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Fundamentals (Nurs 113) > Urinary Elimination (Exam 2) > Flashcards

Urinary Elimination (Exam 2) Flashcards

1
Q

How does the kidney help maintain normal bodily functions

A

Remove urea and excess water
Regulates the ph
Secrets hormones that manages homeostasis
Marian’s sodium, potassium, chloride, bicarbonate, magnesium, copper and phosphate

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2
Q

What is the role of the bowels in elimination

A

Maintains immunity
Produces bicarbonate
Removes solid waste from the body
The bacterial flora absorbs nutrients, vitamins and protect the gut

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3
Q

When you do a physical assessment for characteristics of urine what are u looking for?

A

The color
pH
Specific gravity: 1.15-1.025
Constituent: urine acid , creatinine
Odor
Turbidity

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4
Q

What is the normal color of urine. And what is abnormal

A

Normal is pale yellow or amber
Dark colored urine

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5
Q

Normal ph range of urine

A

5-6 with a range of 4.5-8

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6
Q

What is the normal specific gravity for urine

A

1.015-1.025

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7
Q

What is the normal smell for urine

A

Urine should be aromatic. If it is sweet in smell is a sign of glucose

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8
Q

Normal findings for turbidity of urine

A

Should be clear or translucent

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9
Q

Abnormal findings for turbidity of urine

A

Freshly voided is cloudy

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10
Q

What assessment can be used to identify altered elimination

A

Physical characteristics
Intake and output
Bladder assessment
Voiding pattern
Urine output measurement incontiney patients: foley
Urine output measurement continent patient who are incontinent: remove foley after use

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11
Q

What are some habits or conditions that cause a risk factor with altered urinary elimination

A

Smoking
Pregnancy
Pain
Impaired mobility
Sedentary lifestyle or not exercising enough
Impaired muscle tone in abdomen
Decrease exercise gastrointestinal mobility
Not drinking enough water
Constipation

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12
Q

Who is at greater risk for UTI

A

Pregnant women
Sexually actively with genitalia
People who use diaphragm for contraception: silicone cup inserted in vagina
People with diabetes
Older adults
This e with urinary catheter
Post menopausal

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13
Q

Pathological conditions that causes altered urinary elimination

A
  1. Congenital GI tract abnormalities or bladder disease
  2. Renal failure: inability to remove waste or regulate fluid, electrolyte and ph balance in the body
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14
Q

What test and procedures should we do for one’s with alteration in urination

A

Urinalysis
Specific gravity from urine
Bladder scan
Clean catch midstream spicemen
Urine culture
24 hour urine collection

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15
Q

What is the normal specific gravity

A

1.015-1.025

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16
Q

What is the normal intake of fluid daily

A

2,000-3,000 ml daily

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17
Q

Purpose of a bladder scan

A

Obtain bladder volume post void residual

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18
Q

Clean catch midstream spicemen

A

To confirm a urine infection and determine the best antibiotics to treat the infection

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19
Q

How much ml of urine for clean catch test

A

3 ml

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20
Q

Which urine test is used for a urine sample

A

Midstream clean catch

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21
Q

Urine culture: how do you obtain this?

A

Obtain a sterile urine specimen via a port of urinary catheter

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22
Q

Which urine sample is strike and which one is not sterile

A

Sterile: collected from the bladder (catheter)
Non sterile: collected from a container (bed pan)

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23
Q

Purpose of. 24 hour urine collection

A

Check for kidney problem, protein, hormone or mineral in urine
Provide enough hormone

