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Exam 4 > Urinary Elimination > Flashcards

Urinary Elimination Flashcards

1
Q

Primary functions of kidneys

A

filter metabolic wastes, toxins, excess ions, and water from the bloodstream and excrete them as urine.

regulate blood volume, blood pressure, electrolyte levels, and acid–base balance by selectively reabsorbing water and other substances.

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2
Q

Secondary function of kidneys

A
  • Produce erythropoietin
  • Secrete the enzyme rennin
  • Activate vitamin D3 (calcitriol)
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3
Q

Urine is formed in the

A

nephrons

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4
Q

transport urine from the kidneys to the bladder.

A

ureters

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5
Q

stores urine until it is excreted.

A

bladder

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6
Q

transports urine from the urinary

bladder to the body exterior.

A

urethra

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7
Q

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

A

Approximately 200–450 mL of urine in adults

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8
Q

Identify at least three indications for determining whether hydration is adequate and urine output is within normal limits.

A

The person voids 1,500 mL in a 24-hour period in five to six voids.
• An infant has 8–10 wet diapers per day.
• For most adults, pale to clear urine indicates adequate hydration.

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9
Q

What common medications increase the amount of urine voided?

A

Diuretics increase urine output.

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10
Q

What types of medications are associated with urinary retention?

A

Medications with anticholinergic effects may lead to urinary retention.

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11
Q

A ________catheter has a single lumen and is inserted for ______ periods for immediate drainage of the bladder

A

straight

brief

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12
Q

An _________ catheter (Foley or retention catheter) is used for _______bladder drainage and may have two or three lumens

A

indwelling

continuous

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13
Q

Why is intermittent catheterization preferred for patients who must be catheterized over lengthy periods of time?

A

carries a substantially lower risk of infection than an indwelling catheter.

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14
Q

sandy particles around the urethral meatus of an indwelling catheter are signs of

A

encrustation and indicate the catheter should be replaced

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15
Q

How often should the urine collection bag be emptied?

A

Empty the urine collection bag at least every 8 hours, or more often if it is full, to make it more convenient for the patient to ambulate.

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16
Q

Labs - BUN

A

10 to 20

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17
Q

Labs - Creatinine

A

0.4 - 1.5

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18
Q

Important for 24 hour urine collection:

A 
Collect first voiding and discard
Record time
Collect all urine for next 24 hours
Keep container on ice
Complete test by collecting next morning’s first void
Compare I&O to amount in container
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19
Q

means blood can be seen in the urine

A

gross hermaturia

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20
Q

means blood can be only be seen with a microscope

A

microscopic hermaturia

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21
Q

Labs - Specific gravity

A

1.002 - 1.030

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22
Q

13% of Americans have a problem with

A

overactive bladder

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23
Q

Self catheterization is a _________ (clean/sterile) procedure?

A

CLEAN

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24
Q

Big risk factor for bladder cancer

A

smoking

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25
Q

s/s of bladder cancer

A 
blood in urine
frequency
urgency
maybe none until advanced then - 
dysuria, abd pain, pain in bone
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26
Q

Empty stomas when

A

1/2 - 2/3 full or sooner

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27
Q

occasional involuntary passage of urine

A

Enuresis

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28
Q

The size and functioning of the kidneys begin to decrease at about age

A

50

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29
Q

urination also called _______ and ______

A

voiding and micturition

30
Q

The kidneys produce about _________ of urine per hour, or_______mL per day

A

50 to 60 ml or 1500

31
Q

measure of dissolved solutes in a solution

A

Specific gravity

32
Q

The normal specific gravity range for urine is

A

1.002 to 1.030.

33
Q

Older adult Changes in Urinary:

A

lose ability to dilute and concentrate urine
reduction in renal blood flow & filtration
reduced bladder capacity - frequency/urgency/nocturia

34
Q

Caffeine acts as a _____ and ______ urine production

A

diuretic and increases

35
Q

alcohol impairs the release of _________ hormone (ADH), resulting in__________ production of urine.

A

antidiuretic

increased

36
Q

a diet high in salt causes water________ and _______urine production.

A

retention and decreases

37
Q

Risk factors for UTI

A

Sexually active women (short urethra)
Menopausal women (estrogen)
pregnant women
Diabetes (glucose in urine)

38
Q

most common microorganism for UTI

A

Escherichia coli (E coli)

39
Q

Interventions for UTI

A 
lots of water
showers instead of baths
don't hold it in
cranberry juice - (doesn't allow organism to stick)
wipe from front to back
40
Q

Which blood studies are commonly used to to assess renal function and hydration?

