Unit IV (Bladder) Flashcards

1
Q

Where does the nurse palpate when assessing the kidneys? What is the nurse assessing for?

A

Flanks are assessed (side between hips and ribs) and Costovertebral angle. The nurse is assessing for pain/tenderness.

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2
Q

What does pain/tenderness at the flank or costovertbral angle signify?

A

Possible inflamed or enlarged kidneys.

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3
Q

How is the patient positioned to assess the kidneys?

A

Sitting, facing away from the nurse.

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4
Q

What are the normal color limits of urine?

A

Pale yellow-Amber

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5
Q

What affects the color of urine?

A

Concentration, food and medication, disease process.

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6
Q

The nurse notes the patients urine to smell of ammonia. What does this signify?

A

Urinary Stasis

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7
Q

What can affect the odor of urine?

A

Food, medications, disease process.

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8
Q

What are the normal contents of urine?

A

Water, urea nitrogen, sodium chloride, and creatinine.

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9
Q

What is considered abnormal in urine?

A

Blood, WBC’s, Glucose (sugars), protein, pus.

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10
Q

What is the clarity of normal freshly voided urine?

A

Clear

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11
Q

What would the nurse expect the clarity of urine that has been in the specimen cup for a long period of time to be?

A

Cloudy

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12
Q

What is the normal range of urine output for adults?

A

1,200-1,500 ml/day

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13
Q

What is the normal range of urine pH for adults?

A

5.0-9.0

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14
Q

What is the ‘mean’ pH of urine?

A

6.0

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15
Q

Is urine acidic or basic?

A

Acidic

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16
Q

What is the normal range of specific gravity of urine?

A

1.001-1.029

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17
Q

The patient asks the nurse what specific gravity measures. How does the nurse respond.

A

Specific gravity measures the density of urine compared to water.

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18
Q

The specific gravity for your patients urine is 1.032. Is the urine more concentrated, or diluted?

A

Urine is concentrated.

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19
Q

The specific gravity for your patients urine is 1. Is the urine more concentrated, or diluted?

A

Urine is more dilute.

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20
Q

The higher the specific gravity, the more _______ the urine.

A

concentrate

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21
Q

The lower the specific gravity, the more _______ the urine.

A

dilute.

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22
Q

Your patient is dehydrated. The nurse would expect the specific gravity to be _____ (High/Low)?

A

High (more solids than water)

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23
Q

Your patient is overhydrated. The nurse would expect the specific gravity to be _____ (High/Low)?

A

Low (more water than solids)

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24
Q

Ingesting food and beverages high in caffeine or alcohol can ______ urine production. Alcohol and Caffeine are considered _______.

