Urinary Elimination Flashcards
all are terms for the process of emptying the bladde
Micturition / urination / voiding
difficult or painful urination
Dysuria
urination at shorter than usual intervals (without an increase in the total daily urine output)
Urinary frequency
difficulty or delay in starting the urinary stream, often with a decreased force of the stream
Urinary hesitancy
sudden overwhelming need to urinate
Urinary urgency
low urine output, less than 30 mL/hour
Oliguria
absence of urine, usually defined as 100 mL/day or less
Anuria
production of a larger than normal amount of urine, assuming intake is not excessive. It is usually often seen in the early stages of diabetes (due to the osmotic effect of high glucose levels in the blood), or pituitary trauma secondary to head injury (due to underproduction of antidiuretic hormone
Polyuria
used for increased urine output when it is due to ingestion of substances (for example, caffeine-containing beverages, alcohol, or certain medications) that stimulate urine production. Often, when patients are experiencing fluid retention, medications are prescribed to intentionally produce diuresis
Diuresis
frequent urination at night (more than 2 times per night)
Nocturia
blood in urine. Can be gross (visible to the naked eye) or microscopic (visible under a microscope or urine test strips)
Hematuria
protein in the urine
Proteinuria
involuntary urination, incontinence
Enuresis
a term usually used in pediatrics to describe bedwetting during sleep after the age that control has (or should have) been attained. 70% of 4-year-olds and 91% of 8-year-olds have attained nighttime continence
Nocturnal enuresis
involuntary passage of urine. Can be temporary or permanent, depending on the cause. About 13 million Americans are estimated to suffer from incontinence. It is more common in women than men: 15-30% of all adult women experience incontinence. More common in the elderly but should never be considered a normal consequence of aging.
Incontinence
dribbling whenever abdominal pressure is increased, such as during coughing, sneezing, laughing, etc. The muscles that seal off the bladder “let go” without warning. Occurs when pelvic muscular is weak, stretched after childbirth, etc.; or due to the loss of pelvic tone that occurs in women when estrogen secretion drops after menopause.
Stress incontinence
sudden, almost uncontrollable desire to urinate.
IMMEDIATELY. There is a ‘warning”, but very little time to get to the bathroom.
Also known as “overactive bladder”.
Urge incontinence
incontinence due either to cognitive problems(patient unresponsive to need to urinate) or difficulty (due to physical disability) to make the toilet in time or prepare self to urinate.
Functional incontinence
incontinence in patient with spinal cord injury above the level of the 3rd sacral vertebra (S3). The patient has no sensation of need to urinate, and urinates spontaneously (by reflex), without being aware, whenever a certain bladder volume is reached.
Reflex incontinence
Patients with incontinence should keep a ___________. They should record how many times per day urination occurs, and how much urine produced each time.
“bladder diary”
Urinary retention: some urine remains in the bladder after the person has urinated
(“residual urine”)
Retained urine tends to become alkaline, which predisposes to
Urinary Tract Infections
is a bedside ultrasound that can be performed to determine how much urine is retained.
Bladder scanning
UTI symptoms include
dysuria, hematuria, urgency, pressure, and frequency
Most common organism is_______, accounting for more than 80% of UTIs.
E. coli
infection of the bladder
Cystitis
infection of the urethra
Urethritis
infection of the ureters
Ureteritis
infection of the substance of the kidney itself
Pyelonephritis
normal color of urine
Usually clear, yellow or straw colored
If urine is VERY dark, it may indicate the presence of ______ in the urine
bilirubin
urine will be pink to dark red
Hematuria
a measure of the concentration of dissolved solids in the urine
Specific gravity (SG)
1.005 (very dilute)- 1.030
Normal SG
Freshly voided urine that is cloudy usually indicates
infection
Protein, glucose, ketones and bilirubin: should not normally be present in the urine, usually indicates
disease
About__________ of urine is enough for a routine and microscopic test
½ ounce (15 mL)
insertion of a fiber optic “scope” into the bladder via the urethra by a physician.
Cystoscopy
a soft, pliable condom-like sheath that fits over the penis, providing a safe and noninvasive way to contain urine. The risk of infection is lower than with a bladder catheter but higher than without any catheter.
Condom / Texas catheter
are used to strengthen the muscles. Consist of clenching the same muscles that one uses to voluntarily cut off the flow of urine. Mainly for stress incontinence, but also may help urge incontinence.
Kegel exercises
a strip of muscle, ligament, or tendon is wrapped underneath the urethra to make it narrower and improve its ability to close.
Pelvic sling
can be used purely for the collection of a urine culture
Intermittent catheterization
One-time use
Intermittent (Straight cath/in-and-out)
Remains in place over period of time
Indwelling (Foley)
How to prevent cauti
Appropriate use, Proper insertion/ maintenance, Quality improvement, surveillance
