Urinary elimination. Flashcards
What are the learning outcomes for this topic?
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.
What is the simple was to define the function of the kidneys?
The organ which removes waste from the blood to the urine.
What is the simple was to define the function of the Ureters?
The transporter of urine from the kidneys to the bladder
What is the simple was to define the function of the Bladder?
The reservoir for urine until the urge to urinate develops.
What is the simple was to define the function of the Urethra?
Where the urine travels from the bladder to the exit of the body (through the urethral meatus)
What is the function of the adrenal glands of the kidneys?
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.
What is the trigone?
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.
Define Micturition.
the action of urinating.
What are some brain structures that influence bladder function?
The cerebral cortex, thalamus, hypothalamus, and brainstem.
What are some factors that influence urinary elimination?
Growth and development, fluid balance, changes to renal function, disease, changes to bladder function, illness, psychological and environmental factors, surgical procedures, and medications.
What does UTI stand for?
Urinary Tract Infection
What are lower UTIs?
Infections in the bladder and urethra.
What are upper UTIs?
Infections in the upper urinary tract (kidneys)
What is a hospital acquired catheter associated UTI?
a UTI in which the positive culture was taken when an indwelling urinary catheter had been in place for > 2 calendar days
What is the overview of the urinary assessment?
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 .
What is everything you need to gather in a subjective assessment of the urinary system?
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.
What does voiding mean?
Expelling urine aka peeing.
What is involved in the objective assessment of the urinary system?
Skin and mucosal membranes, abdominal assessment, and urinary meatus.
What is a urinary meatus?
The opening of the urethra. Where you void from.
What do you assess for in terms of urine?
Intake and output of fluids, and the characteristics aka colour, clarity, odour, and volume.
If you detect an unusual odour in the urine what should you ask the patient?
What they have been eating.
Would we notice more concentration in the urine in the morning or night?
Morning
What does dark red urine indicate?
Bleeding from the kidneys or ureters.
What does bright red urine indicate?
Bleeding from the bladder or urethra
What foods can produce red urine?
Beetroots, rhubarb, and berries.
What may influence the colour of urine other than foods?
Medications
What food produces a strong odour IN URINE?
Asparagus
What may a sweet/fruity acetone odour of urine indicate?
Diabetes or starvation
What clarity should urine have?
Urine should be clear of particles
What may cloudy or foamy urine indicate?
Renal disease
What may thick and cloudy urine with bacteria indicate?
Infection.
What is the usual daily urine volume?
1000ml to 2000ml
What is the general rule for urine output?
1ml urine/kg/hr for all age groups.
What are the different types of specimen collection types?
Freshly voided, midstream, catheter specimen, timed urine, and urine collection in children.
How is a urinalysis usualy done?
Via ‘dipstick’ on ward or sent to lab for further investigation.
What are the normal urinalysis findings regarding bilirubin?
Trace
What are the normal urinalysis findings regarding blood?
None
What are the normal urinalysis findings regarding glucose?
None
What are the normal urinalysis findings regarding ketones?
None
What are the normal urinalysis findings regarding leucocyte esterase?
None
What are the normal urinalysis findings regarding nitrite?
None
What are the normal urinalysis findings regarding ph?
4.5-8.0 (average 5.0-6.0)
What are the normal urinalysis findings regarding Protein?
none
What are the normal urinalysis findings regarding specific gravity?
1.016-1.022
What are the normal urinalysis findings regarding urobilinogen?
trace
What are some non invasive diagnostic procedures regarding the urinary system?
Abdominal X-ray, intravenous pyelogram (IVP), radionuclide tests e.g renal scan, CT, and a renal ultrasound.
What are some invasive diagnostic procedures regarding the urinary system?
Cystoscopy (visualization of the interior bladder and urethra) and Urodynamic testing.
What are some nursing diagnoses regarding the urinary system?
Incontinence, pain, self-care defict (toileting), skin integrity (impaired), urinary elimination (altered - specify), and urinary retention.
What are four things we can plan for a urinary assessment?
To reinforce good hygiene practices, select interventions that promote normal physiology of micturition, involve the family, and refer to appropriate health professionals.
What are some general patient goals regarding the urinary system.
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.
What are 3 methods of draining the urinary tract?
Indwelling or foley catheter, suprapubic catheterization, and nephrostomy tubes.
What are some interventions to promote incontinence?
Strengthening pelvic floor muscles, continence aids and appliances, urinary sheath application, maintenance of skin integrity, and a voiding program and bladder training.
What is involved in the evaluation step of the urinary assessment?
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.
