Urinary Flashcards
Anuria
No urine
Oliguria
Low urine
Polyuria
Too much urine
Nocturia
Urination at night
Urinary retention
Holding urine in
Stasis
Urine not flowing
Distention
Swelling
Renal clearance
How effective the kidneys are
UA
Urinalysis
Micturination
Term for urination
Urinary calculi
Kidney stones
Enuresis
Bed wetting
Bladder training
Strengthening the bladder
C&S
Culture and sensistivity
IVP
Looking at blood flow through the kidneys
Hematuria
Blood in the urine
What are the main functions of the bladder
To hold 25-600 ml of urine, and void 50-200 of it(child) // 1500(adult)
Describe the characteristics of Urine
Color, pH, Gravity
Color should be amber or yellow
pH of 4.6-8.0, average of 6.0
Unless mixed diet=acidic OR vegetarian diet= alkaline
Gravity should be 1.003-1.030, usually btwn 1.010-1.025
Decreased specific gravity ?
under 1.003, Due to over hydration
Increased specific gravity?
Over 1.030, Due to dehydration
What muscle contracts when emptying the bladder
Detrusor muscle
What can negatively affect kidney function
Poisions, Emboli (clots in kidneys) , Hypertension, Infection, Loss of muscle tone due to age, degenerative changes and decreased blood supply
Urinary Assessment
Find out:
Normal voiding patterns, the frequency or urination, color, odor and changes
Physical assessment of GU system
Test and procedures
Observation of urine
Color: light straw color
Odor: not much odor
Amount: should be depositing normal range
Turbitity: should come out clear, not cloudy or with anything else
Describe what a urinalysis evaluates
used only when you think there is an issue with the urine
Looking for:
Albumin
Glucose
RBC
Ketone bodies
Microbes
Albumin:
Should not be leaving blood vessels=inflammation in kidneys
Glucose:
Should not be there at all=spilled over in urine can be diabetic
RBC:
Should be getting filtered in kidneys=can be infection or inflammation in kidneys
Ketone bodies
Want to show up if your on keto diet, normally no
What are the signs and symptoms of problems in urinary elimination
Edema,dehydration, alteration in blood pressure, pain from calculi, and a UTI
Edema:
Swollen, body is not in fluid balance, need to urinate water out
dehydration:
higher specific gravity, urine will come out darker
alteration in blood pressure:
higher bp, urination will occur more often
pain from calculi:
Kidney stones. They can block up urinary system
Describe Cystis
An infection in the bladder
Symptoms include: Urgency, Frequency, Suprapubic pain, Dysuria(pain and burning), Hematuria (blood), fever, and CONFUSION IN OLDER ADULTS
Describe Pyelonephritis
An infection in the kidneys
Symptoms include: Flank pain, Dysuria( pain and burning), Pain in lower back, and same other symptoms as Cytitis
Nursing Goals for UTI’s
Symptom relief!!
Teaching and Preventions that include:
Showers over baths, perineal cleaning (front to back), Voiding after intercourse, No perfume or other fragrances in perennial area, Emptying bladder regularly ( dont hold pee in!!!)
What are the signs and symptoms of a UTI in THE ELDERLY
Generalized weakness, Fatigue, CHANGE IN MENTAL STATUS, Lethargy, Anorexia, sometimes low grade fever
What are the common tests done
C&S, UA, 24 hour urine, Ultrasound, IVP
Define Functional incontinence
The inability to reach the toilet in time
Can be due to cognitive and functional defects
Define overflow incontinence
Loss of urine due to weak detrusor
Define stress incontinence
Loss of small amounts of urine due to laughing or coughing due to increased pressure in abdomen.
Primarily in older women even men after prostectomy
Define total urinary incontinence
continuous and unpredictable loss of urine
Define Urge incontinence
Involuntary loss of urine associated with the strong urge to void.
Overactive detrusor and leads to nocturia
Define reflex incontinence
The inability to sense a full bladder
What are some interventions to incontinence
Pelvic floor exercises (Kegels “the knack” strength for men and women)
Behavioral modification (bladder training, biofeedback and habit training), Catheterization, Ethereal inserts
What is bladder training
Teaching the patient how long to hold urine in, ideal time is 2 hours
Is a slow process but establishes a routine for fluid intake and voiding.
Bedpan is offered every 2 hours
What is Nocturnal Enuresis
Nighttime bedwetting
30% in 4 yr olds
0.5-1.0% in adults
Uncommon after age 5
Caused by STRESS AND ILLNESS,
Bladder training and moisture alarms would be used, along with medications
Why do we avoid catheterization
Potential for ascending infection
Causes trauma to urethra, especially in males
Want to avoid unless really needed
When would you catheterize
Pre-op( to keep bladder empty)
post-op
for bladder irrigation
to measure PVR
to collect specimen when other means are unacceptable
What are the nursing goals related to the GU system
Maintain optimum function
help restore elimination by catheterization or treating any existing UTI’s
Teaching and rehabilitation
What are the main nursing interventions when it comes to helping with urination
Provide privacy
Assist to the normal position
Run water in bathroom
Pour warm water over premium
Keeping perineal area clean
Encourage client to drink 2000 mL of fluids
If catheterized, change according to policy
