Urinary - Ch. 37

Question 1

Parts of the urinary system

Answer 1

Kidneys, ureters, bladder, urethra

Question 2

What is the function of the kidneys

Answer 2

+ Filter and excrete Unneeded blood and waste products - Urea, creatinine, uric acid from the blood and excrete water, electrolytes other substances

+ Retain products that are still needed

Question 3

Function of the ureters

Answer 3

Transport urine from kidney to bladder

Question 4

Muscle that makes up the bladder

Answer 4

Detrusor muscle - Three layers, the middle layer forms the involuntary sphincter that guards the opening from the bladder to the urethra

Question 5

What job does the SNS have concerning the bladder

Answer 5

Causes detrusor muscle to relax and internal sphincter to constrict to retain urine

Question 6

What function does the PNS half of the bladder

Answer 6

Causes detrusor muscle to contract in the sphincter to relax to release urine

Question 7

What is the capacity of the average adult bladder

Answer 7

150 to 250 mL

Question 8

What actions is the voluntary control of the bladder limited to

Answer 8

+ Initiating
+ restraining
+ interrupting voiding (pinching urine stream)

Question 9

Factors affecting Urination

Answer 9

+ Developmental considerations – toilet training, effects of aging
+ food and fluid intake
+ psychological variables
+ activity in muscle tone
+ pathological conditions
+ medication‘s

Question 10

What is urinary incontinence

Answer 10

Any involuntary loss of urine, small amount

Question 11

Circle star highlight

Types of incontinence (4)

Answer 11

+ Transient – Appear suddenly it goes away

+ Stress - coughing and sneezing - increased abdominal pressure

+ urge – Involuntary – waiting too long, Lasix medicine

+ total - continuous, unpredictable - surgery, trauma, dementia, malformation

Question 12

Ways to fight incontinence

Answer 12

+ Kegel exercises
+ biofeedback devices
+ medication
+ surgery
+ stimulation
+ external barriers

Question 13

Signs and symptoms of a UTI

Answer 13

+ Burning or pain
+ fever
+ odor
+ bloody urine
+ increased frequency
+ confusion / change in level of consciousness (dementia pts)

Question 14

Characteristics of a UTI

Answer 14

+ Change in color
+ odor
+ turbidity

Question 15

Effects of aging on urinary elimination

Answer 15

+ Kidney Function diminishes – nocturia
+ decreased bladder muscle tone + decreased bladder contractibility
+ neuromuscular degeneration

Question 16

Nursing interventions for urinary issues

Answer 16

+ Provide bedpan or bedside commode
+ call light and patient reach
+ assess every hour during 5P’s – position, potty, pain, possessions, pump

Question 17

Affects of medication‘s on urinary & elimination

Answer 17

+ Anticoagulants – red urine
+ diuretics – pale yellow urine
+ Pyridium – orange to orange red
+ Ellaville – Green or blue green + levodopa - brown or black
+ Diuretics – prevent reabsorption of water/electrolytes and tubules
+ cholinergic medication’s – stimulate contraction of detrusor muscle Dash PSNS
+ analgesics and tranquilizers – suppress CNS diminish effectiveness of neural reflex

Question 18

PVR - post void residual
What is it
What is the range that indicates adequate or in adequate bladder emptying

Answer 18

+ The amount of urine remaining in the bladder immediately after voiding, measured by ultrasound or catheter
+ PVR less than 50 mL indicates adequate bladder emptying
+ PVR greater than 100 mL indicates bladder not emptying correctly

Question 19

What is a complication of poor bladder emptying

Answer 19

UTI, urinary tract infection

Question 20

What is a nursing diagnosis for urinary function problems

Answer 20

+ “Urinary functioning” as the problem:
- Incontinence
- Pattern alteration
- Urinary retention

Question 21

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Criteria for catheterization

Answer 21

+ Not for incontinence
+ During surgery
+ urine retention
+ monitoring output in critically ilL
+ obtaining sterile sample
+ provide improved comfort for end-of-life care
+ prolonged patient and mobilization

Question 22

Strategies to promote normal urination

Answer 22

+ Encourage normal voiding habits, not holding
+ Proper fluid intake
+ strengthening muscle tone - Kegel exercises
+ stimulating urination
+ resolving urinary retention
+ assisting with toileting