Urinary Elimination

Question 1

The function of the kidneys is to

Answer 1

remove waste from the blood to form urine

Question 2

The function of the ureters is to

Answer 2

transport urine from the kidneys to the bladder

Question 3

The function of the bladder is to

Answer 3

Serve as a reservoir for urine until the urge to urinate develops

Question 4

The function of the urethra is to

Answer 4

transport urine from the bladder to the urethral meatus and exit the body.

Question 5

Additional functions of the kidneys are

Answer 5

• production of erythropoietin (essential for maintaining RBC volume)
• Production of renin, prostaglandin E2, and prostacyclin affecting blood pressure
• Kidneys affect calcium and phosphate regulation

Question 6

What does renin do?

Answer 6

starts a chain reaction that causes water retention, thereby increasing blood volume

Question 7

What does prostaglandin E2 and prostacyclin do?

Answer 7

aids vasodilation

Question 8

Normal urination patterns are

Answer 8

60 mL per hour or 1500 mL per day
range 1000-2000 mL
if less than 30 mL then get Trina/intervene

Most people void 5-6 times per day

Question 9

Specific gravity is the best indicator for …

Answer 9

hydration

Question 10

Developmental factors of newborns and children r/t urination

Answer 10

newborns produces between 15 and 60 mL/kg and may urinate up to 25 times per day for the first 24 hrs gradually declining to 8-10 diapers per day
their normal sp. gravity is 1.008

Toilet training varies but is usually accomplished between 3 and 5 years
Bedwetting should not be concerning until after age 6

Question 11

Developmental factors of the elderly r/t urination

Answer 11

kidney fx decreases with age
filtration rate declines and dilution and concentration of urine is impaired
Risks for drug toxicity, acid-base and electrolyte balances
Bladder volume decreases
Increases frequency of urination

Question 12

Name examples of personal, sociocultural, and environmental factors r/t urination

Answer 12

Lack of time
Lack of privacy
Loss of dignity
Cultural differences

Question 13

Name some substances that can increase urine production

Answer 13

coffee, tea, cola, chocolate and other caffeine laden products
alcohol (impairs production of ADH)

Question 14

Name substances/activities that can decrease urine production

Answer 14

high salt diet
Dehydration
Exercise - causing temporary dehydration

Question 15

How do medications affect urination?

Answer 15

Depends on the med
Diuretics increase elimination
Some medications cause urinary retention
Some cause damage to kidneys (nephrotoxic)

Question 16

What are steps for a clean-catch urine specimen for a female patient?

Answer 16

• Assist the patient to the appropriate facility if needed
• Open the prepackaged kit and remove contents
• Wash your hands and don clean procedure gloves
• Have the patient spread her legs and wash the perineal area with warm water and mild soap
• Open the antiseptic towelette in the kit or pour antiseptic solution over cotton balls.
• With one hand, spread the labia; with the other, cleanse the perineal area front to back making sure to cleanse the urinary meatus.
• Clean the perineal area at least twice, use a new cotton ball each time
• Remove gloves, wash hands, don a second pair of gloves for the procedure
• Put the patient into a semi-Fowler’s position
• Open the sterile specimen without touching the inside of the lid or container
• Hold the container near the meatus
• instruct the patient to begin voiding
• Allow a small stream to pass, then place the container into the stream and collect between 30-60 mL
• Remove the container from the stream and allow the patient to finish voiding
• Carefully replace the container lid and clean the outside of the container
• Label the container and place in carrier for transport
• Remove gloves and wash your hands
• Assist the patient back to bed
• Transport the specimen to the lab

Question 17

What are the steps for a clean-catch urine specimen for a male patient?

Answer 17

• Assist the patient to the appropriate facility if needed
• Open the prepackaged kit and remove contents
• Wash your hands and don clean procedure gloves
• If the penis is uncircumcised, retract the foreskin
• Open the antiseptic towelette in the kit or pour antiseptic solution over cotton balls.
• With one hand grasp the penis, with the other hand, cleanse the meatus in a circular motion outwards and a few inches down the penis
• Remove gloves, wash hands, don a second pair of gloves for the procedure
• Put the patient into a semi-Fowler’s position
• Open the sterile specimen without touching the inside of the lid or container
• Hold the container near the meatus
• instruct the patient to begin voiding
• Allow a small stream to pass, then place the container into the stream and collect between 30-60 mL
• Remove the container from the stream and allow the patient to finish voiding
• Carefully replace the container lid and clean the outside of the container
• Label the container and place in carrier for transport
• Remove gloves and wash your hands
• Assist the patient back to bed
• Transport the specimen to the lab

Question 18

What are the steps to obtaining a sterile urine specimen

Answer 18

• Empty the drainage tube of urine
• Clamp the drainage tube below the level of the specimen port for 15-30 minutes
• Don clean gloves and swab the specimen port with an antiseptic swab
• Insert the needle into the specimen port and withdraw the sample
• Transfer the specimen into a sterile specimen container
• Discard the needle and syringe into the sharps container
• Tightly cap the specimen container
• Remove the clamp from the catheter
• Label and package the specimen
• Transport to the lab

Question 19

What is ARF, acute renal failure?

Answer 19

an acute rise in the serum creatinine level of 25% or more.

Question 20

What is anuria?

Answer 20

the absence of urine

less than 100mL in 24 hours

Question 21

What is Dysuria?

Answer 21

Painful or difficult urination

Question 22

What is end-stage renal disease, ESRD?

Answer 22

A permanent rise in serum creatinine levels associated with loss of kidney function that must be treated with dialysis or transplantation

Question 23

What is Frequency?

Answer 23

The need to urinate at short intervals

Question 24

What is hematuria?

Answer 24

blood in the urine

Question 25

What is Oliguria?

Answer 25

Urine output less than 400mL in 24 hours

Question 26

What is Nephropathy?

Answer 26

disease of the kidney

Question 27

What is Nephrotoxic?

Answer 27

A substance that damages kidney tissue

Question 28

What is Nocturia?

Answer 28

Frequent urination after going to bed

Question 29

What is Polynuria?

Answer 29

Excessive urination

Question 30

What is Proteinuria?

Answer 30

The presence of protein in the urine

Question 31

What is Pyuria?

Answer 31

Pus in the urine

Question 32

What is urgency?

Answer 32

A sudden, almost uncontrollable need to urinate