Urinary Elimination Flashcards
Kidneys
Remove waste from the blood to form urine
Functional unit of the kidneys
Nephron
what kind of muscle are ureters made of?
Smooth muscle, they are smooth muscle tubules
Function of the ureters
Transport urine from the kidneys to the bladder
What is the bladders purpose?
Storage compartment. It is a reservoir for urine until the urge to urinate develops
Urethra
Urine travels from the bladder and exits through the urethral meatus
When should inflants void after birth?
Within 24 hours
Kidneys Functions
- Filter waste from the blood 2. Produce substances that from red blood cells (ethropoeitin) 3. Fluid and electrolyte balance 4. Blood pressure control (RAAAASTA)
What does hypertension lead to?
Decreased urine
What worries is about extra potassium?
Worried about the heart
Brain structures that influence bladder emptying
Cerebral Cortex, Thalmus, Hypothalmus, Brain Stem
What does normal voiding involve?
Contraction of the bladder muscles and relaxation of the urethral spinchter
Maturation
The act of peeing
What can happen after surgery?
Stress—ADH release—urinary retention
Factors influencing urination
Amount of urine in bladder, increasing urine volume stimulates the micturation center in the spinal cord, normally voiding is a voluntary process
How much urine does a normal adult hold?
600 mL is full. 250-400 is normal
Process of peeing
Pressure stresses the detrusor muscles forces bladder open. Sends sensation to spinal cord, reflex back, detrusor contracts
Factors affecting urination: Preneral
(not purfusing well) decreased blood flow to and thru the kidneys
Factors affecting urination: Renal
Diseases in kidney. Disease conditions of the renal tissue
Factors affecting urination: Postrenal
Obstruction. Obstruction in the lower urinary tract
Hydropneprosis
Distention and dilation of kidney pelvis. Obstruction can cause this
Disease/Conditions that influence urination
Diabetes, Multiple Scelerosis, BPH, Cognitive disorders (Alzheimers), End-Stage renal disease
Other Factors that influence urination
Sociocultural factors, psychlogical factors, fluid balance, surgical procedures, medications, diagnostic examination
Are upper or lower UTIs more serious?
Upper. Ureters and kidneys
Where do lower UTIS take place?
Urethra and bladder
Nocturia
Waking up to pee. Should normally be able to sleep 7-8 hours without having to pee
Polyuria
2500-3000 mL/day
Oliguria
Less than 500 mL in 24 hours
Anuria
Less than 100 mL in 24 hours
Diuresis
Lots of urine. Usually because of diuretic
Cystitis
Bladder inflammation
Hematuria
Blood
Pylonephritis
Renal pelvis
Nocturnal Enuresis
peeing the bed
When should you be able to palpate the bladder?
Greater than 600 mL
Urinary retention
Accumulation of urine resulting from an inability of the bladder to empty properly. Bladder unable to the micturation reflex
Possible causes or urinary retention
urethral ubstruction (stone/tumor), surgical trauma, child birth, alterations in sensory innervation, anxiety, side effects of medications
UTIs
Most common healthcare associated infection
What can UTIs be caused by in a healthcare setting?
Catheterization, surgical manipulation, 75-90% caused by ecoli
What is the leading cause of UTI and sepsis
Indwelling (foley) catheter
Urinary Incontenence
Worsens with aging. 50% of all long term care residents suffer from incontinence
Urinary Diversion
Taking normal pathway of urine and re-routing it
Causes of urinary diversion
cancer of the bladder, trauma, radiation, chronic cystitis
Suprapubic stoma
Takes urine right out of the bladder
Nephrostomy
Goes right into kidney. The ureters arnt working
Urostomy
Made from part of the intestine. Still have ureters
Neo bladder
Make a pouch out of the small intestine
Dialysis
Can be short or long term
Peritoneal Dialysis
Right into abdomen. Can be done at home. It is indirect and uses osmosis and and diffusion. Peritoneum uses a semipermeable membrane. Sterile solution instilled into peritoneum by gravity, left for time, drained out
Hemodialysis
Usually about 2-4 hours, 3 days a week. Mechanical filtering of blood via membrane. Blood exits and returns via A/V fistula, CVL (central venous line)
Kidney Transplant
Only cure for normal kidney function. On immunosuppresent medication for life.
normal urine values
clear, straw yellow to light amber, slight ammonia odor, ph 4.6-7.8, SG 1.010-1.035
What can Amber colored urine indicate?
Rhabdo, liver failure, blood
Increased urine pH
Respiratory or metabolic alkalosis, gastric suction, vomiting, UTI
Decreased urine pH
Metabolic acidosis, diabetes, diarrhea, respiratory acidosis
Abnornal Findings: Increased Protein
Diabetes, CHF, Precalampsia, glomerulonephritis, polycystic disease, lutus erythematous, heavy metal poisoning, bladder tumor
Abnoraml Findings: SG concentrated
dehydration, glycosuria proteinuria, fever, vomiting, diarrhea
Abnormal Findings: DG Diluted
overhydration, renal failure, hypothermia, pyelonephritis
Low and High end SG
1.010 and 1.035
Abnormal Findings: Increased RBC
glomerulonephrits, acute tubular necrosis, cystits, traumatic catheterization
Abnormal Findings: increased WBC
Bacterial infection in urinary tract, glomerulonephritis, acute pyelonephritits, lufus
Cloude catheter
curved tip, easier to put in males with enlarged prostate
Common Urinary Alterations
urgency, frequency, hesitancy, retention, dribbling, incontinence, residual urine
Obtaining a urine speciman
random (anywhere), clean-catch (dont use first bit, clench and then pee), sterile (collected from catheter), timed collection (24 hr urine collection, done to see of theres kidney damage)
