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NUR 333: > Urinary Elimination > Flashcards

Urinary Elimination Flashcards

1
Q

bacteremia

A

presence of bacteria in blood stream

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2
Q

bacteriuria

A

presence of bacteria in the urine but no symptoms
- e coli most common, often health care associated

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3
Q

catheter associated UTI

A

develop with presence of indwelling cath (break sterility on insertion)
- can be costly w no reimbursement
- can be reasonably prevented
- focus on early recognition and prompt treatment

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4
Q

catheterization

A

putting a catheter into the urinary tract

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5
Q

cystitis

A

inflammation of the bladder caused by bladder infection

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6
Q

dysuria

A

pain, burning, discomfort when urinating

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7
Q

hematuria

A

presence of blood in someones urine

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8
Q

micturition

A

to urinate
- complex process that involves the bladder, urinary sphincters, CNS

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9
Q

nephrostomy

A

an opening between the kidney and skin to allow for the removal or urine

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10
Q

pelvic floor muscle training

A

repeated contracting and relaxing of muscles to help with urination

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11
Q

postvoid residual

A

the amount of urine left in the bladder after a void

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12
Q

proteinuria

A

high levels of protein in the urine

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13
Q

pyelonephritis

A

kidney infection

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14
Q

suprapubic catheter

A

placed in the bladder through the abdominal wall
- sutured in place
- used when blockage or urethra or indwelling causes irritation

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15
Q

urinary incontinence

A

involuntary loss of urine
- urgency, stress, overflow
- often multifactorial

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16
Q

ureterostomy

A

surgery to create a urinary diversion
- have stoma for ureter or kidney
- urine bypasses bladder and exits through stoma

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17
Q

voiding

A

bladder contraction and urethral sphincters and pelvic floor muscles
- impulses sent from brain
- external sphincter relaxes and bladder empties

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18
Q

factors that influence urinary elimination

A
  • growth and development
  • sociocultural factors
  • psychological factors
  • personal habits
  • fluid intake
  • pathological conditions (nervous system)
  • surgical procedures (post op, abdomen area)
  • diagnostic examinations
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19
Q

urinary changes in older adults

A

decreased
- amount of nephrons
- bladder muscle tone
- bladder capacity
- time btw initial desire and becomes urgent
increased
- bladder irritability
- bladder contractions during bladder filling
- risk of urinary incontinence

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20
Q

common urinary problems

A
  • urinary retention
  • UTI
  • incontinence
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21
Q

urinary retention

A

inability to partially or completely empty bladder
- acute or chronic
- diagnose w bladder scan (postvoid residual)
- incontinence considered overflow incontinence

22
Q

bladder scanner

A
  • independent nursing intervention
  • should be done after post void
  • can lead to i and o cath before full cath
23
Q

risk factors for UTI

A
  • presence of indwelling catheter
  • any instrumentation of urinary tract
  • urinary retention
  • urinary or fecal incontinence
  • poor peri care
  • female
  • frequent sexual intercourse
  • uncircumcised pts
24
Q

incontinence of risk factors

A
  • more common in women and elderly
  • obesity
  • multiple pregs / vaginal birth
  • neurological disorders (parkinsons, CVA, spinal cord, MS)
  • med therapy: diuretics, opioids, anticholinergics, Ca channel blockers, sedatives, hypnotics
  • confusion
  • dementia
    -immobility
  • depression
25
Q

assessment of pts w urinary problems

A
  • assess understanding and expectations of treatment
  • be professional
  • assess ability to perform necessary behaviors associated w voiding
  • assess for any culture or personal considerations
  • past medical and surgical hx
  • med use
  • normal bowel and urinary elimination patterns
  • sleep, activity, nutrition
26
Q

focused assessment for urinary incontinence

A
  • focused urinary and abdominal
  • looking at kidneys, bladder, external genitalia, meatus, urethra, perineal skin
27
Q

pattern of urination

A
  • frequency and times
  • normal amount w each void
  • hx of recent changes
28
Q

assessment: nursing hx

A
  • pattern of urination
  • symptoms of urinary alterations
  • urination, dysuria, freq, hesitancy, polyuria, oliguria, nocturia, dribbling, hematuria, retention
29
Q

