Urinary Elimination Flashcards
Excessive output of urine (diuresis)
Polyuria
Low urine output; 24 hour output < 400 mL
Oliguria
Complete kidney shutdown, renal failure; 24 hours output < 50 mL
Anuria
Voiding 2 or more times at night
Nocturia
Feeling that the person must void
Urgency
Increased incidence of voiding
Frequency
Voiding that is painful or difficult
Dysuria
Emptying of bladder is impaired; bladder becomes over distended
Urinary Retention
person does not perceive bladder fullness and is unable to control the urinary sphincters due to dysfunctional neurological function
Neurogenic bladder
Involuntary loss of urine
Incontinence
Reasons for catheterization
Relieving urinary retention (Ms.Wagner)
Obtaining a sterile urine specimen
Obtaining a urine specimen (when usual methods can’t be used)
Emptying bladder before, during, or after surgery
Monitoring critically ill patients
Increasing comfort for terminally ill patients
Urge Incontinence
Sudden need to urinate Caused by bladder contractions Bladder may not be full Over active Bladder Causes Inflammation, infection, neurological disease BPH, “Overactive bladder” Treated with anticholinergic medicines May increase symptoms of dementia
Stress incontinence
Involuntary loss of urine (coughing, laughing, standing, exercising)
Cause
Childbirth, Menopause, Chronic Constipation
Not a complication of normal aging
Treatment
Kegal Exercises
Surgery
High post-void residual incontinence (overflow incontinence)
Indicates urinary retention
Only type of urinary incontinence for which a urinary catheter may be used
Patient may require indwelling catheterization or
Intermittent urethral catheterization
Can result from neurogenic bladder
transient incontinence
D = delirium or acute confusion I = infections (UTI) A = atrophic vaginitis P = pharmocologic agents P = psychiatric disorders (depression; sedative and antianxiety agents) E = endocrine disorders R = restricted mobility S = stool impaction
Functional incontinence
Inability to reach toilet or adjust clothing Cause Mobility deficits, visual loss, dexterity, dementia, severe depression, medications (sedatives) Caregiver inattention Toilet inaccessible Treatment Treat underlying cause Assist with mobility
Quality of Life Issues r/t incontinence
Isolation
Alterations in lifestyle
Depression
Impaired sexual function
nursing interventions to manage urinary incontinence in the older adult
Maintain fluid intake
Provide easy access to the bathroom
Assess factors that influence voiding
Use assistive devices when necessary (examples?)
Use collection devices when necessary (examples?)
Encourage safety when ambulating (how?)
Encourage performance of kegel exercises several times daily
Encourage participation in a bladder retraining program
Nursing interventions for nocturia, frequency and urgency in the older adult
Ensure easy access to the bathroom or commode.
Use night light.
Discourage fluid intake at bedtime.
Discourage alcohol use before bedtime.
Evaluate med. Regimen.
Use clothing that is easily removed for voiding
Keep assistive devices readily available
Evaluate gait and ability to ambulate safely
Asses for urinary tract infection
