L7 Urine Flashcards
Factors affecting urination
Age
1. Infant: 2-3 sin know
2. Elderly weak kidney-) nocturia
Weak bladdar muscle tone-) frequency up
Weak bladdar contractility-) urinary retension
- Activity level
Up-) good production & elimination
Low-) weak control
Food intake: coffee-) diuretic effect
Med
Diuretic-) output increase
Patho
UTI: dysuria 尿痛 frequency
Psycho status
Stress-) frequency.
Purpose of bladder scan
Assess bladder volume of urinary retension
Assess post-voiding residual volume
Type of urinary incontinence
Stress incontinence
Increase intra-bladder pressure
Cause: childbirth, menopause, obesity
Urge incontinence
Strong sensation of need to urine-) inable to suppress the need
Cause: UTI
Overflow incontinence
Over-distention of urine-) absent urine signal
Cause: effect of drug
Reflex incontinence
Voiding without urge
Cause: spinal cord injury
Treatment of urinary incontinence (5)
- Pelvic muscle exercise
- Timed urination
- Bladder trainning
- Avoid bladder irritant
- Regulate fluid intake
Pharmalogical: no diuretic after 4pm
Surgical: colposuspension, support the bladder
Urinary retention cause
- Benign prostatic hyperplasia
- Side effect of anesthesia
- Med: antidepressant, antiparkinson
- Neuro dysfunction
Treatment of urinary retention
- Inhibit bladder contraction
- Relax or tighten bladder neck muscle
- Insert urinary catheter
Intermittent vs indwelling catherization
Intermittent: apply when needed
Indwelling: will be kept in long-term
Purpose of urinary catheterization
- To relieve acute bladder retension
- To obtain a sterile urine specimen
- To accurate monitor urinary output
- To increase comfort for terminal-ill patient
How to prevent urinary catheter infection
- Perform perineal swab daily
- Strict Aseptic technique
- Place bag below bladder level
- Empty bag regularly
- Encourage fluid intake
- Assess s/s of infection
Why bladder irrigation
Catheter patency
Flush clot away from catheter
Give med
Nursing care after catheterization
Monitor output
Monitor catheter
Minimize trauma
Prevent infection
