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Assessment > Urinary Elimination > Flashcards

Urinary Elimination Flashcards

1
Q

Major structures of the urinary system

A

kidneys
ureters
bladder
urethra

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2
Q

Primary functions of the kindey

A
  • filter metabolic wastes, toxins, access ions, and water from the bloodstream and secret them as urine.
  • They also help to regulate blood volume, blood pressure, electrolyte levels, and acid-base balance by selectively reabsorbing water and other substances
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3
Q

secondary functions of the kidneys

A
  • produce erythropoietin
  • secrete enzyme rennin
  • activate vitamin d3 (calcitrol)
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4
Q

Role of ureters, bladder and urethra in urinary elimination

A
  • ureters transport urine from the kidneys to the bladder
  • the bladder stores urine until it is excreted
  • urethra transports urine from the urinary bladder to the body exterior
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5
Q

What quantity of urine in the bladder will stimulate the urge to void

A

200-450 of urine in adults (50-200ml in children) are sufficient to stimulate urination.

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6
Q

three methods for knowing if hydration is adequate and output is normal

A
  • person voids 1500mL in 24 hours in 5-6 voids
  • an infant has 8-10 wet diapers in a day
  • pale clear urine indicates adequate hydration
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7
Q

What medication increases amount of urine voided

A

diuretics

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8
Q

what type of medication are associated with urinary retention

A

anticholinergic effects may lead to urinary retention

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9
Q

What conditions and surgeries are associated with high incidence of altered urination

A

surgeries with pathology involving the genitourinary tract have a high incidence of altered urination

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10
Q

what should you discuss with a patient during a focused history

A
  • normal urination pattern
  • appearance of urine
  • changes in urination habits or urine appearance
  • history of urination problems
  • use of urination aids
  • lifestyle questions
  • presence of urinary diversions if any
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11
Q

Key elements of a physical assessment

A
  • kidneys: examine the kidneys by assessing for costovertebral angle tenderness
  • bladder: asses the bladder with inspection, palpation and percussion.
  • Urethra: asses the urethra by inspecting the urethral orifice. Look for erythema, discharge, swelling or odor. These are all signs of infection, trauma, or inflammation.
  • perineal area: inspect the skin in the perineal area for signs of breakdown or irritation
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12
Q

What activities promote normal urination patterns

A
  • Privacy
  • Assist with positioning: preferred position
  • facilitate toilet routines
  • promote adequate fluid and nutrition: 8 to 10 large glasses a day
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13
Q

An instrument used to measure specific gravity

A

refractometer

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14
Q

the application of gentle, manual pressure over the bladder to promote bladder emptying

A

crude’s maneuver

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15
Q

a urinary diversion that involves implanting the ureters into a small segment of the small intestine, which is then brought to the abdominal wall where a stoma is created

A

conventional urostomy or ill conduit

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16
Q

involuntary urination after the age of 5 or 6 is sometimes this condition

A

enuresis

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17
Q

During chemotherapy what labs should be checked

A

serum blood urea nitrogen and serum creatinine

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18
Q

what is frequently responsible for UTIs

A

esherichia coli

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19
Q

specific gravity

A

is the measure of resolved solutes in a solution. high gravity means the person is dehydrated and low gravity may mean the kidney is not concentrating the urine enough

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20
Q

signs of UTI

A 
back pain
bladder spasms
chills
dysuria
edema
fever
foul0smelling urine
hematuria
sauce and vomiting
pyuria
urgency
urinary frequency
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21
Q

reasons for urinary retention

A 
obstruction
inflammation and swelling
neurological problems
medications
anxiety
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22
Q

urge incontinence

A

involuntary loss of larger amounts of urine accompanied by a strong urge to void. its is often referred to as overactive bladder.

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23
Q

stress incontinence

A

is an involuntary loss of small amounts of urine with activities that increase intra-abdominal pressure. etiological factors include pregnancy, childbirth, obesity, chronic constipation and straining at stool. activities that produce leakage of urine also include exercise, laughing sneezing and coughing

24
Q

mixed incontinence

A

is a combination of urge and stress incontinence

25
Q

overflow incontinence

A

is the loss of urine in combination with a distended bladder. causes of overflow incontinence include fecal impaction, neurological disorders, and enlarged prostate

26
Q

functional incontinence

A

is the untimely loss of urine when no urinary or neurological cause is involved

27
Q

reflex incontinence

A

is loss of urine when the person does not realize the bladder is full and has no urge to void. CNS cause problems

28
Q

enuresis

A

is familial, is involuntary urination after about 5 to 6 years of age, when control is usually established. Is primary if bladder control was never achieved and secondary if control was established and then lost

29
Q

nocturnal enuresis

A

bedwetting

30
Q

acute renal failure (ARF)

A

an acute rise in the serum creatinine level of 25% or more. may be caused by inadequate blood flow to the kidney, injury to the kidney glomeruli or tubules, or obstruction of kidney outflow

31
Q

anuria

A

absence of urine. less than 100mL in 24 hours. often associated with kidney failure or congestive heart failure

32
Q

dysuria

A

painful or difficult urination. associated with infection or partial obstruction o the urinary tract as well s medications that trigger urinary retention

33
Q

end-stage renal disease (ESRD)

A

a chronic rise in serum creatinine levels associated with loss of kidney function that must be treated with dialysis or transplantation. AKA chronic renal failure

34
Q

enuresis

A

involuntary loss of urine

35
Q

hematuria

A

blood in urine. due to trauma, kidney stones, infection, or menstruation.

36
Q

micturition

A

the start of stream of urine

37
Q

nephropathy

A

a broad term meaning disease of the kidney

38
Q

nephrotoxic

A

a substance that damages kidney tissue. some antibiotics, NSAIDs, lead, chemo

39
Q

nocturia

A

frequent urinatiins after going to bed

40
Q

nocturnal enuresis

A

involuntary loss of urine while asleep

41
Q

oliguria

A

urine output of less than 400mL in 24 hours.

42
Q

pessary

A

an incontinence device that is inserted into the vagina to reduce organ prolapse or pressure on the bladder

43
Q

polyuria

A

excessive urination. may be caused by hydration, diabetes mellitus, diabetes insidious or kidney disease .

44
Q

proteinuria

A

the presence of protein in the urine/ may be a sign of infection or kidney disease

45
Q

pyuria

A

pus in the urine. may be caused by lesions or infection in the urinary tract.

46
Q

urgency

A

a sudden, almost uncontrollable need to urinate

47
Q

pyelonephritis

A

an infection of the kidneys

48
Q

cystitis

A

infection involving the bladder

49
Q

urethritis

A

infection of the urethra

50
Q

prostatitis

A

infection of the prostate

51
Q

prompted voiding

A

part of bladder training. learns to void on schedule rather than to empty bladder

52
Q

crede technique

A

is applying manual pressure with your hands to the top portion of the bladder to initiate urine flow

53
Q

Urate crystals

A

common in newborn period. indicated dehydration. in older people they result from too much uric acid in the blood, not age related

54
Q

Cutaneous ureterostomy

A

reroute the ureters directly to the surface of the abdomen forming a small stoma

55
Q

conventional urostomy

A

a small piece of ileum is removed and sutured closed at one end the other end is brought out to the abdominal wall to create a stoma.

56
Q

continent urinary reservoir

A

urine drains from the ureters into a surgically created ileal pouch. stoma created on abdomen with nipple value to prevent leaking. patient inserts a catheter into stoma.

57
Q

neobladder

A

mimics function of urinary bladder. portion of intestine is made into a pouch that is connected to urethra.

Assessment (4 decks)

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