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Foundations 3 > Urinary Elimination > Flashcards

Urinary Elimination Flashcards

1
Q

Volume Minimum per hour

A

30 ml per hour

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2
Q

What does Urine Color indicate?

A
  • indicates hydration status

- impacted by meds

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3
Q

Dark amber urine

A

dehydration

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4
Q

Clear Urine

A

adequate hydration

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5
Q

Odor

A

-Ammonia is normal smell

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6
Q

Strong odor

A

Is infection

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7
Q

What urine has less of a smell?

A

Dilute Urine

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8
Q

Which would you Assess clarity? Fresh or unfresh urine

A

Fresh!

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9
Q

Newborn and Infant

A

Urinate frequently

No bladder control

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10
Q

Toddler and preschooler

A

Develop voluntary urine control

Toilet training

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11
Q

School-age child and adolescent

A

Nocturnal enuresis

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12
Q

Adult and older adult

A

With older age incontinence, nocturia

An older adult with confusion is a strong indicator for a urinary tract infection

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13
Q

Voiding

A

Term means to urinate

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14
Q

Dysuria

A

Painful urination

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15
Q

Polyuria

A

Excessive urination

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16
Q

Anuria

A

Severely decreased or absent urine

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17
Q

Oliguria

A

decreased urination

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18
Q

Urgency

A

Feeling like one is unable to delay voiding voluntarily

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19
Q

Urinary Retention

A

Urine remains in the bladder after voiding

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20
Q

Nocturia

A

Waking up to void at night

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21
Q

Frequency

A

Voids frequently in small amounts

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22
Q

Hematuria

A

Blood in the urine

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23
Q

Pyuria

A

When urine contains pus

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24
Q

incontinence

A

Involuntary loss of urine from the bladder

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25
Q

Any intake of fluids

A

Oral
Intravenous
Nasogastric or PEG tube

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26
Q

What hormone makes the body retain fluid?

A

ADH

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27
Q

What triggers the release of that hormone?

A

Increased plsama osmolarity

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28
Q

How many oz 1 ML

A

30

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29
Q

How can the body lose fluids?

A

Multiple routes

Vomiting, diarrhea, diaphoresis, wound drainage, urine, burns, or blood loss

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30
Q

You can record fluid loss by measuring

A

output

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31
Q

Output should

A

match intake or be within 200-300 mL

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32
Q

What does it indicate if output is less?

A

Decreased kidney perfusion or dehydration

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33
Q

What do you use to get urine output without a catheter?

A

Graduate, hat, urinal, bedpan

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34
Q

How does Hypotension affect the kidneys?

A

Leads to poor renal perfusion

Kidneys are unable to filtrate

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35
Q

What conditions cause decreased muscle tone?

A

Obesity
Multiple pregnancies
Chronic constipation
Continuous bladder drainage

36
Q

Surgery

A

Volume deficit
Urinary retention from anesthesia
Need to void within 8 hours of surgery

37
Q

What medications increase urine output

and what medications cause retention?

A

Diuretics = increase urine output

Opioids, tricyclic, antihistamines = urinary retention

38
Q

Diet: What foods promote diuresis and what foods promote retention?

A

Alcohol and caffeine promote diuresis

Salty foods promote retention

39
Q

What position makes it difficult for a patient to use a bedpan or urinal?

A

Difficult to use a bedpan or urinal while laying flat

40
Q

Cognitive/ Psychological factors

A

Neurologic conditions, brain tumor, stroke, confusion can all impair drinking or voiding
Heat can promote urination, cold can prevent it.
Hearing water running can promote urination

41
Q

Obstruction

A

Tumor, renal stones, prostate
Kinked or clogged urinary catheter
Increases risk of urinary stasis and infection

42
Q

Risk Factors for UTI

A
  • female anatomy: shorter urethra and incorrect wiping
  • sexual intercourse
  • urinary catheter
  • CAUTI
43
Q

What is a CAUTI

A

Catheter-associated urinary tract infection (CAUTI)
A UTI that develops when a catheter is in place greater than 48 hours prior to the onset of infection
One of the most common healthcare-acquired infections
Increases morbidity and morality for patients

44
Q

Education on prevention of UTIs

A
  • Adequate water intake? flush microorganisms
  • Aim to void at least every 4 hours
  • Void immediately after sexual intercourse?
  • flushing miccroorganisms
  • Wash hands carefully with soap and water
45
Q

S/s of UTI

A 
Fever
Flank pain
Dysuria
Frequency
Urgency
Pyuria
Hematuria
46
Q

Timed Voiding

A

Timed voiding
Used for cognitive or physical impairment
Void on a fixed schedule
Urge urinary incontinence

47
Q

Habit retraining

A
  • Schedule bathroom trips around when incontinence episodes occur
  • Functional and total urinary incontinence
48
Q

Prompted Voiding

A
  • Take time to check to see if there is a need to void

- Functional and total urinary incontinence

49
Q

Bladder training

A
  • schedule voiding times with a narrow range of 2 hours
  • Eventually widen range to 4 hours
  • Urge and reflex incontinence
50
Q

Urinary Diversion

A
  • Surgical procedure to alter the pathway of urine elimination
  • commonly performed after the removal of the bladder (cystectomy)
  • Two types: Ileal conduit and neobladder
51
Q

What happens if a patient doesn’t void after surgery?

