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Fundamentals of Nursing > Urinary Elimination > Flashcards

Urinary Elimination Flashcards

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1
Q

if someone is fluid deficit what do we do

A

give fluids

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2
Q

when someone has urinary issues what do we want to keep an eye on

A

I&O

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3
Q

what is the main involuntary muscle of the urinary system

A

detrussor muscle

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4
Q

what is included under voluntary control

A

imitating
stoping
interrupting

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5
Q

what is the minimum normal urine output

A

30mL/hr

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6
Q

can we control the internal sphincter

A

no

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7
Q

internal sphincter is controlled by

A

neurogenic

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8
Q

external sphincter is controlled by

A

you
- able to control this one

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9
Q

how does age influence urination

A

decreased ability to concentrate urine
decreased bladder tone
decreased bladder contractility
neuromuscular/cognitive problems

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10
Q

what does it tell you that older adults have decreased ability to concentrate urine

A

frequent getting up throughout the night which is a fall risk
- able to concentrate urine allows us to not have to go at night

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11
Q

what does it tell you that older adults have decreased bladder tone and bladder contractility

A

the bladder does not empty fully so they will have statsis of urine which leads to a UTI

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12
Q

what does it tell you that older adults have neuromuscular/cognitive problems

A

they are not aware they have to do

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13
Q

how can food and fluid intake affect urination

A

decreased drinking could lead to increased sodium

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14
Q

what do we want fluid intake at

A

2-3L

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15
Q

what are some pathology that can affect urination

A

renal disease, diabetes

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16
Q

what are some medications that can increase urine output

A

diuretics

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17
Q

what should we ask about voiding history

A

how often do you go
are you routinely going

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18
Q

who might be at risk for high post void residuals

A

BPH

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19
Q

what do we use to confirm how much fluid is in post void residual

A

bladder scanner

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20
Q

what is a normal post void residuals

A

> 50mL

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21
Q

what can be an assessment of urine include

A

color
clarity
odor
volume over 24 hour period
specimens

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22
Q

UA

A

urine analysis

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23
Q

how much do we need for a UA

A

10mL

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24
Q

is a UA a gross or specific

A

gross

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25
Q

what does a UA tell us

A

WBC, RBC, sugar, protein

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26
Q

if we notice a possible problem on the UA what will we order next

A

urine culture and sensitivity

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27
Q

how much do we need for a urine culture and sensitivity

A

3mL

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28
Q

CCMS

A

clean catch mid stream

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29
Q

how do we collect a CCMS in a patient with a catheter

A

specimen port

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30
Q

how do we collect a CCMS on a patient with no catheter

A

good peri care
start
stop
start and collect
stop
finish

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31
Q

why do we want the patient to pee at first when getting a CCMS

A

gets rid of any contaminants

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32
Q

if we have a patient with no catheter and they cannot perform a CCMS what do we do

A

straight Cath for the procedure

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33
Q

how do we do a 24 hour urine sample

A

at the time the 24 hour starts have patient void because this urine was now produced during that 24 hour. at the end of the 24 hour collect that urine because it was produced in that 24 hour

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34
Q

what happens if we dump a void for a 24 hour urine sample

A

start over

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35
Q

what can a 24 hour urine sample tell us

A

renal function
creatine
clearance

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36
Q

is culture and sensitivity a sterile procedure

A

yes

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37
Q

BUN normal

A

8-23

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38
Q

what does BUN measure

A

can the kidneys remove urea from blood
nitrogen in blood that comes out in urine
how well the kidneys work

