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Nurs 220 > January 21 - Nursing Care and the Urinary System > Flashcards

January 21 - Nursing Care and the Urinary System Flashcards

1
Q 
Oliguria
Anuria
Hematuria
Proteinuria
Dysuria
Polyuria
A

Oliguria-dec urine output

Anuria-no urine output

Hematuria-blood in the urine

Proteinuria- abnormal quantities of protein in the urine

Dysuria- painful urination

Polyuria-large amount of urine output

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2
Q

Assessment of Urine

  • what do you look for
  • normals of urinalysis 4
A 
Colour, clarity
Odour
Urinalysis :
-pH (4.8 – 8) 
-Specific gravity – 1.005 to 1.030
-Glucose, ketone, blood, protein
-Leukocyte esterase, nitrates, wbcs
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3
Q

Urine Output normals

  • adult urine output
  • Avg adult bladder capacity
  • how much mL to urge to urinate, discomfort lvl
  • Normal urine output adult mL/hour
A

Adult urine output: 1500 mL/day
Average adult bladder capacity 600-1000 mL
200-250 urge to urinate; 400-600 discomfort
Normal urine output adult 30 to 60 mL/hour *report < 30ml/2hr.

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4
Q

How often do you empty urine bag

How full before you empty

A

When do you empty the big bag- every shift (8 or 12 hours)

Empty at about 40% full

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5
Q

What is urinary retention
What is dehydration
What helps?

A

Urinary retention- its in their bladder and they’re not peeing it out, urine is being produced

Dehydration- isn’t producing urine

Things to help- push fluids, mobilizing, pt education, running water, sit in a bath tub and pee, warm water, regular toileting, call bells, aesthetics

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6
Q

What is a bladder scanner
Whats it for
when do you use it

A

Ultrasound beside

Can use this to tell if they are dehydrated or urinary incontinent

Use this with post void residuals- can see how much is left in the bladder (greater than 150-200 requires some intervention) this is when there is urine left in the bladder after the pt has voided

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7
Q

What is an intermittent catheter/ indwelling (short term / long term)

When would you use

In and out used for

Tieman’s (Coude) Catheter has what at the end of its indwelling cath

A

Intermittent (irregular) retaining urine, after surgery and want them to pee, have a spinal cord injury and self catheterize

Indwelling catheter (short/ long term)- critically ill pt, sepsis, trauma- want to monitor the urine output every hour, post-op (depending on where the surgery was may need to keep the bladder empty to allow it to heal), terminal illness, late stag cancers

In and out- may also be used for medication into the bladder or for prostate surgery

The curl on the end is suppose to allow to get past the prostate

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8
Q

Remember what when giving catheter 4

A

A physician’s order is required for urethral catheterization removal

this is a sterile procedure

Gather all supplies, bring extra gloves and catheter, flashlight, lubricant, extra catheter for female catheterization

Bed at working height, position patient

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9
Q 
Choice of catheter
Kinds
Material types
Caution
Size for adults and children 
Urological procedures 
Bulb Sizes
A

Straight (intermittent) vs. indwelling
Plastic (in and out), rubber, silicone or Teflon coated
Caution: allergy to rubber or latex
Size: #14-16 adult, #8 to10 for children
Urological procedures #20 -24
Bulb size: 3, 5, 10 or 30 mL SW

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10
Q

Cleaning Pubic areas

Male and females

A

Man - Man- clean from the urethra meatus down to the glands

Vagina - clean top to bottom, starting with

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11
Q

Balloon Inflation steps

Tape: non allergenic

A

We stop when we get urine back and then we go another 2.5cm and then we inflate the balloon
If you are on the edge still, deflate wait go further

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12
Q

Urine Tests 4

Methods of collection 3

A 
Urine Tests:
Urinalysis
Urine culture (C &amp; S)
Timed urine e.g. 24 hour
Dipstick (e.g. protein, glucose, pH)

Methods of Collection:
Clean voided: clean catch or midstream
Indwelling catheter
Suprapubic

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13
Q

Sterile Specimen Collection: where do you take it

A

Want to take a specimen from the bladder not from the catheter bag because then it is contaminated

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14
Q

Emptying Urine Bags

A

Safety Glasses

Don’t attach it to side sails

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15
Q

Perineal Care with Urinary Catheter

A

Perform after inserting catheter

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16
Q

Open/Closed Catheter Irrigation

A

Closed is better, no organisms

17
Q

Catheter Removal

  • is it sterile
  • -what kind of syringe

DONT GO 6-8 HOURS WITHOUT VOIDING AFTER REMOVAL

A

no

The size of the balloon

18
Q

UTI (Second most common bacterial disease)

-What are defense mechanisms to maintain sterility

What increases risk and its factors

What is community acquired

Classification and symptoms of uti Upper and lower tract and CAUTI

What is urethritis pyelonephritis

What is cystitis

A 
Complete emptying of bladder
Ureterovesical junction competence (where the urethral attaches to the bladder)
Peristaltic activity
Acidic pH
High urea concentration
Alteration in defence mechanisms increases risk of UTI
Predisposing factors:
Factors increasing urinary stasis
Foreign bodies
Anatomical factors
Compromised immune system
Functional Disorders
Other: catheter

Community acquired means that the person did not get it in the hospital it was contracted while out in everyday life and in the community (E. coli/ Pseudomonas)

Upper tract: Renal parenchyma, pelvis, and ureters. Causes fever, chills, flank pain, (can lead to sepsis / urosepsis) Pyelonephritis: inflammation of renal parenchyma and collecting system

Lower tract: bladder and down (no systemic symptoms) (cystitis)

Catheter-associated UTIs (CAUTIs):
Bacterial biofilms develop on inner surface of catheter

If things aren’t flowing well or aren’t treated properly

Cystitis—Inflammation and infection of the bladder wall

19
Q

Pre-existing factors causing UTI:
Vesicoureteral reflux
Dysfunction of lower urinary tract

A

Vesicoureteral reflux:
Backward movement of urine from lower to upper urinary tract

Dysfunction of lower urinary tract:
Obstruction from BPH
Stricture
Urinary stone

20
Q

Clinical Manifestations of UTI

And for elder

A 
Frequency 
Urgency
Dysuria
Cloudy urine, blood present
Incontinence
Abdominal pain, flank pain (upper)
Fatigue, malaise
Fever, chills
Nausea, vomiting

Symptoms are often absent
Experience non-localized abdominal discomfort rather than dysuria
May have cognitive impairment
Less likely to have a fever

21
Q

What is urosepsis
Leads to?
Diagnosed with:

A

Systemic infection from urological source

Leads to septic shock and death involving gram negative organism

Urinalysis/dipstick :
Presence of nitrites, WBCs, leukocyte esterase, blood

Nurs 220 (10 decks)

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