Urinary Elimination (Week 3) Flashcards
1
Q
Anuria
A
24-hour urine output is less than 50 mL; little to no elimination
2
Q
Bacteriuria
A
an asymptomatic condition where bacteria are present in the urine
3
Q
Bladder
A
- a smooth muscle sac serving as a reservoir for urine
- innervated by the autonomic nervous system (ANS)
- normally contains urine under little pressure
- when pressures become sufficient to stimulate nerves in the bladder (stretch receptors) the person feels a desire to empty the bladder
4
Q
Blood urea nitrogen (BUN)
- normal range?
- meaning of abnormal
A
- normal: 10-20 mg/dL
- meaning of abnormal
>20 mg/dL
- renal disease
- liver disease
- bleeding in the GI tract
- dehydration
<10 mg/dL
- overhydration
5
Q
Catheter
A
6
Q
Creatinine
- what is the normal value?
- what is the role?1
A
0.5 - 1.2 mg/dL
7
Q
Direct Visualization
- what is done, how do you prep your client, and how do you care for you client after?
A
- Cytoscopy
8
Q
Dysuria
A
painful or difficult urination
9
Q
Frequency
A
increased incidence of voiding
10
Q
Hematuria (microscopic and gross)
A
- Microscopic hematuria - more common; counting RBCs and chemically pick up tests; the blood might not look red
- Gross hematuria - blood that you can physically see in the patient’s urine
11
Q
Urinary Incontinence
A
any involuntary control/loss of urine
12
Q
Indirect Visualization
A
- CT scan “CAT Scan” (X-Ray)
- Pyelography (X-Ray)
- Ultrasound (abdominal) (sound waves)
- KUB (Kidney urinary bladder) (X-Ray)
13
Q
Invasive
A
14
Q
Noninvasive
A
15
Q
Meatus
A
16
Q
Micturition
A
17
Q
Nephrotoxic
A
- capable of causing kidney disease
- many prescription and nonprescription known to be nephrotoxic
- MEDICATIONS
- analgesics (aspirin or ibuprofen)
- antibiotics (gentamicin)
18
Q
Nocturia
A
awakening at night in order to urinate
19
Q
Oliguria
A
24-hour urine output is less than 400mL; little urine elimination
20
Q
Polyuria
A
Excessive output of urine (diuresis)
21
Q
Prostate
A
22
Q
Proteinuria
A
protein in the urine
23
Q
Pyuria
A
pus in the urine
24
Q
Ureter
A
25
Ureterostomy
26
Urethra
27
Urostomy
28
Urgency
strong desire to void
29
Urination
process of emptying the bladder
30
Void
31
Urine
- waste product excreted by the kidneys
- organic, inorganic, and liquid wastes
32
Urinary Retention
urine is produced normally but is not excreted from the bladder
- associated factors - medications, an enlarged prostate, or vaginal prolapse
33
Urge incontinence
the involuntary loss of urine that occurs soon after feeling an urgent need to void
34
Diuretic
prevent the reabsorption of water and certain electrolytes in the tubules
35
Glycosuria
presence of glucose in the urine
36
Continent
self-control over urination
37
What are the characteristics of normal urine?
(color/quantity/odor/clarity/constituents)
color: pale yellow, straw-colored, or amber
odor: aromatic, but as urine stands it often develops an ammonia odor because of bacterial action
Turbidity: clear or translucent; as urine stands it becomes cloudy
pH - normal pH is 5-6 with a range of 4.5-8
specific gravity: a measure of the density of the chemicals and particles in the urine and is a measure of the ability of the kidneys to concentrate urine; normal range is 1.005-10.30
constituents:
- organic constituents: urea, uric acid, creatinine, hippuric acid, Indian, urene pigments, undetermined nitrogen
- inorganic constituents: ammonia, sodium, chloride, traces of iron, phosphorus, sulfur, potassium, and calcium
38
1. What are commonly used procedures for collecting urine specimens?
2. When is each one appropriate?
- Routine urinalysis - a sterile urine specimen is not required; patient can void into a clean bedpan, urinal, or receptacle (ex: specimen hat in the toilet bowl)
- Random
- Clean catch (Midstream) - collected during midstream voiding and minimizes bacterial contamination; initial voiding of small amounts helps to flush out any organisms near the meatus and minimizes risk of inaccurate findings if these findings were to enter the specimen
- Sterile - obtained by catheterizing the patient's bladder or by taking the specimen from the indwelling catheter already in place
- Timed specimens: 24-hour urine specimens- let the patient void (don't collect until after they void the first time; ALL urine must be collected--> they cannot pee in the toilet because if they do they will have to start over the 24-hour urine specimen)
- Catheters (Foley, Intermittent, Indwelling, Suprapubic)
39
What actions can the nurse take to help a client void normally in the healthcare setting?
- schedule - nursing actions support patient's usual urinating pattern as much as possible
- urge to void - assist patient to void when first feel the urge to void
- privacy
- positioning
- techniques
- fluid intake
- hygiene
40
How does the nursing interventions reduce the risk of urinary tract infections?
41
What is a CAUTI?
Catheter-associated urinary tract infection
- a common HAI
- increases healthcare costs and is associate with increased morbidity and mortality
42
How can the nurse teach a client how to reduce the risk of UTIs?
- Drink PLENTY of FLUIDS
- six to eight 8oz glasses of liquid daily
- cranberry juices
- urinate when you feel the urge to void and empty the bladder when urinating
- if you have female genitalia dry the perineal area from front to back after urination or defecation (urethra to rectum)
- void after sex
- if you have repeat bladder infection and use a diaphragm, unlubricated condoms, or spermicide these may increase the chances of developing a bladder infection --> talk to your health care provider about switching birth control methods
- wear cotton underwear and avoid clotting that is tight/restrictive
- administer meds (antibiotics and urinary analgesics)
43
What are the risk factors, assessment findings, and essential nursing interventions (this includes teaching) for urinary retention (acute and chronic), urinary incontinence (urge, stress, overflow, functional, and reflex), and lower urinary tract infections?
1. Urinary retention
- acute
- chronic
2. Urinary incontinence
- urge incontinent or overactive bladder (OAB) detrusor muscle contracts more forcefully
- diabetes, obesity, smoking, neurologic diseases
- stress incontinence - intraabdominal pressure increases
- childbearing, sneezing, coughing, heavy exercises
- mixed is urge and stress
- overflow incontinence - small amount of urine
- functional incontinence
- reflex incontinence
3. Lower urinary tract infections
44
normal urine output (UOP)
1500 mL/24hr
45
minimal urine output
30 mL/hr or 0.5 mL/kg/hr
