Urinary - Ch. 37 Flashcards
Parts of the urinary system
Kidneys, ureters, bladder, urethra
What is the function of the kidneys
+ 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
Function of the ureters
Transport urine from kidney to bladder
Muscle that makes up the bladder
Detrusor muscle - Three layers, the middle layer forms the involuntary sphincter that guards the opening from the bladder to the urethra
What job does the SNS have concerning the bladder
Causes detrusor muscle to relax and internal sphincter to constrict to retain urine
What function does the PNS half of the bladder
Causes detrusor muscle to contract in the sphincter to relax to release urine
What is the capacity of the average adult bladder
150 to 250 mL
What actions is the voluntary control of the bladder limited to
+ Initiating
+ restraining
+ interrupting voiding (pinching urine stream)
Factors affecting Urination
+ Developmental considerations – toilet training, effects of aging
+ food and fluid intake
+ psychological variables
+ activity in muscle tone
+ pathological conditions
+ medication‘s
What is urinary incontinence
Any involuntary loss of urine, small amount
Circle star highlight
Types of incontinence (4)
+ 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
Ways to fight incontinence
+ Kegel exercises
+ biofeedback devices
+ medication
+ surgery
+ stimulation
+ external barriers
Signs and symptoms of a UTI
+ Burning or pain
+ fever
+ odor
+ bloody urine
+ increased frequency
+ confusion / change in level of consciousness (dementia pts)
Characteristics of a UTI
+ Change in color
+ odor
+ turbidity
Effects of aging on urinary elimination
+ Kidney Function diminishes – nocturia
+ decreased bladder muscle tone + decreased bladder contractibility
+ neuromuscular degeneration
Nursing interventions for urinary issues
+ Provide bedpan or bedside commode
+ call light and patient reach
+ assess every hour during 5P’s – position, potty, pain, possessions, pump
Affects of medication‘s on urinary & elimination
+ 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
PVR - post void residual
What is it
What is the range that indicates adequate or in adequate bladder emptying
+ 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
What is a complication of poor bladder emptying
UTI, urinary tract infection
What is a nursing diagnosis for urinary function problems
+ “Urinary functioning” as the problem:
- Incontinence
- Pattern alteration
- Urinary retention
Circle star highlight
Criteria for catheterization
+ 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
Strategies to promote normal urination
+ Encourage normal voiding habits, not holding
+ Proper fluid intake
+ strengthening muscle tone - Kegel exercises
+ stimulating urination
+ resolving urinary retention
+ assisting with toileting
