GU Assessment Flashcards
Producing urine and the process of peeing.
Micturition
Decreased ability to form urine
Oligouria
What is the range for oligouria?
<400-500mL/24 hour
Inability to form urine
Anuria
What is the range for anuria?
0-100mL/24 hour
Pain on urination
dysuria
excretion of abnormally large quantities of urine
Polyuria
Excessive thirst
Polydipsia
Increased urine formation and secretion
diuresis
Excessive urination at night
nocturia
Blood in the urine
Hematuria
May not be peeing out more quantities, but going more often.
Diuresis
We see dysuria mostly with what conditions?
UTIs and STIs
How much urine should a healthy individual produce every hour?
0.5mL/kr/hr
What are some factors that influence micturition (5)?
- Disease or disability
- Fluid balance
- Medication
- Pelvic floor muscle tone
- Psychological factors
Generally defined as a change in volume or quality of urine produced.
generally expressed in relation to where the dysfunction arises.
Disease or disability
What is the best example of continence/retention concerns in males?
BPH
What sorts of physical signs or symptoms would one see with issues in fluid balance?
Pitting edema Decreased skin turgor (tenting - after pinching, stays up) urine colour, odour LOC affected in extreme cases CHF - difficulty breathing electrolyte imbalances Dry and cracked mucous membranes
What are some physical signs and symptoms of dehydration in babies?
stop producing tears but still cry
sunken fontanels
What is a sign of fluid overload in babies?
Fontanels will be heightened
How can medications and drugs affect fluid retention?
Diuretics will increase output Other meds (e.g. flowmax) may increase retention
Are the pelvic floor muscles under voluntary or involuntary control?
Both
Provides structural support to pelvic organs and prevents urine loss at bladder neck
PFM
What predisposes a person to PFM issues?
Pregnancy and child birth - puts pressure on ligaments and stretches them out
What are some things that people can do to increase pelvic floor muscle tone?
Kegal exercises
- contract to stop urinating
- contract to stop gas from coming out
What are some psychological factors that can play a role in urination?
Embarassment (can’t go at work, need to use bedpan, etc.)
Pain
Motivational issues
How does being an infant or young child affect micturition?
Continence develops over time - need to have ability to sense the urge to go, recognize and control the PFM and have time to go to the washroom
How does pregnancy affect micturition?
Hormones can raise the amount of urine and increased intra-adbominal pressure will push on the bladder and give the urge to go more often
What are some reasons for increased incidence of nocturia in the geriatric population?
Overall atrophied bladder, enlarged prostate
The increased frequency of urination in the elderly is related to what?
decreased muscle tone and bladder capacity
The increased residual urine in the older population is related to what?
reduced effectiveness of muscle control voiding
Why are some elderly individuals more at risk for UTIs?
residual urine can lead to possible infection
In some instances of UTIs, what is a common presentation, without other signs?
Delirium
What are some tests to assess issues with residual urine?
Bedside bladder scan using ultrasound (>10% is considered abnormal)
What are the major issues related to micturition for older men?
Older women?
Prostate enlargement
PFMs for women
What are some of the questions we should ask related to normal urinary patterns?
Frequency, time of day, volume, colour, odour
Back pain and issues with urination are a sign of what?
Kidney issues (pyelonephritis)
Vitamin __ makes your urine yellow.
B
What are the different parts of the history we do for urinary issues?
Review client’s normal pattern and assess changes
Conduct an associated symptom review
Identify contributing factors
Functional impact
For inspection related to the urinary system, what are we looking for?
Skin and mucous membranes for fluid balance
Perineum - skin breakdown or atrophy
Curvature of lower abdomen (distension of bladder may affect this)
What type of atrophy do we look for in females related to fluid balance issues?
What are they more at risk for?
Vaginal atrophy - after menopause, lack of estrogen - dries out vaginal mucosa which can increase risk for UTIs
Who would you be more concerned for if they had a UTI, man or woman?
man
the urinary system is normally a _______ environment.
sterile
Tea coloured urine is an indication of what?
Glomeruloneprhitis
What is a urine dip?
Lab test - take litmus like paper and assess for presence of proteins, glucose, etc.
When would you do a culture and sensivity for urine?
UTI
When would you do a cytology for urine?
Looking for cancer cells
What is the difference between collecting urine for and STI vs. C&S?
C&S has to be sterile
It is best to collect urine when for specific disease processes?
Morning
Should the bladder be palpable?
Should be non palpable if not distended
if the bladder is distended, where will it reach to?
Above pubic symphisis and may extend to below umbilicus
If the bladder is distended and palpation is done, what will the patient feel?
increased urgency, tenderness or even pain
What can be done to assess volume post-void?
Bladder scan
