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essentials > urinary objectives > Flashcards

urinary objectives Flashcards

1
Q

What pathological conditions commonly influence urinary elimination?

A

Spinal cord injury, prostate issues (BPH), neurologic conditions (MS, Parkinson’s), and dementia.

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2
Q

What physical characteristics commonly affect urinary elimination?

A

Pregnancy and overweight/obesity.

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3
Q

What surgical procedures may affect urinary elimination?

A

Lower abdominal and pelvic surgeries, use of anesthetic agents.

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4
Q

How can medications influence urinary elimination?

A

Diuretics increase urine output; sedatives may decrease the urge to void and some medications can change urine color.

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5
Q

Which diagnostic examinations can influence urinary elimination?

A

Cystoscopy and urinary catheterization.

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6
Q

What is urinary retention?

A

The inability to completely or partially empty the bladder, leading to an accumulation of urine.

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7
Q

What is Post Void Residual (PVR)?

A

The amount of urine left in the bladder after an attempt to void, measured via bladder scan.

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8
Q

What are the common types of urinary tract infections (UTIs)?

A

Bacteriuria (bacteria in the urine), pyelonephritis (kidney infection), and cystitis (bladder infection).

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9
Q

What is an iatrogenic urinary infection?

A

An infection resulting from medical procedures, such as catheterization.

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10
Q

What is urinary incontinence?

A

Involuntary leakage of urine.

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11
Q

Describe urgency incontinence.

A

A sudden, intense urge to urinate with involuntary loss.

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12
Q

Describe stress incontinence.

A

Leakage due to increased abdominal pressure, such as coughing or sneezing.

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13
Q

Describe functional incontinence.

A

Urinary leakage caused by factors outside the urinary system, such as mobility issues or cognitive impairment.

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14
Q

What should be included in a nursing history for a client with urinary elimination problems?

A

Past urinary issues, current symptoms, medication use, dietary habits, and lifestyle factors.

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15
Q

What are key nursing interventions for the acute care of urinary problems?

A

Maintaining elimination habits, allowing time/privacy, using medications, and catheterization if necessary.

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16
Q

What is the purpose of parasympathetic stimulation of the detrusor muscle?

A

It aids in bladder emptying.

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17
Q

How do cholinergic drugs assist with urinary elimination?

A

They increase bladder contraction and improve emptying.

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18
Q

What medication is used to increase bladder contraction and capacity?

A

Oxybutynin.

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19
Q

What are some nursing measures to promote normal micturition and reduce incontinence?

A

Encouraging scheduled voiding, providing a comfortable environment, and using assistive devices.

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20
Q

What are nursing measures to reduce urinary tract infection?

A

Maintaining a closed system, preventing catheter-associated infections, and using sterile solutions.

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21
Q

How should a clean void/midstream specimen be collected?

A

Explain the procedure, provide a specimen hat or sterile cup, and use a cleansing technique.

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22
Q

Can collecting a clean void/midstream specimen be delegated?

A

Yes, clean void/midstream specimens can be delegated, but sterile specimens cannot.

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23
Q

How should a urine specimen be stored or transported to the lab?

A

Specimens should be sent within 2 hours, and those for C&S should be refrigerated or preserved within 30 minutes.

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24
Q

How should a 24-hour urine specimen be collected?

A

Collection begins after the first void (not included), with urine transferred into a specific lab container and stored as per policy.

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25
Q

What happens if a timed urine specimen collection is contaminated?

A

If contamination occurs (e.g., feces or TP), the collection must start over.

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26
Q

When can a urine specimen be collected from a catheter drainage bag?

A

Only immediately after catheter insertion.

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27
Q

How is a catheter specimen collected?

A

Using a needle-free system and following manufacturer/policy instructions for port sampling.

28
Q

What are the components analyzed in a urinalysis?

A

Urine appearance, concentration, glucose, protein, ketones, nitrites, leukocytes, and pH.

29
Q

What does specific gravity in a urinalysis indicate?

A

Urine concentration, with values ranging from 1.005 (less concentrated) to 1.030 (more concentrated).

30
Q

What is the purpose of a urine culture and sensitivity (C&S) test?

A

To identify and treat urinary tract infections.

31
Q

What are indications for non-invasive incontinence appliances?

A

KUB, CT, MRI, bladder scans, and uroflowmetry are non-invasive tools used to assess urinary issues.

32
Q

What is a KUB scan?

A

A non-invasive imaging procedure of the kidneys, ureters, and bladder.

33
Q

What is a bladder scan?

A

A non-invasive ultrasound to measure the volume of urine in the bladder.

34
Q

What is the purpose of intravenous pyelogram (IVP)?

A

To visualize the urinary tract using contrast dye.

35
Q

What invasive procedures assess urinary issues?

A

Cystoscopy and arteriography.

36
Q

What is a condom catheter used for?

A

For patients with complete bladder emptying who have incontinence or nocturia.

37
Q

How is a condom catheter held in place?

A

With adhesive and attached to a drainage bag (bedside or leg bag).

38
Q

What are the indications for intermittent catheterization?