A

increase

diuretics

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25
Eating foods that are high in sodium cause fluid ________, and will ______ urine output.
retention | decrease
26
Your patient is not producing urine. The nurse would chart this as:
anuria
27
You patient is having difficulty urinating due to pain and burning. The nurse would chart this as:
dysuria
28
Your patient has voided 10 times in the past hour. You would chart this as:
frequency.
29
Blood is noted in the urine. This is termed:
hematuria
30
You patient voices the need to urinate, but has trouble initiating urination. The nurse charts this as:
hesitancy
31
Your patient is unable to control urination. This is termed:
incontinence
32
You patient wakes every hour during the night to void. This is charted as:
nocturia
33
You patient has voided less than 500ml of urine for the entire day or less than 30ml/hr. This is termed:
oliguria
34
While reviewing your patients I/O sheet, you notice their total urinary output to be 3,000ml. The nurse recognizes this to be:
polyuria
35
While emptying the patients indwelling catheter, the nurse notes strands of pus in the tubing and collection bag. The nurse will chart the findings as:
pyuria
36
After voicing the need to void, and scanning the bladder to identify 300ml of urine are present, the nurse identifies the patient is experiencing:
retention.
37
The patient has just voided. Any urine left in the bladder is termed:
residual.
38
You patient has a very strong desire to void. The nurse charts the patient to experience:
Urgency (if ignored leads to incontinence)
39
What is determined when assessing the bladder?
Symmetry, location, size, and sensation.
40
What considerations does the nurse make when palpating the bladder?
Gentle palpation should always be used, as pressing firmly may cause the sensation to void.
41
What would the nurse expect to find when palpating a patient who's bladder is empty?
Bladder should not be palpable.
42
What is the normal bladder capacity?
300-600ml
43
The usually continent patient has an involuntary episode of urinary incontinence. (Does not involve system but is due to waiting and now can't reach toilet in time) What type of incontinence will the nurse document?
Functional Incontinence
44
The patient sneezes and leaks approximately 30ml-50ml of urine. The nurse identifies this type of incontinence as:
Stress Incontinence.
45
The patient who's bladder has reached a certain level will automatically begin voiding. This type of incontinence is termed:
Reflex Incontinence.
46
What type of incontinence is related to spinal cord injury?
Reflex Incontinence
47
The patient has experience a strong urgency to void, and involuntary passes urine. This type of incontinence is called:
Urge incontinence
48
Mixed incontinence combines what two incontinence types?
Urge & Stress
49
Normal Blood Urea Nitrogen levels
8-21 mg/dl
50
Urea Nitrogen is the end result of _______ __________.
protein metabolism.
51
A dehydrated patient would be expected to have _____ (High/Low) Blood Urea Nitrogen levels.
High
52
Elevated BUN levels suggest what two conditions may be present?
Dehydration or renal dysfunction.
53
Normal Creatinine level for men?
0.6-1.2 mg/dl
54
Normal Creatinine level for women?
0.5-1.1 mg/dl
55
Creatinine is a product of ________ __________.
Muscle Catabolism
56
Creatinine is filtered by ______ of the ______.
Glomeruli of the kidney
57
How is creatinine usually excreted?
Urine
58
Elevated creatinine levels indicate damage to what part of the kidney?
nephrons
59
How is a clean catch specimen collected?
"Mid Stream"- Patient cleanses perineal area, begins urinating, passes specimen cup under stream to obtain specimen and removes cup before the urine stream stops.
60
How is a 24 hour urine collection-timed specimen obtained?
The first voided specimen of the morning is discarded. All urine for the next 24 hours is collected in a large collection bottle.
61
What special precautions must the nurse and patient be aware of for a patient obtaining a 24 hour collection-timed specimen?
Do no contaminate the urine with tissue paper or stool.
62
What is a KUB?
Xray of the size and structure of the kidney, ureter, and bladder.
63
What does a KUB detect?
Renal stones (Calculi) Kidney Masses Bladder Masses
64
The visualization of the bladder with a scope is termed:
cystoscopy
65
What procedure can visualize the entire urinary tract by visualizing dye as it is excreted by the urinary system.
Intravenous Pyelography (IVP)
66
Which diagnostic procedure uses dye to visualize the renal system?
Intravenous Pyelography (IVP)
67
What increases are seen in the urinary system for geriatric considerations?
Increased urgency and frequency. (Enlarged prostate for males)
68
What does the nurse inspect during a kidney assessment? (VISUAL)
Color of skin | Symmetry of area
69
Sodium intake causes
Fluid retention | Decrease urine excretion
70
Oliguria reflects
Inadequate blood flow | Kidneys slowly shutting down
71
Range for polyuria
Above 1500-2500 ml estimate of urine excretion
72
Define retention
Urine produced normally but inability to excrete from the bladder
73
Distended bladder feels
Smooth Round Taut (tight) Visible in supra pubic area
74
What lab values indicate renal dysfunction
BUN | Creatinine
75
Purpose of a clean catch
C&S
76
The cystoscopy can obtain ______ is needed during inspection.
Biopsies
77
What minimizes pain during cystoscopy
Local anesthesia
78
What does IVP identify
``` Abnormal: size Shape Function Of the kidney, ureters, & bladder ```
79
What decreases in the urinary system are seen as we age
``` Decrease: Nephrons Blood supply to the kidneys Bladder tone & contractility Ability to concentrate urine Bladder capacity Sphincter tone in females ```
80
What does the nurse inspect during a kidney assessment? (VISUAL)
Color of skin | Symmetry of area
81
Sodium intake causes
Fluid retention | Decrease urine excretion
82
Oliguria reflects
Inadequate blood flow | Kidneys slowly shutting down
83
Range for polyuria
Above 1500-2500 ml estimate of urine excretion
84
Define retention
Urine produced normally but inability to excrete from the bladder
85
Distended bladder feels
Smooth Round Taut (tight) Visible in supra pubic area
86
What lab values indicate renal dysfunction
BUN | Creatinine
87
Purpose of a clean catch
C&S
88
The cystoscopy can obtain ______ is needed during inspection.
Biopsies
89
What minimizes pain during cystoscopy
Local anesthesia
90
What does IVP identify
``` Abnormal: size Shape Function Of the kidney, ureters, & bladder ```
91
What decreases in the urinary system are seen as we age
``` Decrease: Nephrons Blood supply to the kidneys Bladder tone & contractility Ability to concentrate urine Bladder capacity Sphincter tone in females ```