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B3 - MS > URINARY > Flashcards

URINARY Flashcards

1
Q

Urethra in males…

A

is longer at 20cm ⤻ external urethral orifice opens at the tip of the penis - the male urethra transports both urine and semen and passes through the prostate gland ⤻ called the prostatic urethra.

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2
Q

⇧ risk for CAUTI?

A 
women
⇧ age / debilitation
malnourishment
chronic illness
immunosuppression
DM
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3
Q

S/Sx of infection in a catheterized PT?

A

cloudy malodorous urine, hematuria, fever, chills, anorexia, malaise

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4
Q

On a UA, what finding may indicate infection/presence of bacteria?

A

+ for nitrates/nitrites

bacteria has enzymes that would cause these to appear in urine.

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5
Q

The nurse is educating a patient who will be performing self-catheterization at home. What information provided by the nurse will help reduce the incidence of infection?

  1. Clean the catheter with antibacterial soap, thoroughly rinse and dry before reinsertion.
  2. Sterilize the catheter by boiling it in water for 20 minutes.
  3. Insert the catheter for urine drainage three times per day.
  4. A new catheter must be used each time catheterization is required.
A
  1. Clean the catheter with antibacterial soap, thoroughly rinse and dry before reinsertion.
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6
Q

The nurse performs a physical examination on a client diagnosed with acute pyelonephritis to assist in determining which of the following?

  1. Abnormalities in urine
  2. Location of discomfort
  3. Elevated calcium levels
  4. Structural defects in the kidneys
A

2.Location of discomfort

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7
Q

To help with odor, a patient with an ileal conduit can…

A

use deodorizer or a few drops of diluted vinegar inserted through the drainage spout of bag

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8
Q

A client is learning how to perform Kegel exercises. Which statement by the client indicates a need for additional teaching?

  1. “I need to sit or stand with my legs slightly apart.”
  2. “I should draw in my muscles like when I’m moving my bowels.”
  3. “I need to hold the position for at least 15 seconds.”
  4. “I should repeat the sequence of exercises 3 to 4 times a day.”
A
  1. “I need to hold the position for at least 15 seconds.”
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9
Q

RN should assess PT with ileal conduit for…

A

Urinary leakage

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10
Q

IVP - What is it?

A

An IVP shows the kidneys, ureter, and bladder via x-ray imaging as the dye moves through the upper and then the lower urinary system..

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11
Q

Suprapubic catheter size

A

16-24F

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12
Q

RN actions post-IVP

A

Monitor patient closely for allergic reaction, and monitor urine output.

Maintain hydration status.

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13
Q

Amount of urine produced by kidneys

A

1-2 L / day

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14
Q

anuria

A

UOP <50 mL in 24 hr period

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15
Q

Complicated UTI (upper or lower)

A

Often acquired in the hospital and related to catheterization, occur in patients with urologic abnormalities, pregnancy, immunosuppression, diabetes, and obstruction, and usually recurrent
Broader spectrum of organisms than uncomplicated; lower response to tx ⤻ tend to recur

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16
Q

It is important to monitor …. in a patient who has undergone a ureterosigmoidoscopy

A

Fluid & Electrolytes

as bowel mucosa exposed to urine and electrolyte reabsorption - K and Mag can cause diarrhea.

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17
Q

Primary symptom of primary glomerular disease

A

hematuria

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18
Q

Medications that increase risk of urinary incontinence

A

Diuretics, sedatives, hypnotics, opioids

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19
Q

Primary symptom of acute pyelonephritis

A

Tenderness in the area of the costovertebral angle

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20
Q

Food that create odors:

A

asparagus, cheese, eggs

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21
Q

What should you ask the patient about if they have bright yellow urine?

A

Multi-vitamin intake

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22
Q

A client with bladder cancer had his bladder removed and an ileal conduit created for urine diversion. While changing this client’s pouch, the nurse observes that the area around the stoma is red, weeping, and painful. What should the nurse conclude?

  1. The skin wasn’t lubricated before the pouch was applied.
  2. The pouch faceplate doesn’t fit the stoma.
  3. A skin barrier was applied properly.
  4. Stoma dilation wasn’t performed.
A
  1. The pouch faceplate doesn’t fit the stoma.
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23
Q

The nurse advises the patient with chronic pyelonephritis that he should:

  1. Limit his fluid intake to 1.5 L/day to minimize bladder fullness, which could cause backward pressure on the kidneys.
  2. Decrease his sodium intake to prevent fluid retention.
  3. Increase fluids to 3 to 4 L/24 hours to dilute the urine.
  4. Decrease his intake of calcium rich foods to prevent kidney stones.
A
  1. Increase fluids to 3 to 4 L/24 hours to dilute the urine.
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24
Q

Important to know about urinary incontinence…

A

It is NOT inevitable with illness or aging; it is often reversible and treatable

25
Q

Fluids normally ingested by a person in a day

A

1300 mL of liquid

1000 mL from food

26
Q

Iatrogenic incontinence

A 
Involuntary loss of urine due to extrinsic medical factors
Predominantly medications (alpha-adrenergic blocking agents for HTN) keeping bladder neck relaxed ⤻  alfuzosin/Uroxatral, doxazosin/Cardura, tamsulosin/Flomax
27
Q

What is an expected finding for the first 48hr after patient receives ileal conduit?

