Urinary Elimination Flashcards
What is normal urine production?
30ml/hr
How often should you urinate?
Q 3-4 hours
Factors influencing urination:
age
food/fluid intake
activity and muscle tone
pathology
medications
How many mL’s should you find in the bladder after emptying it?
less than 50 mL
Routine Urinalysis
need at least 10mL of urine
Urine for C&S
STERILE
only need about 3mL of urine
CCMS
NOT sterile, BUT clean
clean catch, mid-stream culture - this will test for resistance or sensitivity to antibiotics
Timed Urine Collections
“24 hour urine”
The patient will collect every bit of urine in the last 24 hours. (the first urine of the morning patient will not be collected)
BUN - normal value
8 - 23
Creatinine - normal value
0.6 - 1.2
GFR - normal value
90 or higher
**age/race/gender specific
Stress incontinence:
involuntary loss of urine
Overflow incontinence
missing the signal to let them know their bladder is full and have to urinate
Functional incontinence
Solution: bladder training
How often should a pure wick be changed?
8 - 12 hours
UTI risk factors:
females
Older adults
after menopause
indwelling catheters
diabetics
How do you avoid UTI’s?
Liberal fluid intake
Shower V tub baths
Void Q4 hours
Void after sex
Do not use powders in genital area
Urinary Retention
an inability to empty all of the urine from the
bladder
What medications cause urinary retention?
Anticholinergics
Tricyclic antidepressants
Calcium channel blockers
Narcotic analgesics
Anesthetic agents
What is the normal post-void residual in older adults?
50 - 100mL
What is considered abnormal for post-void residual?
greater than 150mL
When is bladder scanning inaccurate?
Morbid obesity
Inadequate gel
Improper aim or Moving the probe during scanning
Scar tissue, incisions, staples
Straight Cath/Intermittent Catheterization
used to drain urine quickly or get a urine sample.
NOT long term use
Indwelling Catheter
Stays in the bladder and held in with the balloon
Supra Pubic Catheter
goes through the abdominal wall. LONG term
What are the appropriate uses of a urinary catheter?
- Need for accurate measurements
- Perioperative
- To assist in the healing of open sacral or perineal wounds in incontinent patients
- Patient requires prolonged immobilization
- To improve comfort for end-of-life care
- Patients anticipated to receive large-volume infusions or diuretics during surgery
6 steps of foley care:
Clean Perineal Area
Clean 6 inches down the tube
Secured to thigh
No dependent Loops
The green clamp is clamped to the bed
Not on the floor