A
  • Use a bladder scanner to check bladder for urine
52
Q

Urine specimen types: Random

A

-Can be poured from nonsterile container into cup

53
Q

Urine specimen types: Clean-catch

A
  • sterile cup or bedpan

- seek specimen without microorganisms

54
Q

Urine specimen types: 24 hour

A
  • Specific measurement of kidney’s excretion of substances

- Educate all personnel and family about need to keep all urine for the 24 hour period

55
Q

Urine specimen types: Catheter

A
  • In and out to obtain specimen at a specific time

- Indwelling, can collect from a port near the top of catheter (not from drainage bag)

56
Q

Urine Tests: Reagent Strips

A

-Detect substances an their amounts such as pH, glucose, protein, ketones

57
Q

Urine Tests: Urine culture and sensitivity

A
  • Determine microorganism that causes UTI

- Determine correct antibiotic to use

58
Q

Urinalysis Color

A 
Normal: Light yellow- amber 
Almost colorless: increase fluid intake 
Dark color: decrease fluid intake 
Red, pink , dark brown: rbcs in urine 
Pink, Orange, Dark-brown, Blue-green: medications or foods
59
Q

Urinalysis Turbidity

A

Normal: Clear
Hazy, Cloudy, Smoky: urine specimen allowed to stand at room temp
RBCs, WBCs, bacteria, mucus threads: mucosal irritation

60
Q

Urinalysis pH

A

Normal: 6
Range: 4.6-8
<6: Diet high in meat or some fruits, metabolic acidosis( DM, starvation), respiratory acidosis (emphysema).
>6: Diet high in vegetables and citrus fruits, UTIs, metabolic alkalosis (hyperventilation)

61
Q

Specific Gravity

A

Range: 1.015-1.025
<1.015: increased fluid intake, diuretic therapy, diabetes insipidus, renal diseases
>1.025: decreased fluid intake, increase fluid loss (vomiting, diarrhea, fever), ADH secretion (trauma, stress).

62
Q

Protein

A

Normal: None-trace

-Protein is present in severe stress, renal disease, preeclampsia

63
Q

Glucose

A

Normal: None

-Present in DM

64
Q

Ketones

A

Normal: None

Present in DM, Ketoacidosis, Starvation

65
Q

Microscopic Exam

A

RBCs: Normal 0-30 abnormal: >30 UTI, bleeding, urinary tract trauma, anticoagulant therapy
WBCs: 0-5 abnormal: > UTI
Bacteria/ yeast: None-few abnormal: few- contamination from perineal skin
Casts: None-occasional abnormal: many- possible renal diseases

66
Q

BUN Test

A

Urea is normally excreted

Impaired kidneys are unable to excrete urea leading to an increased BUN

67
Q

Creatinine

A

Creatinine is a waste product excreted by the kidneys
Increased creatinine indicates renal impairment
More sensitive indicator than BUN for renal impairment

68
Q

Creatinine Clearance

A

Need creatinine level from urine and blood
Need the amount of urine developed in 24 hours
Estimates the kidneys glomerular filtration ability

69
Q

Glomerular Filtration Rate

A

Best indicator of kidney function
Requires multiple data
Age, race, gender, serum creatinine

70
Q

External Catheter Method:

A

External or condom catheter

Other noninvasive form is PrimaFit

71
Q

External Catheter Indications

A

Indications for use:
Sphincter damage
Spinal cord injury
Impaired skin integrity in areas where incontinence occurs

72
Q

Urinary Catheterization

A

Inserting a small tube through the urethra to the bladder to promote urine drainage

73
Q

Intermittent or Straight

A

In-and-out catheter, temporary for a single voiding session or specimen collection

74
Q

Indwelling

A

Inserted and kept in place by inflating a balloon
Connected to a drainage bag
A securement device is used on the thigh

75
Q

What techniques is important in placement of all catheters!

A

Sterile technique is paramount

76
Q

Indications for catheterization

A

Critically or acutely ill patients that need accurate intake and output measurements

Urinary retention that persists despite multiple intermittent or straight catheter attempts

Management of urinary incontinence with a stage III or IV pressure ulcer on the trunk

77
Q

Catheter types and sizing

A

Catheters are sized using the French system

The higher the number the larger the lumen

Average range is 12-22 (16 most common)

78
Q

Catheter Tube

A

Straight or intermittent

79
Q

Catheter tube with bend created in it

A

Coude catheter: good when patient has prostate problems

80
Q

Catheter tube with one port and balloon

A

Indwelling

81
Q

Catheter tube with 2 ports and balloon

A

Bladder irrigation

82
Q

DO NOT __________ the drainage bag from catheter

A

disconnect

83
Q

How often should you empty drainage bag

A

every 8 hours

84
Q

Why do we empty drainage bag

A

to prevent the development of microorganisms

85
Q

Always keep drainage at what level?

A

Below the bladder

86
Q

When to wash hands?

A

before and after handling catheter and wear clean gloves

87
Q

Catheter care tips

A

Clean patient’s perineal area and catheter after any bowel movement
Clean at least once a shift if no bowel movement present
Use soap and water for cleaning

Foundations 3 (5 decks)

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