A

Hematuria (resolves spontaneously)

28
Q

If a PT has recurrent UTIs the RN should discourage the consumption of…

A

Coffee, tea, alcohol, & colas (urinary irritants)

29
Q

strategies for promoting urinary continence

A

Avoid bladder irritants – caffeine, ETOH, artificial sweeteners
Avoid diuretics after 4pm
⇧ awareness of the amount and timing of all fluid intake
Perform pelvic floor exercises as prescribed, every day
Stop smoking (decreases coughing)
Take steps to avoid constipation
Void regularly – 5-8 times a day – every 2-3 hours
First thing in am, before each meal, before bed, one during night if needed

30
Q

A nurse is caring for a client who had a stroke. Which nursing intervention promotes urinary continence?

  1. Encouraging intake of at least 2 L of fluid daily
  2. Giving the client a glass of soda before bedtime
  3. Taking the client to the bathroom twice per day
  4. Consulting with a dietitian
A
  1. Encouraging intake of at least 2 L of fluid daily
31
Q

Urethra in females…

A

is short at 3-4cm ⤻ external urethral orifice opens just anterior to the opening for the vagina.

32
Q

condition that ⇧ risk of kidney stones

A

hyperparathyroid

33
Q

Normal micturation (urination)

A

8 x / 24 hr period

34
Q

Catheter size for women

A

12-14F

35
Q

Maintenance guidelines for prevention of CAUTIs

A

Daily assessment of need (EMR alerts), tamper evident seal is intact, catheter secured to prevent migration, hand hygiene, drainage bag emptied into clean container that is provided for each patient every 8 hours or less, twice daily perineal care with soap and water – no powder and avoid to- and fro- motion, ensure unobstructed flow of urine

36
Q

Most common urinary diversion

A

ileal conduit

37
Q

After a PT has an indwelling catheter removed, when would the RN expect the PT to void and would bladder scan the PT?

A

4-6 hr mark

38
Q

Post-infectious causes of primary glomerular disease

A

Post-infectious causes are group A beta-hemolytic streptococcal infection of the throat that precedes the onset of glomerulonephritis by 2-3 weeks

39
Q

Catheter irrigation…

A

should NOT be done routinely –

only if clot or large sediment is present and a three way catheter should be utilized.

40
Q

Prevention of urolithiasis and nephrolithiasis

A

Avoid protein intake to decrease urinary excretion of calcium and uric acid (purine is an amino acid that forms uric acid when metabolized)
Limit sodium to 3-4g/day – competes with calcium for reabsorption in the kidneys
Low-calcium diets for only those with true absorptive hypercalcemia
Avoid intake of oxalate-containing foods (spinach, strawberries, rhubarb, tea, peanuts, wheat bran)
Add cranberry juice to fluid intake
Avoid dehydration and excessive sweating
Call provider first sign of UTI

41
Q

Functional incontinence

A

Involuntary loss of urine due to severe cognitive impairment (Alzheimer’s, dementia)
Can’t identify they need to void or unable to physically reach the toilet ⤻ urinary function intact

42
Q

Most common route of infection for lower UTIs

A

transurethral

43
Q

oliguria

A

UOP < 0.5 mL/kg/hr

44
Q

Catheter size for men

A

16-18F

45
Q

IVP - Assessment

A

ASSESS for allergy to iodine or shellfish and renal function ⤻ ALWAYS BEFORE ANY CONTRAST DYE FOR ANY PROCEDURE/STUDY

46
Q

Where does the urine go when a PT has a continent ileal urinary reservoir (Indiana pouch)?

A

The colon pouch stores the urine

47
Q

Appropriate intervention for a patient with urinary retention

A

Have them use the bathroom or BSC rather than a bed pan;

Males should stand when using their urinal.

48
Q

Chronic urinary retention can lead to…

A

Overflow incontinence

49
Q

One kg = how much fluid?

A

1000 mL

50
Q

Complication to assess for in patients with lower UTIs

A

Urosepsis

51
Q

Causes of hypercalcemia/hypercalciuria

A

Excessive intake of vitamin D, milk, and alkali (dietary supplements to prevent osteoporosis & antacids)

52
Q

One pound = how much fluid?

A

500 mL

53
Q

Stress incontinence

A

Involuntary loss of urine through intact urethra as a result of sneezing, coughing, changing positions
Common in women who have had vaginal deliveries and men after radical prostatectomy

54
Q

When should a patient perform intermittent self-catheterization?

A

Every 4-6 hr and HS (bedtime)

55
Q

⇧ risk for UTIs

A 
females
DM
pregnancy
neurodisorders
gout
immunosuppression
catheterization
cystoscope procedures
inability to fully empty bladder/obstruction of urine
56
Q

Urge incontinence

A

Involuntary loss of urine associated with a strong urge to void that cannot be suppressed
Seen with neurologic dysfunction that impairs inhibition of bladder contraction and in patients without overt neurologic dysfunction

57
Q

Normal residual urine in older adults

A

50-100mL

58
Q

What is an important teaching/nursing intervention for patients with a continent ileal urinary reservoir (Indiana pouch)?

A

The pouch MUST be drained at regular intervals to prevent reabsorption of metabolic waste from urine, reflux of urine to ureters, and UTI

59
Q

Normal residual urine in middle age adults

A

No more than 50 mL

B3 - MS (3 decks)

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