Urinary elimination. Flashcards

1
Q

What are the learning outcomes for this topic?

A

Define key terms, identify influencing factors, describe nursing measures, obtain health history for this type of patient, complete testing of urinary specimens, and be able to create a relevant nursing care plan.

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2
Q

What is the simple was to define the function of the kidneys?

A

The organ which removes waste from the blood to the urine.

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3
Q

What is the simple was to define the function of the Ureters?

A

The transporter of urine from the kidneys to the bladder

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4
Q

What is the simple was to define the function of the Bladder?

A

The reservoir for urine until the urge to urinate develops.

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5
Q

What is the simple was to define the function of the Urethra?

A

Where the urine travels from the bladder to the exit of the body (through the urethral meatus)

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6
Q

What is the function of the adrenal glands of the kidneys?

A

Adrenal glands, also known as suprarenal glands, are small, triangular-shaped glands located on top of both kidneys. Adrenal glands produce hormones that help regulate your metabolism, immune system, blood pressure, response to stress and other essential functions.

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7
Q

What is the trigone?

A

a smooth triangular region of the internal urinary bladder formed by the two ureteric orifices and the internal urethral orifice. The area is very sensitive to expansion and once stretched to a certain degree, the urinary bladder signals the brain of its need to empty.

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8
Q

Define Micturition.

A

the action of urinating.

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9
Q

What are some brain structures that influence bladder function?

A

The cerebral cortex, thalamus, hypothalamus, and brainstem.

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10
Q

What are some factors that influence urinary elimination?

A

Growth and development, fluid balance, changes to renal function, disease, changes to bladder function, illness, psychological and environmental factors, surgical procedures, and medications.

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11
Q

What does UTI stand for?

A

Urinary Tract Infection

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12
Q

What are lower UTIs?

A

Infections in the bladder and urethra.

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13
Q

What are upper UTIs?

A

Infections in the upper urinary tract (kidneys)

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14
Q

What is a hospital acquired catheter associated UTI?

A

a UTI in which the positive culture was taken when an indwelling urinary catheter had been in place for > 2 calendar days

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15
Q

What is the overview of the urinary assessment?

A

Gather nursing history for the patients urination pattern, symptoms and factors affecting urination. Conduct a physical assessment. Assess characteristics of urine. Assess the patients perception of urinary problems. And gather relevant lab and diagnostic results .

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16
Q

What is everything you need to gather in a subjective assessment of the urinary system?

A

Presenting concern, usual voiding pattern, characteristics of the urine, fluid intake/balance, signs/symptoms, history of smoking, family history regarding cancer, medications, and self care practices.

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17
Q

What does voiding mean?

A

Expelling urine aka peeing.

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18
Q

What is involved in the objective assessment of the urinary system?

A

Skin and mucosal membranes, abdominal assessment, and urinary meatus.

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19
Q

What is a urinary meatus?

A

The opening of the urethra. Where you void from.

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20
Q

What do you assess for in terms of urine?

A

Intake and output of fluids, and the characteristics aka colour, clarity, odour, and volume.

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21
Q

If you detect an unusual odour in the urine what should you ask the patient?

A

What they have been eating.

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22
Q

Would we notice more concentration in the urine in the morning or night?

A

Morning

23
Q

What does dark red urine indicate?

A

Bleeding from the kidneys or ureters.

24
Q

What does bright red urine indicate?

A

Bleeding from the bladder or urethra

25
Q

What foods can produce red urine?

A

Beetroots, rhubarb, and berries.

26
Q

What may influence the colour of urine other than foods?

A

Medications

27
Q

What food produces a strong odour IN URINE?

A

Asparagus

28
Q

What may a sweet/fruity acetone odour of urine indicate?

A

Diabetes or starvation

29
Q

What clarity should urine have?

A

Urine should be clear of particles

30
Q

What may cloudy or foamy urine indicate?

A

Renal disease

31
Q

What may thick and cloudy urine with bacteria indicate?

A

Infection.

32
Q

What is the usual daily urine volume?

A

1000ml to 2000ml

33
Q

What is the general rule for urine output?

A

1ml urine/kg/hr for all age groups.

34
Q

What are the different types of specimen collection types?

A

Freshly voided, midstream, catheter specimen, timed urine, and urine collection in children.

35
Q

How is a urinalysis usualy done?

A

Via ‘dipstick’ on ward or sent to lab for further investigation.

36
Q

What are the normal urinalysis findings regarding bilirubin?

A

Trace

37
Q

What are the normal urinalysis findings regarding blood?

A

None

38
Q

What are the normal urinalysis findings regarding glucose?

A

None

39
Q

What are the normal urinalysis findings regarding ketones?

A

None

40
Q

What are the normal urinalysis findings regarding leucocyte esterase?

A

None

41
Q

What are the normal urinalysis findings regarding nitrite?

A

None

42
Q

What are the normal urinalysis findings regarding ph?

A

4.5-8.0 (average 5.0-6.0)

43
Q

What are the normal urinalysis findings regarding Protein?

A

none

44
Q

What are the normal urinalysis findings regarding specific gravity?

A

1.016-1.022

45
Q

What are the normal urinalysis findings regarding urobilinogen?

A

trace

46
Q

What are some non invasive diagnostic procedures regarding the urinary system?

A

Abdominal X-ray, intravenous pyelogram (IVP), radionuclide tests e.g renal scan, CT, and a renal ultrasound.

47
Q

What are some invasive diagnostic procedures regarding the urinary system?

A

Cystoscopy (visualization of the interior bladder and urethra) and Urodynamic testing.

48
Q

What are some nursing diagnoses regarding the urinary system?

A

Incontinence, pain, self-care defict (toileting), skin integrity (impaired), urinary elimination (altered - specify), and urinary retention.

49
Q

What are four things we can plan for a urinary assessment?

A

To reinforce good hygiene practices, select interventions that promote normal physiology of micturition, involve the family, and refer to appropriate health professionals.

50
Q

What are some general patient goals regarding the urinary system.

A

The understanding of normal urinary elimination, promotion of normal voiding, achieving complete bladder emptying, preventing of infection, maintaining of skin integrity, and the maintaining of self image.

51
Q

What are 3 methods of draining the urinary tract?

A

Indwelling or foley catheter, suprapubic catheterization, and nephrostomy tubes.

52
Q

What are some interventions to promote incontinence?

A

Strengthening pelvic floor muscles, continence aids and appliances, urinary sheath application, maintenance of skin integrity, and a voiding program and bladder training.

53
Q

What is involved in the evaluation step of the urinary assessment?

A

Reassessing the patients urination patter and signs/symptoms of alterations, inspect the character of the patients urine, have patient and family demonstrate self-care skills, have patient discuss any feelings regarding any permanent changes in elimination, and ask if the patients expectations are being met.