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39
Q

what is urea

A

protein broken in body

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40
Q

who might we see a high BUN in

A

decreased kidney function or dehydrated

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41
Q

is creatine a more refined or gross test

A

refined

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42
Q

normal creatine

A

0.6-1.2

43
Q

if you have increased creatine what does that tell you about your body

A

decreased kidney function

44
Q

what is the most specific test

A

GFR

45
Q

what contributes to GFR

A

age and race

46
Q

what is a normal GFR

A

90

47
Q

what do we want the minimum of GFR to get

A

> 60

48
Q

if GFR is less than 60 for 3 months what does that mean

A

renal disease

49
Q

GFR is a parameter for what medication

A

glucophage

50
Q

what habits do we want to maintain while in the hospital

A

privacy
position
hygiene

51
Q

how do we maintain muscle tone

A

kegal exercises and bladder training

52
Q

what is kegal exercises

A

increase pelvic floor muscule
like holding in pee

53
Q

what is bladder training

A

put patient on toilet every 2 hours

54
Q

incontince

A

cannot control urinary flow

55
Q

is inconntince a normal process of aging

A

no

56
Q

ilulconduit

A

ureter to ilum to abdomen bag

57
Q

uretostomy

A

ureters to surface

58
Q

neobladder

A

small intestine and make fake bladder

59
Q

pros and cons to neobladder

A

no signal about going
body image, no bag

60
Q

UTI symtoms and signs

A

dysuria. frequency, cloudy urine and foul odor, back pain

61
Q

how do we confirm a UTI

A

urine analysis and/or urine culture

62
Q

what might we see in younger person

A

increase temp
increase WBC

63
Q

what is the first sign of UTI in elderly

A

confusion

64
Q

what do we find out from a urine culture and sensitivity

A

the bacteria and what antibiotics treat the infection

65
Q

who has an increased risk factors for UTI

A

females (short urethra)
age (urinary statuses)
indwelling catheters (CAUTI)
diabetics (sugar allows bacteria to grow)

66
Q

interventions for UTI

A

foley care
kegal
I &O
wipe front to back
pee after sex to clear bacteria
cotton underware

67
Q

where can biofilm be harmful

A

indwelling cath

68
Q

urinary retention increased risk

A

age
prostate

69
Q

after foley is removed patient needs to go within

A

6 hours

70
Q

diseases of what could cause urinary retention

A

spinal cord

71
Q

what are some meds that cause urinary retention

A

anticholinergics
tricyclic antidepressants
calcium channel blockers
narcotic analgesics
anesthetic agents

72
Q

why do anesthetic agents lead to urinary retention

A

paralyze internal sphincter

73
Q

we want a urinary retention to be

A

less than 50mL

74
Q

what PVR tells us there is urinary retention

A

150mL

75
Q

who might a bladder scanner be inaccurate in

A

obesity
inadequate gel
improper aim
moving the probe during scanning
scar tissue
incisions
staples

76
Q

straight cath

A

intermitten
put in, drain, pull out

77
Q

indwelling cath

A

stays in

78
Q

suprapubic cath

A

long term

79
Q

normal position for Cath insertion

A

dorsal recumbent

80
Q

when will an indwelling Cath be appropriate

A

acute urinary retention
accurate measurments
periop
healing of wounds
prolonged immobilization
end of life care
large volume infusions of diuretics during surgery

81
Q

inappropriate uses of indwelling caths

A

substitue for nursing care
obtaining a urine culture when patient is capable
prolonged postop duration

82
Q

what is an alternative to indwelling

A

pirwicks

83
Q

what is the sanitation for putting in a cath

A

sterile/aseptic

84
Q

why do we secure caths

A

so it cannot float in

85
Q

when is the most common time to get CAUTI

A

after insertion
poor care after insertion

86
Q

foley care

A

clean clean to dirty
6 in down tube
keep off floor
secure to thigh
green clip on bed
no dependent loops
bag never higher than bladder (back flow)
pericare

87
Q

what suction is the perwicks

A

low

88
Q

how often do we replace pirwicks

A

8-12 hours

89
Q

how often do we change condom caths

A

24hr

90
Q

how do we put a condom Cath on a patient who is uncircumsized

A

replace foreskin before putting Cath on

91
Q

how much space do we leave at end of condom cath

A

1 inch

92
Q

transient incontinence

A

appears suddenly and is usually caused by an illness or temporary problem that is short lived/treatable

93
Q

stress

A

weak pelvic floor muscles and/or deficient urethral spinchter, loss of urine during increased intrabdominal pressure

94
Q

urge

A

involuntary loss of urine that occurs soon after feeling an urgent need to void

95
Q

mixed

A

combination of stress and urgency

96
Q

overlfow

A

chronic retention of urine asscoated with overdistension and over flow

97
Q

functional

A

inability to reach bathroom

98
Q

reflex

A

spinal cord injuries emptying with no signal

99
Q

how to help with stress

A

kegal

100
Q

how to help with urge

A

bladder training

101
Q

how to help with overflow

A

kegal

102
Q

how to help with functional

A

bladder training

103
Q

how to help with reflex

A

bladder training

Fundamentals of Nursing (23 decks)

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