Urinary Flashcards
Diuresis
Increase/excessive production of urine
Nocturia
Urinating frequently at night
Polyuria
Abnormally large amounts of urine
Oliguria
Urine output is below normal
Anuria
No urine produced
Alternations in urinary elimination
Urinary retention- inability to urine
UTI- results from catheterizations
Urinary incontinence- unable to control urine leakage
Urinary diversion- urine to a external source- re route normal urination system
Diuretic
Causing increased passing of urine
For assessment offer patient a bathroom break every 30 minutes
Characteristics of altered urination
Urgency- hits you unexpectedly
Dysuria- abnormal- hurts when you pee
Enuresis- involuntary urination/ bed wetters
Incontinence- not being able to hold pee/ control it
Retention- inability to empty bladder
Neurogenic bladder- bladder damage caused by neurological damage, having a spinal cold injury, can’t feel peeing
Frequency- urinating more then 4-6 times a day
Transient incontinence
Temporary, caused by illness or specific condition that is short lived like a UTI, hyperglycemia, medications (diuretics)
Stress Incontinence
Physical movement such as coughing, sneezing, running, something that puts pressure on your bladder
Urge incontinence
When you have a sudden urge to urinate. Bladder contracts when it shouldn’t
Reflex incontinence
Involuntary loss of urine usually without warning
Functional incontinence
Person is aware of the need to urinate, but physical or mental reasons cause them to not be able to make it to the bathroom
Like a broken hip
Specific gravity
The more concentrated the urine is the more yellow it is, when it is clear it has a low concentration level.
Normal specific gravity- 1.002 to 1.030
Low specific gravity- 1.001- may indicate the kidney is ineffective
High specific gravity- 1.029- person dehydrated
Ureterostomy
Creating is stoma, divert flow of urine away from the bladder
Nephrostomy
Created between kidney and skin which allows urinary diversion directly from the upper part of urinary system
Illeal conduit
Urinary drainage a surgeon creates using small intestine after removing bladder
Kock pouch
A urinary diversion in which the surgeon forms a reservoir from the ileum. The pouch is emptied by clean straight catherization every 2 to 3 hours initially, and every 5 to 6 hours once the pouch expands to capacity
Neobladder
A new bladder created by the surgeon using the ileum that attaches to the uterus and urethra. It allows the client to maintain continence, client learns to void by straining the abdominal muscles
Bedside sonography with a bladder scanner
Noninvasive portable ultrasound scanner for measuring bladder volume and residual volume after urination
Kidneys, ureters, bladder
X-ray to determine size, shape, and position of these structures
Intravenous pyelogram
Injection is contract media (iodine) for viewing of ducts, rank pelvis, ureters, bladder, and urethra
Allergy to shellfish contraindicates the use of this contrast medium
Renal scan
View of renal blood flow and anatomy of the kidneys without contrast
Renal ultrasound
View of gross renal structures and structural abnormalities using high frequency sound waves
Cystoscopy
Use of a light instrument to visualize, treat, and obtain specimens from the bladder and urethra
Urodynamic testing
Test for bladder muscle function by filling the bladder with co2 or 0.9% sodium chloride and comparing pressure readings with reported sensations
Promoting healthy urinary elimination
Equipment: Urinal for males Toilet, bed pan, or commode Fracture pan- for clients who must remain supine and clients in body or leg casts Regular pan- for clients who can sit up
Procedure nursing actions:
Have clients sit when possible
Provide privacy needs with adequate time for urinating
Bladder retaining for treating urge incontinence
- used timed voiding to increase intervals between urination
- assist clients to perform relaxation techniques
- offer incontinence undergarments while clients are retraining
- provide positive reinforcement as clients remain continent
Client education
- perform pelvic floor (kegal) exercises
- do not ignore the urge to urinate
- eliminate or decrease caffeine drinks
- take diuretics in the morning
Specimen collection
Non-sterile- for urinalysis
Sterile for clean- catch midstream and specimens from catheter
Discard the first voiding
Label container with clients identifying information
Refrigerate, label, and transport the specimen
UTI
Most due to E.Coli Risk factors: - in females, close proximity of the urethral meats to the anus - frequent sexual intercourse - menopause: decreasing estrogen levels - uncircumcised clients - use if indwelling catheters
Symptoms:
- urinary frequency, urgency, nocturia, flank pain, hematuria, cloudy, found smelling urine, and fever
- in older adults, new onset of increased confusion, recent falls, new onset incontinence, anorexia, fever, tachycardia, hypotension
Assessment data/ collection
- female sex
- history of multiple pregnancies and vaginal births, aging, chronic urinary retention, chronic bladder infection (cystitis)
- neurological disorders- Parkinson’s disease, cerebrovascular accident, spinal cord injury, multiple sclerosis
- medication- diuretics, opioids, anticholinergics, adrenegic antagonist
- obesity
- Decreased pelvic muscle tone
Urinalysis and urine culture sensitivity
To identify UTI (presences of RBC, WBC, and micro organisms)
Blood creatinine and BUN
To assess renal function
Ultrasound
Defects bladder abnormalities and or residual urine
Voiding cystourethrography
Identifies the size, shape, support, and function of the urinary bladder, obstruction(prostate), residual urine
Urodynamic testing
- cystourethroscopy: visualizes the inside of the bladder
- uroflowmetry: measure the rate and degree of bladder emptying
- electromyography: measure the strength of pelvic muscle contractions
Bladder retraining program
Urinary bladder retraining increases the bladders ability to hold urine and clients ability to suppress urinating
Client education:
Urinate at scheduled times
Gradually increase urination intervals after no incontinence episode for 3 days, working toward the optimal 4 hour interval
Hold urine until the scheduled toileting time
Keep track of urination times
Acute renal failure
An acute ride in the serum creatinine level of 25% or more. May be caused by inadequate blood flow to the kidney, injury to the kidney glomeruli or tubes
Anuria
The absence of urine, often associated with kidney failure or congestive heart failure. This term is used when urine output is 100mL in 24 hours
Dysuria
Painful or difficult urination. May be associated with infection or partial obstruction of the urinary tract
End stage real disease
A chronic rise in serum creatinine levels associated with loss of kidney function that must be treated with dialysis
Enuresis
Involuntary loss of urine
Hematuria
Blood in the urine
Micturition
To start the stream of urine
Nephropathy
Disease of the kidney
Nephrotoxic
A substance that damages kidney tissue
Nocturia
Frequent ruination after going to bed. May be caused by excessive fluid intake as well as a variety of urinary tract and cardiovascular problems