CVA

A

costovertebral angle
- checks for kidney infection

30
Q

assessing urine

A
  • input and output
  • characteristics of urine
31
Q

intake and output assessment

A
  • evaluates bladder emptying
  • renal function
  • fluid and electrolyte balance
  • can be HCP or nurse decision to measure
32
Q

normal urine output rate

A

more than 30 mls for every hour

33
Q

characteristics of urine

A
  • color
  • clarity
  • odor
34
Q

color

A

normal
- pale straw color to amber
abnormal
- hematuria
- color changes

35
Q

clarity

A

normal
- transparent to void
- urine that sits could become cloudy
- thick and cloudy can indicates bacteria and WBC
- early morning voids can look like cloudy

36
Q

odor

A

normal
- odorless
- ammonia smell
abnormal
- offensive, may indicate UTI
- some foods can alter smell
- fruity indicates acetone

37
Q

strict i and os

A

must have a catheter
- often used for people with kidney disease, heart failure

38
Q

urinalysis info

A
  • collect freshly voided urine
  • cant take out of catheter bed
  • sometimes can use reagent strips
  • send to lab w/in 30 mins
  • use sterile specimen cup
39
Q

urinalysis normal results

A
  • clear, amber, yellow
  • aromatic
  • ph 4.6-8.0
  • protein 8 mg/100 mls
  • glucose, bacteria, ketones all negative
  • specific gravity 1.005-1.030
  • RBC up to 2
  • WBC 0-4
40
Q

abdominal x-ray

A

determines size, shape, symmetry, location of structures of urinary track
- detects and measures urinary calculi
- no special prep like NPO

41
Q

nursing problems for urinary elimination

A
  • impaired urinary elimination
  • urinary retention
  • incontinence
  • impaired comfort and pain
  • impaired skin integrity or risk for impaired skin integrity
  • knowledge deficit
  • body image disturbance
  • risk for infection
42
Q

health promotion and pt education

A
  • promote self care practices
  • maintain normal routine
  • promote healthy nutrition and fluid intake
  • avoid smoking and constipation
  • strengthen pelvic floor muscles
  • be aware of mens prostate
  • report changes in urinary tract
43
Q

maintaining adequate fluid intake

A
  • 2300 mls/day (if no renal function problems, no heart disease)
  • helps flush solutes to limit bladder irritability
  • if fluid needs to be inc, schedule times to drink, identify preferences, high fluid fruits, stop drinking about 2 hrs before bed
44
Q

urinary retention

A
  • assess and monitor urine output, bladder distention
  • assess for normal elimination position
  • run water or flush commode
  • apply cold compress
  • encourage double voiding
  • around the clock voiding
  • crede method (applying manual pressure, not recommended)
  • intermittent cath, cath
45
Q

preventing infection

A
  • follow hospital protocol
  • assess for s/s of infection
  • preform peri care
  • void at regular intervals
  • adequate fluid intake
  • female considerations (wiping, solutions for leakage, inc pelvic floor strength)
46
Q

incontinence care

A
  • be respectful of feelings
  • pelvic floor muscle training
  • lifestyle changes
  • bladder retention
  • toilet schedule
  • inter cath
  • meticulous skin care
  • absorbant pads and catheters
  • electrical stimulation
  • meds (anticholinergic)
  • interventional therapies
  • surgery
47
Q

skin care do

A
  • identify and treat early
  • use skin risk assessment tool
  • use appropriate skin barrier problems
  • ensure adequate hydration
  • consult wound
48
Q

skin care donts

A
  • use traditional soap and water
  • double padding the bed
  • leave soiled pads
49
Q

types of catheters

A
  • single lumen
  • indwelling cath
  • 3 lumen
  • coude tip
  • suprapubic
    external
50
Q

nursing catheter care

A
  • regular peri care
  • secure cath to prevent movement
  • empty drainage bag when 1/2 full
  • ensure no kinks
  • bag below bladder
  • drainage bag cant touch floor
  • maintain closed system
  • accurate monitoring
  • timely removal
51
Q

before cath insertion

A
  • peri care (front to back, uncircumcised)
  • can delegate to assistant
  • CHG or castille wipes (done before insertion, daily/qshift)
  • follow algorithm for removal
52
Q

post cath removal

A
  • pt should void w/in 6-8 hrs
  • monitor ability to void and empty
  • measure accurate urine output
  • check for retention
  • pt education like firrst void can cause discomfort)

NUR 333: (10 decks)

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