrated but it should never have a foul smell associated to it.
- Volume: the amount of urine will depend on the situation

19
Q

What is Fluid Balance?

A

Fluid Balance - describes the balance of the input and output of fluids in the body to allow metabolic processes to function correctly.

  • Balance is maintained through intake (food and water), and output (urine, feces, and insensible losses)
20
Q

What is Considered ‘Intake’?

A
  1. All fluids are taken orally (gelatins, ice creams, soups)
  2. Feeding tubes
  3. IV fluids
  4. Blood products

Intake should = output + 500mL to cover insensible losses

21
Q

What is Considered ‘Output’?

A
  1. Urine
  2. Vomit (emesis)
  3. Diarrhea
  4. Gastric suction
  5. Drainage from tubes or drains
  6. Insensible losses
22
Q

What is Considered ‘Insensible Fluid Loss’?

A
  • Fluid loss that can not be measured:
  1. Sweat
  2. Moisture excreted from lungs (ie. talking, breathing)
  3. Fluid lost via solid bowel movements
  4. Metabolic processes (ie. Fevers)
23
Q

What are the Signs of Fluid Overload?

A
  1. Difficulty breathing
  2. Crackles on auscultation of lungs
  3. Pitting edema of lower legs/ankles
  4. Fatigue
  5. Bloodwork shown
  6. Hypertension
24
Q

What are Signs of Fluid Deficit?

A
  1. Impaired cognitive function
  2. Headaches
  3. Fatigue
  4. Dry skin and mucous membranes
  5. Hypotension, tachycardia, weakened pulse
  6. Oliguria
  7. Pediatric population: lack of tears, sunken fontanelles
  8. Higher concentration of electrolytes, increased creatine level

N1180 (13 decks)

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