Urinary elimination labs Flashcards
A patient specific gravity results was 1.010. Is this normal or abnormal and if its abnormal what does it mean?
Normal
1.005-1.030
A patient specific gravity results was 1.001. Is this normal or abnormal and if its abnormal what does it mean?
Abnormal
<1.005 means renal disease or overhydration
A patient specific gravity results was 1.036. Is this normal or abnormal and if its abnormal what does it mean?
Abnormal
> 1.030 means dehydration
Protein- Positive Glucose-Negative Ketones- Negative RBC- 2 Bilirubin- Negative Nitrite- Negative Whats wrong?
Positive protein means : Renal disease
Protein- Negative Glucose- Positive Ketones- Negative RBC- 2 Bilirubin- Negative Nitrite- Negative Whats wrong?
Positive Glucose means abnormal glucose metabolism, such as diabetes
Protein- Negative Glucose-Negative Ketones- Positive RBC- 2 Bilirubin- Negative Nitrite- Negative Whats wrong?
Positivie Ketones means poorly controlled diabetes
Protein- Negative Glucose-Negative Ketones- Negative RBC- 4 Bilirubin- Negative Nitrite- Negative Whats wrong?
3 or more means UTI, cancer in urinary tract, or trauma
Protein- Negative Glucose-Negative Ketones- Negative RBC- 2 Bilirubin- Positive Nitrite- Negative Whats wrong?
Positive Bilirubin means Gallbladder or liver disease
Protein- Negative Glucose-Negative Ketones- Negative RBC- 2 Bilirubin- Negative Nitrite- Positive Whats wrong?
Positive Nitrite means UTI
Positive Leukocyte, WBC, or Bacteria means……
UTI
Labs
BUN “blood urea nitrogen”
23mg/dl means what
> 20 mg/dL means
- Renal disease
- Liver disease
- Bleeding in the GI tract
- Dehydration
Labs
BUN “blood urea nitrogen”
8 mg/dl means what
<10 mg/dL means
- Renal dysfunction
- Overhydration
What is normal BUN levels?
10-20 mg/dL
What are normal Creatinine levels?
0.5-1.2 mg/dL
What does Creatinine level over 1.2 mg/dL mean?
- renal dysfuntion
- dehydration
Normal urine output:
1500mL/ 24
Minimum urine ouput:
30 mL/hr or 0.5 mL/kg/hr
Bladder holds
-need to void occurs about 200-450 mL
About 400-500 mL/voiding
Urge incontinence
overactive bladder
inability to reach the bathroom
large amount of incontinence
try pelvic floor exercises or kegel’s
bladdertraining- know how long they can go without having to pee
Nursing interventions:
- Avoid bladder irritants
- Pelvic floor exercises (PFME) or Kegel’s
- Bladder training
- Medications
Stress incontinence
increased abdominal pressure
abdominal muscles not strong enough to keep it from coming out
ex. laughing, sneezing. seen in pregnancy pt’s
try pelvic floor exercises
bladder training
weight reduction
Nursing interventions:
- PFME
- Bladder training
- Weight reduction
Mixed incontinence
combination of urge and stressed
Overflow incontinence
bladder so full that a little dribbles out. can happen often
sometimes due to enlarged prostate
Functional incontinence
inability or blockage, can’t get to bathroom
no urinary or psychosocial reason
prompted toileting
hourly rounding
remove the barrier
Nursing interventions:
- Prompted toileting
- Hourly rounding and the 4 Ps
- Remove the barrier
Reflex incontinence
neurological problem– stroke, spinal cord injury, bladder being damaged
scheduled voiding
intermittent catheterization
Nursing interventions:
- Scheduled voiding
- Intermittent catheterization
Urinary diversions
Cutaneous (skin) Ureterostomy (opening)
surgery reroutes the ureter directly to surface of abdomen forming a small stoma
limited use bc it provides a pathway for pathogens to enter the kidney drainage bag
Urinary diversions
Conventional urostomy
most common type
small piece of ileum used to make a patch into which the ureters are implanted.
urine drains continuously from stoma & is collected in a pouch (drainage bag)
Urinary diversion
Continent urinary reservoir
valve.
same as ileal conduit but instead of urine constantly flowing, the patient inserts a catheter into the stoma to drain urine through the valve no drainage bag
Urinary diversion
Neobladder
mimics the function of a urinary bladder.
portion of intestine is removed and put in same location as bladder
patient must work on pelvic floor exercises
most natural
