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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
Q

What questions are you asking the patient

A

How often do you urinate?
Characteristics of urine?
Recent changes in urine elimination
Recent or past urinary elimination problems

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26
Q

What’s one important medication to give the patient who has urinary elimination

A

Opioid: it is a stool softener which lessens constipation

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27
Q

What order do you assess the abdomen

A

Inspect
Auscultate
Percuss
Palpate

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28
Q

What are you assessing

A
  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
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29
Q

Name some nursing diagnosis related to urinary elimination

A

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

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30
Q

What are some patient goals/planning

A

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

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31
Q

Implementation

A

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

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32
Q

What are some common causes of urinary elimination

A

Dysuria: pain with elimination
Bladder control
Trauma
Infection
Obstruction: urinary retention
Illnesses: hypertension, diabetes and ckd(chronic kidney disease)

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33
Q

What is dysuria

A

Pain or difficulty with urination

34
Q

What are some causes of dysuria

A

Infection: uti
Trauma to perineal area
Vaginal or urethral irritation
Pregnancy
Depression
Urologic obstruction

35
Q

What are some findings that might show that your patient has dysuria

A

Fever
Flank pain (towards back)
String smelling urine/ foul smell
Cloudy urine
Increase I’m frequency to urge
Hesitancy
Burning or tingling

36
Q

What are some interventions

A

Monitor for changes
Promote ambulation
Keep the perineal area clean and dry
Promote good hand hygiene
Increase fluid intake
Admin med

37
Q

How much fluid intake should we have

A

2-4 liters a day

38
Q

What is urinary retention

A

The inability to urinate appropriate amount of urinate voluntarily

39
Q

What might urinary retention cause

A

Bladder distention
Urine accumulation

40
Q

What might cause urinary retention

A

Mediation or surgery
And obstruction
Weakness to the bladder muscle
Neurological: stroke signal from the brain to the bladder is blocked

41
Q

What are some findings to show that a patient has urinary retention

A

Abdominal distention
Increased abdominal pressure
Firmness and pain
Urgency, inability to urinate
Painful urination
Sever lower abdominal pain
Bloating
Frequency
Hesitancy
Urgency
Nocturia

42
Q

What are some nursing interventions for a patient with urinary retention

A

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
Q

What time should a diuretic be prescribed

A

Early morning or early afternoon

44
Q

Whern do we use an indwelling catheter

A

Short term

45
Q

When do we use a intermittent catheter / straight catheter

A

Quadriplegic patient
Chronic urinary retention

46
Q

When do we use a suprapubic catheter

A

When the urethra is blocked
Long term

47
Q

What is the ultimate plan for a patient with incontinence

A

Restore continence and educate patient intervention

48
Q

Transient incontinence

A

Sudden and last up to 6 months
From treatable factors
Eg: uti

49
Q

Stress incontinence

A

Weak pelvic floor muscles
Infra abdominal pressure increases
Eg: laugh, cough or sneeze

50
Q

Urge Incontinence

A

Urine lost during abrupt and string desire to pee

51
Q

Mixed incontinence

A

Combination of stress and urge

52
Q

Overflow incontinence

A

Chronic retention keeping to distention and overflow of the bladder

53
Q

Functional

A

When the patient cannot get to the bathroom
Functional problem
Cognition orientation or physical

54
Q

Reflex/spastic

A

Involuntary loss of urine without the feeling or sensation of need to void
Spinal cord injury

55
Q

Neurologenic

A

Damage to the nervous system with the bladder nerves

56
Q

Total incontinence

A

Continuous, unpredictable loss of urine

57
Q

What are the causes of urinary incontinence

A

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
Q

History and assessment for urinary incontinence

A

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
Q

Nursing intervention for urinary incontinence

A

Teach about diary
Timed voiding
Changes in lifestyle
Prescribed diuretic

60
Q

Are some evidenced based practiced interventions

A
  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
Q

Pelvic floor muscle training/ kegal exercise

A

Usually used for women

62
Q

Timed voiding

A

This is a bladder training on a set schedule
every hour etc

63
Q

UTI: who is at risk

A

Females
Sexually active
Hygiene
Use of diaphragm for birth control
Menopause
Urinary obstruction

64
Q

Infection to the urinary tract is caused by what

A

E. coli

65
Q

Nursing interventions for uti

A

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
Q

Prevent cauti

A
  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
Q

When should you change the catheter

A

Signs and symptoms of infection
Crusting around the meats, sediment in foley
Leakage, blockage or bleeding

68
Q

What should you teach the patient to prevent reoccurring urinary elimination

A

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
Q

Name foods that are good for the gu system

A

Pears
Banana
Winter squash
Green bean
Potatoes
Lean meats
Whole grain
Kale
Cauliflower
Breads
Nuts
Eggs
Berries and vegetables

70
Q

Food that irritate gu system

A

Coffee
Caffeine
Citrus food
Spicy food
Alcohol
Tomato products
Artificial sweeteners

71
Q

Which catheter lessens risk for cauti

A

Straight catheter or intermittent

72
Q

Tools that identify/diagnose altered urinary pattern elimination

A

Urodynamic test
Never e and muscle function
Urine flow rates
Internal and external pressure measured

73
Q

A post residual volume of how much indicates that the bladder is unable to empty properly

A

100 ml

74
Q

How do you assess for functional incontinence

A

Beside commode
Ability to use assistive devices in bathroom
Timed voiding

75
Q

How you document urine

A

How often it occurred
The urine characteristics
Bladder diary

76
Q

How do you document for infants

A

You weigh their diapers

77
Q

For infants who do you teach

A

The parent

78
Q

How many glasses of water a day

A

6-8

79
Q

How to avoid uti with female condom

A

Lubricant

80
Q

Sterile specimen for urine

A

Catheter

81
Q

How to get a sterile specimen of urine

A

From the catheter

Fundamentals (Nurs 113) (11 decks)

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