A

One-time bladder emptying, relieving bladder distention, obtaining a sterile specimen when clean-catch is unobtainable, assessing residual urine, managing patients with spinal injuries, neuromuscular degeneration, or incompetent bladders long-term.

39
Q

What are the indications for short-term indwelling catheterization?

A

Obstruction to urine outflow, surgical repair of bladder or urethra, preventing urethral obstruction post-surgery, measuring urinary output in critical patients, and continuous or intermittent bladder irrigation.

40
Q

What are the indications for long-term indwelling catheterization?

A

Severe urinary retention with recurrent UTIs, skin issues irritated by urine, terminal illness for comfort, and when linen changes are painful.

41
Q

What are the steps for maintaining a catheter?

A

Check vital signs, ensure adequate urine output, maintain a closed system, prevent obstructions, keep the bag below bladder level, avoid bag contact with the ground, and perform perineal/catheter care every 8 hours.

42
Q

How should catheter insertion and care be managed to prevent CAUTIs?

A

Follow aseptic techniques, secure the catheter, use the smallest size necessary, and maintain closed drainage; avoid urine flow obstructions, and empty the bag when it’s half-full.

43
Q

What are the steps for removing an indwelling catheter?

A

Confirm need and order, ensure balloon is deflated, document voiding post-removal for 24-48 hours, and monitor for inadequate bladder emptying.

44
Q

What are proper catheter care techniques?

A

Keep the meatus clean, perform perineal care, cleanse the first 4 inches of the catheter, and use sterile techniques after defecation if needed.

45
Q

Can catheter care be delegated?

A

Yes, but assessment cannot be delegated. If the patient has had recent surgery or trauma, catheter care should not be delegated.

46
Q

What nursing diagnoses are appropriate for clients with urinary elimination issues?

A

Risk for infection/UTI, urinary incontinence (stress or urge), impaired urinary elimination, urinary retention (acute or chronic), toileting self-care deficit, and impaired skin integrity.

47
Q

What are nursing responsibilities before invasive diagnostic exams?

A

Obtain signed consent, assess allergies (especially to contrast agents), administer bowel-cleansing agents, and ensure the patient follows any pre-test diet or NPO instructions.

48
Q

What are nursing responsibilities after diagnostic exams?

A

Monitor I&O, assess urine for color, clarity, and dysuria, and encourage fluid intake.

49
Q

What are interventions to reduce the risk of UTIs?

A

Educate on hygiene (front-to-back), use cotton underwear, avoid perfumed products, void before/after sex, and consider acidifying urine with vitamin C or cranberry juice.

50
Q

What interventions support normal micturition?

A

Regular voiding intervals, sufficient fluid intake, and complete bladder emptying.

51
Q

What interventions address stress urinary incontinence?

A

Weight loss, smoking cessation, regular toileting, and pelvic floor muscle exercises (e.g., Kegels).

52
Q

What interventions address urge urinary incontinence?

A

Limit fluids at bedtime, avoid bladder irritants, and perform pelvic floor muscle exercises.

53
Q

What are causes and interventions for acute urinary retention?

A

Causes: surgery, anesthesia, medications. Interventions: catheterization, bladder scan.

54
Q

What are causes and interventions for chronic urinary retention?

A

Causes: progressive blockage (prostate, stricture), medications, nerve issues. Interventions: long-term catheter, bladder training.

55
Q

What is pelvic floor muscle training?

A

Identifying and strengthening pelvic floor muscles through exercises like Kegels, aiming for 3 sets of 10-15 reps daily.

56
Q

What are restorative care techniques for men and women?

A

Women: manage urinary incontinence, pain during intercourse. Men: manage urinary incontinence, erectile dysfunction.

57
Q

What are considerations for urinary elimination in older adults?

A

Frequent toileting, hydration, bladder emptying at regular times, and limiting fluids before bedtime.

58
Q

What is a suprapubic catheter?

A

A surgically inserted catheter that directly drains the bladder; if dislodged, it must be reinserted immediately.

59
Q

What are signs of infection to report in a patient with a suprapubic catheter?

A

Drainage, foul odor, redness, and irritation at the insertion site.

60
Q

What is a urostomy and when is it used?

A

A surgical diversion for continuous urine drainage, often for patients who have had their bladder removed.

61
Q

How is a urostomy pouch changed?

A

Clean skin, measure and cut pouch opening, press firmly over the stoma, and ensure no skin exposure to urine.

62
Q

What are nephrostomy tubes, and when are they used?

A

Small tubes tunneled through the skin into the renal pelvis to drain when the ureter is obstructed.

63
Q

What is the difference between intermittent and indwelling catheters?

A

Intermittent: single-lumen for temporary emptying; Indwelling: double/triple lumen for longer use, with options for irrigation.

64
Q

What is a Coude catheter?

A

A single-lumen catheter with a stiffer, angled tip for easier insertion in patients with enlarged prostates.

65
Q

What is an indwelling triple lumen catheter used for?

A

Continuous or intermittent bladder irrigation and to clear clots or sediment; helps maintain catheter patency.

66
Q

Why is catheter irrigation performed, and can it be delegated?

A

It’s done post-surgery to prevent clots and maintain flow; it cannot be delegated, though a UAP can report changes to the RN.

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