Urinary Elimination - Exam IV Flashcards
what physical risk factors affect urinary elimination?
- infection
- irritable/overactive bladder
- obstruction in urine flow
- impaired bladder contractility
- sensor/motor dysfunction
-surgery/anesthesia
-age related changes (decrease capacity/control)
what psychological risk factors affect urianry elimination?
- self-concept,
- culture
- sexuality
- anxiety stress
- diet/meds
What are the diagnostic tests and for urinary elimination
- Routine urinalysis
non invasive: abodminal roentgenogram - CT scan of abdomen and pelvis
- Intravenous pyelogram (IVP)
- ultrasound of renal bladder (<100mL)
Invasive: Cystoscopy - midstream clean-catch urine - timed specimens
- sterile specimen via straight cath
collections from an indwelling catheter
Normal routine urinalysis lab value
pH (4.6-8.0)
Protein (up to 8mg/100ml)
Glucose (not present)
Ketones (not present)
Specific Gravity (1.005-1.030)
Microscopic Exam RBCs (up to 2)
WBCs (04)
Bact (not present)
Casts (not present)
Crystals (not present)
What are normal examinations for Urinary elimination?
- check usual pattern
- check urine charactersitics for color, clarity, oder, presence of blood,
- check for changes (nocturia? leackage? dribbling? frequency? urgency? amlunt?
- check intake/output ( (o.5 mL/kg/hr)
- bladder distension
-fluid status - systemic signs of infection
Nursing considerations for routine urinalysis
- collect during normal voiding
- use clean specimen cup
- reagent strips in some settings
Nursing considerations for clean-void/midstream
- sterile specimen cup always
- pt. may do after detailed instruction
Nursing considerations for sterile specimen for culture and sensitivity
- with an indwelling cath collect with sterile aseptic technique through sampling port NEVER from the drainage bag
Nursing considerations for TImed urine specmens
- collections at specific time of day ofver specific time period
- depending on test, urine container may be kept cool by setting it in a container of ice
- no feces or toilet tissue
Nursing considerations for abdominal roentgenogram
no special prep
Nursing considerations for CT of abdomen and pelvis
prep: explain tp pt.
check for allergies
restirct food/fluid 4 hours before test
After: give fluids to get rid of dye
Pt. Teaching:
pt placed o on a special bed that will move though a tunnel like imaging chamber , pt will need to lie still
Nursing considerations for IVP
prep: assess for allergies to iodinated dyes and shellfish
assess for dehydration
after: assess urine output less than 30ml/h increases risk for contrast-induce nephropathy
pt teaching: facial flushin normal response during dye injection. may feel dizzy, warm, some nausea
Nursing considerations for ultrasound
may be instructed to void or come with full bladder do not do within 24 hrs of IVP
Nursing considerations for cytoscopy
pt teaching: urine may be pink tinged after procedure and sings and symptoms of a UTI
What are the assessments, priority interventions, and evaluations of urinary elimination
perform bladder scan,
voiding schedule
monitor for trend of UTI
facilitate tight control of blood glucose
educate patient on bladder training
evalu:
voiding Q2-3
urine output >.5ml/kg/hr
no dribbling, hsitancy or weak stream
no pain
no distension
