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NRS 125 > Urinary Elimination > Flashcards

Urinary Elimination Flashcards

1
Q

Normal urinary output rids the body of ______.

A

Waist

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2
Q

Clients with urinary alterations are at risk for altered _____ ______.

A

body image

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3
Q

What is important for the nurse to understand about urinary elimination?

A
  • the importance of begin sensitive to clients needs
  • factors which alter urinary elimination patterns
  • nursing strategies to support normal patterns
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4
Q

What factors can influence urination?

A
  • age related changes
  • physical condition/function of kidneys, bladder, and urethra
  • environment
  • fluid balance
  • psychological
  • surgery or diagnostic tests
  • medications
  • psychosocial cultural
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5
Q

What are some age related changes related to urinary output?

A
  • by age 80 30% of nephrons are lost
  • decreased pelvic floor muscle tone and elasticity
  • decreased ability of kidneys to concentrate urine
  • residual urine
  • men suffer from enlarged prostate which causes incomplete emptying
  • women suffer from stress incontinence/increased UTI’s
  • cognitive impairment
  • decreased mobility
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6
Q

Define nocturia.

A

having to wake at night for one or more times to void

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7
Q

What is residual urine?

A

urine left in bladder after voiding, increases risk of infection

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8
Q

What is a result of decreased pelvic floor muscle tone and elasticity?

A

Causes frequency of urination and nocturia

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9
Q

How do physical condition/function of kidneys, bladder, and urethra effect urinary output?

A
  • diseases that affect the nervous system (stroke, parkinsons), UTI’s, tumours, blockages (stricture, stones), MS, spinal cord injury, diabetes
  • conditions which affect the blood flow to the kidneys results in oliguria or anuria
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10
Q

Define oliguria.

A

decreased capacity to form urine

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11
Q

Define anuria.

A

inability to produce urine due to fluid loss of another means (hemorrhage, diarrhea, CHF (congestive heart failure), etc.)

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12
Q

What are some environmental factors that may affect urination?

A
  • access to bathroom

- assistance

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13
Q

What fluid balance issues affect urination?

A
  • increase in fluid increases output
  • polyuria
  • diuresis
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14
Q

Define polyuria.

A

excess urine output, common in diabetics

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15
Q

Define diuresis.

A

increased production of urine and excretion

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16
Q

What psychological issues can affect urination?

A
  • embarrassment

- need for own bathroom

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17
Q

What affect does surgery/diagnostic test have on urination?

A
  • may cause localized edema or spasm
  • surgery may produce difficulty in initiating urine stream
  • surgery to urinary system
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18
Q

What affect to medications have on urination?

A
  • may affect production of urine by affecting electrolyte balance
  • may affect kidney or bladder directly
  • may need to adjust dose
19
Q

What psychosocial/cultural issues affect urination?

A
  • incontinence may impact self worth or self image, sexuality
  • may need to social isolation
  • may have cultural influences (types of facilities, religious practice, male or female nurse aiding)
20
Q

What are Gordon’s elimination patterns questions?

A
  • normal output
  • changes
  • experience urinary frequency, dysuria, nocturia, urgency, incontinence, hematuria or retention
  • medications
  • excess persperation
21
Q

Define micturition.

A

release of urine from the bladder; urination

22
Q

What are Gordon’s patterns for urination; health history?

A
  • baseline (diary)
  • changes
  • dysuria
  • leakage/dribbling
  • hesitancy
  • frequency
  • incontinence
  • factors that precipitate leakage or incontinence (coughing, sneezing)
  • identify factors that affect urination
  • complete a bladder history
23
Q

What physical aspects should be assessed?

A

Skin, kidneys, bladder, female perineum, male perineum

24
Q

What skin assessment in needed?

A
  • turgor
  • oral mucosa
  • hydration status
  • skin breakdown r/t incontinence
25
Q

What kidney assessment is needed?

A

flank pain r/t infection or inflammation

26
Q

What needs to be assessed on the bladder?

A
  • distention
  • swelling
  • feeling of needing to void
  • tenderness and pain
27
Q

What needs to be assessed on the female perineum?

A
  • check for rashes r/t use of incontinence pads
  • skin integrity
  • redness/inflammation
  • dischange
28
Q

What needs to be assessed on the male perineum?

A
  • discharge
  • inflammation
  • lesion
29
Q

What aspects of urine input and output are assessed and what is cause for concern?

A
  • changes in volume
  • normal input 1500-2000ml /output 1500-1600ml
  • measure input and output
  • report extreme changes
  • oliguria (less than 30ml/ 2hr or 15ml/hour causes for concern)
  • polyuria (more than 2000-2500 ml is concerning)
  • anuria (inability to produce urine)
30
Q

What is normal input and output of urine?

A

normal input 1500-2000ml /output 1500-1600ml

31
Q

Define oliguria.

A

Production of abnormally small amount of urine. Less than 30 ml/2hrs or less than 15ml/hour causes for concern.

32
Q

Define polyuria.

A

Production of an abnormally large volume of dilute urine. Urinating 2000-2500ml a day causes for concern.

33
Q

Define anuria.

A

An inability to produce urine.

34
Q

What are the 4 things that need assessing in urine?

A
  • input output
  • colour
  • odour
  • clarity
35
Q

Describe aspects of assessing colour.

A
  • normal colour is pale to straw coloured to amber (depending on concentration; more concentrated in the morning)
  • presence of blood (hematuria)
  • ask about food intake that could alter colour of urine (beets, dyes from tests)
36
Q

Describe aspects of assessing clarity of urine.

A
  • transparency
  • mucous plugs, thick
  • cloudy, foamy
37
Q

If urine is cloudy or foamy what might this indicate?

A

bacterial infection or high protein intake

38
Q

Define hematuria.

A

presence of red blood cells in the urine

39
Q

Describe the aspects of odour for assessment in urine.

A
  • faint aromatic

- strong, offensive, musty, ammonia

40
Q

What could cause strong offensive smelling urine?

A
  • infection
  • asparagus, etc
  • excess glucose excretion
41
Q

What are 2 types of urine tests?

A

Urinalysis R&M (routine and microscopic)

Urine culture for C&S (culture sensitivity)

42
Q

What does urinalysis R&M (routine and microscopic) test for?

A
  • pH
  • protein (nitrogen not typically in urine)
  • glucose
  • ketones (fat metabolism)
  • blood (may have a few red blood cells
  • specific gravity and kidneys not concentrating
  • stones
43
Q

What does the urine culture C&S (culture sensitivity) test for?

A

bacteria

NRS 125 (6 decks)

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