Urinary Flashcards
Normal urinary output rate
30 ml/hour
what does urine color indicate?
hydration status
dark = dehydrated
clear = normal/over hydrated
Normal urine clarity?
-urine is normally clear
Can you assess urine that has been sitting?
No, always use fresh
-sitting urine might be cloudy or bubbly
what causes that distinct urine smell?
ammonia
a strong offensive urine odor indicates?
infection
1st indicator of UTI in older adult?
confusion
dysuria =
painful urination
excessive urination
polyuria
severely decreased or absent urine
anuria
decreased urination
oliguria
pyuria
urine contains pus
what hormone makes the body retain fluid?
ADH
what triggers the release of ADH?
-increased plasma osmolarity
blood is filled with stuff, want to hold onto to H2O to decrease amount of stuff to water ratio
how can body lose fluid?
vomiting diarrhea diaphoresis wound drainage urine burns blood loss
Where is fluid loss recorded?
output
Output and intake correlation
-output and intake should match within 200/300 mL
what does it indicate if output is less?
- decrease kidney perfusion
- dehydration
how does hypotension impact fluids?
- leads to poor renal perfusion
- kidneys are unable to filtrate
How does decrease muscle tone impact fluid volume?
obesity
multiple pregnancies
chronic constipation
continuous bladder drainage
After surgery, what are some fluid considerations?
- be at a volume deficit
- nedd to void within 8 hrs of surgery
MEdications that increase urine output
diuretics
medications that cause urinary retention
opioids, tricyclics, antihistamines
alcohol and caffeine promote
diuresis
salty foods promote
retention
heat can ____ urination, cold can ____ urination
promote, prevent
urinary obstructions increase risk of
urinary stasis and infection
Cauti
uti develops when a catheter is in place greater than 48 hours prior to onset of an infection
UTI prevention education
- 6-8 glasses h2o dault
- void at least every 4 hours
- void immediately after intercourse
- wash hands with soap and water
- watch for signs and symptoms of uti
Signs and symptoms of UTI
fever flank pain dysuria frequency urgency pyuria hematuria
Urge urinary incontinence can be helped by using
timed voiding schedule
Functional and Total Urinary incontience can be helped by
prompted voiding and habit retraining voiding
what is habit retraining voiding?
schedule bathroom trips around when incontinence occurs
what is bladder training?
schedule voiding times within a narrow range of 2 hours and eventually widen to 4 hours
What helps with urge and reflex urinary incontinence?
bladder training
2 types of urinary diversion
ileal conduit
neobladder
what do you do if patient hasn’t voided after srugery/ several hours?
-bladder scanner
Random urine specimen- what kind of cup?
-can be poured from nonsterile container into cup
clean catch urine specimen
-sterile cup or bedpan
24 hour urine specimen
- measures specific kidney functions
- educate staff/family on not dumping urine in toilet
ketones in urine
diabetes mellitus, ketoacidosis, stervation
protein in urine
severe stress, renal disease, preeclampsia
glucose in urine
diabetes mellitus
BUN
- urea is normally excreted
- impaired kidneys are unable to excrete urea leading to an increased BUN
- highly effected by hydration status*
creatinine
- waste product of kidneys
- increase creatinine indicate renal impairment
- more sensitive indicator than BUN for renal impairment
Creatinine clearance
- need creatinine level from urine and blood
- 24 hour urine
- estimates kidneys glomerular filtration ability
GFR
- *best indicator of kidney function
- requires multiple demogrpahic data and serum creatinine
indications for use of external catheter
- sphincter damage
- spinal corn injury
- impaired skin integrity in perineum
use ____ technique for catheter insertion
sterile
indications for catheterization
- critically ill need precise I and O
- persistent urinary retention
- management of incontinence in stage III or IV pressure injury
best way to decrease risk of cauti
remove catheter
how are catheters sized?
french system
- higher number = larger lumen
- 16 most common
coude catheter
slight bend in end
-good for prostrate problems
catheter with 2 ports
bladder irrigation
Can you disconnect catheter from drainage bag?
not recommended
How often to empty drainage bag?
at least every 8 hours
Level of drainage bag?
below level of bladder
The nurse is caring for a client with a suspected urinary tract infection. What signs or symptoms are present with a urinary tract infection? Select all that apply.
fever, flank pain, dysuria, frequency, urgency, pyuria, and hematuria.