A

Blood urea nitrogen (BUN) and creatinine levels

41
Q

Normal BUN

A

8–20 mg/dL

42
Q

Normal creatinine

A

0.5–1.1 mg/dL

43
Q

Direct visualization of the urethra, bladder, and ureteral orifices by insertion of a scope.

A

Cystoscopy

44
Q

Done to determine whether a muscle or nerve problem is causing problems with how well the bladder holds or releases urine. A catheter is inserted into the bladder and a pressure probe into the rectum.

A

Cystometry

45
Q

uses intravenous radiopaque contrast medium to visualize the kidneys, ureters, bladder, and renal pelvis. It evaluates renal function by analyzing flow of contrast over time.

A

Intravenous Pyelogram (IVP

46
Q

uses radiopaque contrast medium to visualize the renal collecting system. Contrast media is injected via a ureteral catheter inserted through a cystoscope.

A

retrograde pyelogram

47
Q

Causes of urinary retention

A 
obstruction
enlarged prostrate
spinal cord injuries
medications/anesthesia 
removal of catheter
48
Q

The client must cleanse the genitalia before voiding and collect the sample in midstream because the initial flow of urine may contain organisms from the urethral meatus, distal urethra, and perineum. A midstream sample is free of these contaminants

A

clean catch specimen

49
Q

Obtain this specimen by inserting a catheter into the bladder or by withdrawing a sample from an indwelling catheter. Do not take the specimen from the collection bag because that urine may be several hours old.

A

Sterile urine specimen

50
Q 
Urinalysis WNL
Color
odor
ph
specific gravity
glucose
ketone
protein
A 
A freshly voided sample is pale yellow to deep amber.
Fresh urine has a scent.
5.0-9.0, with an average of 6.0
1.002–1.030
Negative
Negative
< 20 mg/day
51
Q

Blood in the urine.

A

Hematuria

52
Q

Gross hermaturia

A

can be seen in the urine

53
Q

The absence of urine, or urine output of less than 100 mL in 24 hours

A

Anuria

54
Q

Painful or difficult urination

A

Dysuria

55
Q

Involuntary loss of urine.

A

Enuresis

56
Q

Urine output of less than 400 mL in 24 hours.

A

Oliguria

57
Q

Excessive urination.

A

Polyuria

58
Q

Credé’s maneuver

A

manual pressure over the bladder

59
Q

Presence of __________ indicates impaired carbohydrate metabolism (e.g., diabetes, fever, fasting, high-protein diets, starvation, vomiting, or the post-anesthesia period)

A

ketones

60
Q

is a single-lumen tube that is inserted for immediate drainage of the bladder (e.g., to obtain a sterile urine specimen, to measure PVR volume, or to relieve temporary bladder distention). After the bladder is empty or the sample obtained, the catheter is removed and the patient resumes voiding independently.

A

Straight catheter

61
Q

also known as a Foley or retention catheter, is used for continuous bladder drainage (e.g., when the bladder must be kept empty or when continuous urine measurement is needed). It is usually a double-lumen tube: one lumen is used for urine drainage, and the second lumen is used to inflate a balloon near the tip of the catheter.

A

indwelling catheter

62
Q

used when the patient requires intermittent or continuous bladder irrigation. The inflated balloon holds the catheter in place at the neck of the bladder. The balloon is sized according to the volume of fluid used to inflate it. For most patients you will use a 5-mL balloon; and for achieving hemostasis after a prostatectomy, a 30-mL balloon

A

triple lumen catheter

63
Q

is used for continuous urine drainage when the urethra must be bypassed (e.g., after gynecological surgery or where there is prostatic obstruction). It is inserted through an incision above the symphysis pubis

A

suprapubic cathete

64
Q

CBI is ____ _____ _____ and monitoring ____ & ____ is important

A

continuous bladder irrigation

I&O

65
Q

is a surgically created opening for elimination of urine

A

urinary diversion, or urostomy

66
Q

Is the most common type of urinary diversion because it is the simplest to perform surgically and eliminates the need for ______ ________

A

ileal conduit

intermittent catheterization

67
Q

is used to treat bladder and urethral pain, burning, increased urination, and increased urge to urinate. This medication turns the urine a deep orange-red color and is classified as an

A

Pyridium

Analgesic

68
Q

Medication for incontinence

A

oxybutynin (Ditropan)

69
Q

Medication for retention

A

Bethanechol (Urecholine)

70
Q

Medication for dribbling/overflow (think men/prostrate)

A

Tamulosin (Flomax)

Exam 4 (14 decks)

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