Urinary Elimination Flashcards
Minimum volume of urine per hour
30 mL/hour
t/f: clear urine could look cloudy if it sits out too long
true. Assess fresh urine.
minimum volume of urine per 24 hours
720 mL
This symptom is an indicator of UTI in older adults
confusion or mental status change
voiding
urination
dysuria
painful urination
polyuria
excessive urination
anuria
severely decreased or absent urine (<100 mL of urine a day)
oliguria
decreased urination (<400 mL of urine a day)
urgency
feeling like one is unable to delay voiding voluntarily
urinary retention
urine remains in the bladder after voiding
nocturia
waking up to void at night
frequency
voids frequently in small amounts
hematuria
blood in the urine
pyuria
when urine contains pus
incontinence
involuntary loss of urine from the bladder (an “accident”)
What counts in fluid intake
oral, IV, nasogastric or PEG tube
what hormone makes the body retain fluid
ADH
what triggers the release of ADH
increased plasma osmolarity
How many mL in one oz
30
How can the body lose fluid
Oral: vomiting
Integumentary: diaphoresis, wound drainage, burns
GI/urinary: diarrhea, urine
Blood
How does hypotension impact fluid
poor renal perfusion, unable to filtrate
how does surgery impact fluid
volume deficit, urinary retention from anesthesia, need to void within 8 hours of surgery
how do medications affect pregnancy
diuretics increase output
opioids, tricyclic, antihistamines decrease output
why does surgery cause a fluid volume deficit
NPO before surgery
Risk factors for UTI
internal urethra: shorter, and exposure to bacteria from wiping sexual intercourse urinary catheter (CAUTI)
When should you suspect a CAUTI?
If an indwelling catheter has been in place for 48 hours or more
How does adequate water intake prevent UTIs?
flushes microorganisms
How does voiding after sexual intercourse prevent UTIs
flushes microorganisms
stress incontinence cause/treatment
cause: abd pressure, prostate surgery
treat: kegels, vaginal pessary, estrogen creams, catheters, surgery
urge incontinence
random involuntary passage of urine after strong urge to void
voiding regimen
Used for cognitive or physical impairment
Void on a fixed schedule
(name and indication)
Timed voiding: urge incontinence
voiding regimen
Take time to check to see if there is a need to void
name and indication
Prompted voiding: functional and total incontinence
voiding regimen
Schedule bathroom trips around when incontinence episodes occur
(name and indication)
habit retraining: functional and total urinary incontinence
- Schedule voiding times with a narrow range of 2 hours
- Eventually widen range to 4 hours
(cause and indication)
bladder training: urge and reflex incontinence
Noninvasive diagnostic if patient doesn’t void after surgery
bladder ultrasound
Urine specimen type
Can be poured from nonsterile container into cup
random
Urine specimen type
- Sterile cup or bedpan
* Seek specimen without microorganisms
clean-catch
Urine specimen type
- Specific measurement of kidney’s excretion of substances
* Educate all personnel and family about need to keep all urine for the 24-hour period
24 hour
Urine specimen type
- 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)
catheter
normal color
light yellow/amber colorless: too much fluid intake dark color: low fluid intake pink: RBC pink/orange/red/brown/blue-green: foods
normal turbidity
clear.
Hazy, cloudy, smoky: red or white blood cells, bacteria, mucus threads, secondary to indwelling catheter
normal urine pH
normal 6, range 4.6-8
<6: diet high in meat or some fruits, acidosis
>6: diet high in vegetables and citrus fruits, UTI, alkalosis
normal urine specific gravity
- 015-1.025
lower: high fluid intake, dieuretics, diabetes insipidus
higher: low fluid intake, high fluid loss, ADH secretion
normal protein in urine
none - present in severe stress, renal disease, preeclampsia
normal glucose in urine
none. Presence indicates DM
Normal ketones in urine
none. Present in diabetes mellitus, ketoacidosis, starvation
lab urine test
- Urea is normally excreted
* Impaired kidneys are unable to excrete urea leading to an increase in this value
BUN
lab urine test
- a waste product excreted by the kidneys
- Increased _____ indicates renal impairment
- More sensitive indicator than BUN for renal impairment
creatinine
lab urine test
- Need creatinine level from urine and blood
- Need the amount of urine developed in 24 hours
- Estimates the kidneys glomerular filtration ability
creatinine clearance
lab urine test
- Best indicator of kidney function
- Requires multiple data: Age, race, gender, serum creatinine
glomular filtration rate
type of catheter: just a tube
straight or intermittent
type of cath: catheter tube with bend in it
coute catheter (prostate problems)
type of cath: catheter tube with one port and balloon
indwelling
type of cath: tube with 2 ports and balloon
bladder irrigation