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24
Q

How can kidney stone affect urinary elimination

A

Cause urinary elimination problems

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25
What questions are you asking the patient
How often do you urinate? Characteristics of urine? Recent changes in urine elimination Recent or past urinary elimination problems
26
What’s one important medication to give the patient who has urinary elimination
Opioid: it is a stool softener which lessens constipation
27
What order do you assess the abdomen
Inspect Auscultate Percuss Palpate
28
What are you assessing
1. Inspect the abdomen for any distention 2. Palpate for tenderness or masses 3. Assess bladder for pain/burning upon urination 4. Assess urine color, odor and sediment 5. assess urinary retention (bladder scan) 6. Inspect urethral Meatus for signs of inflammation 7. Skin color, texture, turgor, excretion of wastes and integrity 8. Inspect presses if urinary catheter diversion
29
Name some nursing diagnosis related to urinary elimination
Incontinence Urinary retention Pattern altercation Risk for infection related to INDWELLING catheter Actuate pain related to bladder spasm, dysuria, retention, kidney infection Impaired skin integrity related to incontinence
30
What are some patient goals/planning
Incontinence under control Maintain fluid, electrolytes and acid base Patient able to demonstrate appropriate hygienic self care behaviors Schedule toilet time Urine output almost equal to fluid intake
31
Implementation
Provide privacy and time to urinate Upright position to urinate Encourage adequate fluid intake 2-4 liters a day Limit high caffeine foods, sodium and sugar Assist with toilet Keep perineal area dry Promote mobility Provide and teach catheter care Initiate bladder training
32
What are some common causes of urinary elimination
Dysuria: pain with elimination Bladder control Trauma Infection Obstruction: urinary retention Illnesses: hypertension, diabetes and ckd(chronic kidney disease)
33
What is dysuria
Pain or difficulty with urination
34
What are some causes of dysuria
Infection: uti Trauma to perineal area Vaginal or urethral irritation Pregnancy Depression Urologic obstruction
35
What are some findings that might show that your patient has dysuria
Fever Flank pain (towards back) String smelling urine/ foul smell Cloudy urine Increase I’m frequency to urge Hesitancy Burning or tingling
36
What are some interventions
Monitor for changes Promote ambulation Keep the perineal area clean and dry Promote good hand hygiene Increase fluid intake Admin med
37
How much fluid intake should we have
2-4 liters a day
38
What is urinary retention
The inability to urinate appropriate amount of urinate voluntarily
39
What might urinary retention cause
Bladder distention Urine accumulation
40
What might cause urinary retention
Mediation or surgery And obstruction Weakness to the bladder muscle Neurological: stroke signal from the brain to the bladder is blocked
41
What are some findings to show that a patient has urinary retention
Abdominal distention Increased abdominal pressure Firmness and pain Urgency, inability to urinate Painful urination Sever lower abdominal pain Bloating Frequency Hesitancy Urgency Nocturia
42
What are some nursing interventions for a patient with urinary retention
Teach the patient about a bladder diary Timed voiding Losing weight, decrease caffeine intake, avoid constipation and lifting heavy Prescribed diuretic morning or early afternoon
43
What time should a diuretic be prescribed
Early morning or early afternoon
44
Whern do we use an indwelling catheter
Short term
45
When do we use a intermittent catheter / straight catheter
Quadriplegic patient Chronic urinary retention
46
When do we use a suprapubic catheter
When the urethra is blocked Long term
47
What is the ultimate plan for a patient with incontinence
Restore continence and educate patient intervention
48
Transient incontinence
Sudden and last up to 6 months From treatable factors Eg: uti
49
Stress incontinence
Weak pelvic floor muscles Infra abdominal pressure increases Eg: laugh, cough or sneeze
50
Urge Incontinence
Urine lost during abrupt and string desire to pee
51
Mixed incontinence
Combination of stress and urge
52
Overflow incontinence
Chronic retention keeping to distention and overflow of the bladder
53
Functional
When the patient cannot get to the bathroom Functional problem Cognition orientation or physical
54
Reflex/spastic
Involuntary loss of urine without the feeling or sensation of need to void Spinal cord injury
55
Neurologenic
Damage to the nervous system with the bladder nerves
56
Total incontinence
Continuous, unpredictable loss of urine
57
What are the causes of urinary incontinence
Temporary: spicy, acid food, citrus food,chocolate, alcohol, caffeine, carbonated drinks, artificial sweeteners, surgery, medication Chronic: ages, pregnancy, childbirth, menopause, BPH, UTI, DM, prostate cancer, tumor, neurological disorders
58
History and assessment for urinary incontinence
Obtain a list of traditional and non traditional medications Timing and volume of urine What patient does when the leakage occurs How often Nocturia? Abdominal assessment PCP for gyn exam
59
Nursing intervention for urinary incontinence
Teach about diary Timed voiding Changes in lifestyle Prescribed diuretic
60
Are some evidenced based practiced interventions
1. Fluid intake of 2,000-3,000 2. Intake and output 3. Promote privacy and hygiene 4. Normal voiding habits 5. Obtain urine specimens 6. Assess skin integrity 7. Bedside assessment 8. Bladder diary
61
Pelvic floor muscle training/ kegal exercise
Usually used for women
62
Timed voiding
This is a bladder training on a set schedule every hour etc
63
UTI: who is at risk
Females Sexually active Hygiene Use of diaphragm for birth control Menopause Urinary obstruction
64
Infection to the urinary tract is caused by what
E. coli
65
Nursing interventions for uti
Wipe from front to back Keep perineal area dry and clean Urinate when you feel the urge Showers instead of bath tub Wear cotton underwear Increase fluid intake Avoid caffeine, species, alcohol, carbonated drinks Administer antibiotics
66
Prevent cauti
1. Assess the urinary output and characteristics 2. Maintain the tubing below the waistline 3. Wipe the end of the catheter with antiseptic solution prior to attaching a new drainage 4.empty the foley at least every 8 hour
67
When should you change the catheter
Signs and symptoms of infection Crusting around the meats, sediment in foley Leakage, blockage or bleeding
68
What should you teach the patient to prevent reoccurring urinary elimination
Urine flow by gravity: men stand up , women sit Stop smoking Avoid caffeine ( restrict the amount of caffeine) Avoid constipation Urinate after and before sex Use cotton underwear Maintain healthy weight and exercise Drink at least 2,000-3,000 ml of fluid Urinate in a relaxed positions and wipe from front to back Wait up to 3 minutes Urinate when youfeel the urge Stop drinking at least 2 hour before bed Assist with toileting and measure input Prevent uti
69
Name foods that are good for the gu system
Pears Banana Winter squash Green bean Potatoes Lean meats Whole grain Kale Cauliflower Breads Nuts Eggs Berries and vegetables
70
Food that irritate gu system
Coffee Caffeine Citrus food Spicy food Alcohol Tomato products Artificial sweeteners
71
Which catheter lessens risk for cauti
Straight catheter or intermittent
72
Tools that identify/diagnose altered urinary pattern elimination
Urodynamic test Never e and muscle function Urine flow rates Internal and external pressure measured
73
A post residual volume of how much indicates that the bladder is unable to empty properly
100 ml
74
How do you assess for functional incontinence
Beside commode Ability to use assistive devices in bathroom Timed voiding
75
How you document urine
How often it occurred The urine characteristics Bladder diary
76
How do you document for infants
You weigh their diapers
77
For infants who do you teach
The parent
78
How many glasses of water a day
6-8
79
How to avoid uti with female condom
Lubricant
80
Sterile specimen for urine
Catheter
81
How to get a sterile specimen of urine
From the catheter

Fundamentals (Nurs 113) (11 decks)

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