Urinary Elimination - Nursing Fun Ch 27 Flashcards
The function of the kidneys is to
remove waste from the blood to form urine
The function of the ureters is to
transport urine from the kidneys to the bladder
The function of the bladder is to
Serve as a reservoir for urine until the urge to urinate develops
The function of the urethra is to
transport urine from the bladder to the urethral meatus and exit the body.
Additional functions of the kidneys are
- production of erythropoietin (essential for maintaining RBC volume)
- Production of renin, prostaglandin E2, and prostacyclin affecting blood pressure
- Kidneys affect calcium and phosphate regulation
What does renin do?
starts a chain reaction that causes water retention, thereby increasing blood volume
What does prostaglandin E2 and prostacyclin do?
aids vasodilation
Normal urination patterns are
60 mL per hour or 1500 mL per day
range 1000-2000 mL
if less than 30 mL then get Trina/intervene
Most people void 5-6 times per day
Specific gravity is the best indicator for …
hydration
Developmental factors of newborns and children r/t urination
newborns produces between 15 and 60 mL/kg and may urinate up to 25 times per day for the first 24 hrs gradually declining to 8-10 diapers per day
their normal sp. gravity is 1.008
Toilet training varies but is usually accomplished between 3 and 5 years
Bedwetting should not be concerning until after age 6
Developmental factors of the elderly r/t urination
kidney fx decreases with age
filtration rate declines and dilution and concentration of urine is impaired
Risks for drug toxicity, acid-base and electrolyte balances
Bladder volume decreases
Increases frequency of urination
Name examples of personal, sociocultural, and environmental factors r/t urination
Lack of time
Lack of privacy
Loss of dignity
Cultural differences
Name some substances that can increase urine production
coffee, tea, cola, chocolate and other caffeine laden products
alcohol (impairs production of ADH)
Name substances/activities that can decrease urine production
high salt diet
Dehydration
Exercise - causing temporary dehydration
How do medications affect urination?
Depends on the med
Diuretics increase elimination
Some medications cause urinary retention
Some cause damage to kidneys (nephrotoxic)
What are steps for a clean-catch urine specimen for a female patient?
- Assist the patient to the appropriate facility if needed
- Open the prepackaged kit and remove contents
- Wash your hands and don clean procedure gloves
- Have the patient spread her legs and wash the perineal area with warm water and mild soap
- Open the antiseptic towelette in the kit or pour antiseptic solution over cotton balls.
- With one hand, spread the labia; with the other, cleanse the perineal area front to back making sure to cleanse the urinary meatus.
- Clean the perineal area at least twice, use a new cotton ball each time
- Remove gloves, wash hands, don a second pair of gloves for the procedure
- Put the patient into a semi-Fowler’s position
- Open the sterile specimen without touching the inside of the lid or container
- Hold the container near the meatus
- instruct the patient to begin voiding
- Allow a small stream to pass, then place the container into the stream and collect between 30-60 mL
- Remove the container from the stream and allow the patient to finish voiding
- Carefully replace the container lid and clean the outside of the container
- Label the container and place in carrier for transport
- Remove gloves and wash your hands
- Assist the patient back to bed
- Transport the specimen to the lab
What are the steps for a clean-catch urine specimen for a male patient?
- Assist the patient to the appropriate facility if needed
- Open the prepackaged kit and remove contents
- Wash your hands and don clean procedure gloves
- If the penis is uncircumcised, retract the foreskin
- Open the antiseptic towelette in the kit or pour antiseptic solution over cotton balls.
- With one hand grasp the penis, with the other hand, cleanse the meatus in a circular motion outwards and a few inches down the penis
- Remove gloves, wash hands, don a second pair of gloves for the procedure
- Put the patient into a semi-Fowler’s position
- Open the sterile specimen without touching the inside of the lid or container
- Hold the container near the meatus
- instruct the patient to begin voiding
- Allow a small stream to pass, then place the container into the stream and collect between 30-60 mL
- Remove the container from the stream and allow the patient to finish voiding
- Carefully replace the container lid and clean the outside of the container
- Label the container and place in carrier for transport
- Remove gloves and wash your hands
- Assist the patient back to bed
- Transport the specimen to the lab
What are the steps to obtaining a sterile urine specimen
- Empty the drainage tube of urine
- Clamp the drainage tube below the level of the specimen port for 15-30 minutes
- Don clean gloves and swab the specimen port with an antiseptic swab
- Insert the needle into the specimen port and withdraw the sample
- Transfer the specimen into a sterile specimen container
- Discard the needle and syringe into the sharps container
- Tightly cap the specimen container
- Remove the clamp from the catheter
- Label and package the specimen
- Transport to the lab
What is ARF, acute renal failure?
an acute rise in the serum creatinine level of 25% or more.
What is anuria?
the absence of urine
less than 100mL in 24 hours
What is Dysuria?
Painful or difficult urination
What is end-stage renal disease, ESRD?
A permanent rise in serum creatinine levels associated with loss of kidney function that must be treated with dialysis or transplantation
What is Frequency?
The need to urinate at short intervals
What is hematuria?
blood in the urine
What is Oliguria?
Urine output less than 400mL in 24 hours
What is Nephropathy?
disease of the kidney
What is Nephrotoxic?
A substance that damages kidney tissue
What is Nocturia?
Frequent urination after going to bed
What is Polynuria?
Excessive urination
What is Proteinuria?
The presence of protein in the urine
What is Pyuria?
Pus in the urine
What is urgency?
A sudden, almost uncontrollable need to urinate
