Urinary test 4 Flashcards
What are the 4 structures of the urinary system?
What is the purpose of the urinary system?
Kidneys
Bladder
Sphincter
Urethra
What is the purpose of the urinary system?
Urination
Identify variables that influence urination.
- Developmental considerations-
- Food and fluid intake-
- Psychological variables-
- Activity and muscle tone-
- Pathologic conditions-
- Medication
• Activity and muscle tone
What are the effects of Immobility?
Activity and muscle tone- Immobility decreases bladder and sphincter tone resulting in poor urinary control and urinary stasis. Indwelling catheters cause a decrease in bladder muscle tone because the bladder muscle is not being stretched other causes include child bearing, menopause(muscle atrophy), and muscle damage from trauma.
• What are some Developmental considerations-
Toilet training 2 to 3 years
Enuresis-Intentional or involuntary urination into bed or clothes that occurs after the age when the continence should be present.
Nocturia- urination during the night (might be old people)
Enuresis
Enuresis-Intentional or involuntary urination into bed or clothes that occurs after the age when the continence should be present.
Nocturia
Nocturia- urination during the night (might be old people)
Food and fluid intake-
What is a dieretic?
Diuretic is any substance that increases the production of urine.
What increases urine output?
Foods with high sodium content cause sodium and water reabsorption and retention, there by decreasing urine.
Pathologic conditions- What pathologic conditions influence urine?
Urinary tract infection (UTI) Polycystic kidney disease Urinary calculi(Kidney Stones), Hypertension(high blood pressure), Diabetes mellitus, Gout
What is the function of the Kidneys
Kidneys are on either side of the vertebral column they maintain the bodyies fluid volume and filter the entire bodyies blood every 30 minutes Urine is a waste product excreted from this.
What is the function of the Sphincter
Sphincter guards opening between urinary bladder and urethra
What is the function of the Urethra
Urethra-conveys urine from bladder to exterior of body Male urethra functions in excretory and reproductive systems
What is the function of the Bladder
Bladder- is the Smooth muscle sac that Serves as a reservoir for urine. Composed of three layers of muscle tissue called detrusor muscle.
What is Micturition
Urination- also called Micturition or Voiding Defined as “ the process of emptying the bladder” Nerve centers for micturition are stimulated in the brain and spinal cord Usually feels the desire to void at about 150-250mls in an adult. Any involuntary loss of urine is called urinary incontinence
An adult usually feels the desire to void at about ___-____mls.
An adult usually feels the desire to void at about 150-250mls.
Nephrotoxic-
Nephrotoxic- medication capable of kidney damage
Cholinergic medications
Cholinergic medications—stimulate contraction of detrusor muscle, producing urination
Analgesics and tranquilizers
Analgesics and tranquilizers—suppress CNS, diminish effectiveness of neural reflex (can not feel the need to void)
Diuretics
Diuretics—prevent reabsorption of water and certain electrolytes in tubules(increase urine production) Pale yellow urine
Anticoagulants
red urine Hematuria- Blood in urine
Hematuria
Hematuria- Blood in urine
Phenazopyridine (Pyridium)
orange to orange-red urine
Amitriptyline
green or blue-green urine
Levodopa
Levodopa — brown or black urine
Specific gravity-
Measure of density of urine compared to density of water should be 1.015-1.025g/ml
pH level should be 4.5-8ml
Identify normal and abnormal characteristics and constituents of urine.
Abnormal findings
- Glucose
- Protein
- Billirubin
- Bacteria
- Blood
UTI- Urinary track infections symptoms?
UTI- Urinary track infections symptoms (frequency, urgency, dysuria, cloudy, foul odor) C&S is positive if it shows at least 100,000 organisms per milliliter of urine Lower counts may be considered if the patient is experiencing symptoms A short course antibiotic is recommended
Patients at risk for UTI include?
Patients at risk for UTI include
- Sexually active women
- Women who use diaphragms as contraception
- Postmenopausal women
- Individuals with indwelling urinary catheter
- Individuals with diabetes mellitus
- Elderly people
Identify appropriate nursing diagnoses for patients who have problems with altered urinary elimination.
Urinary functioning as the problem diagnosis
- Incontinence –all of these are valid nursing diagnosis
- Pattern alteration
- Urinary retention
Urinary functioning as the etiology(cause) P. 1377
a. Caregiver role strain
b. Acute pain
c. Disturbed Sleep pattern
d. Impaired Skin Integrity
Patient outcomes
- Urine output about equal to fluid intake
- Maintain fluid and electrolyte balance
- Empty bladder completely at regular intervals
- Report ease of voiding
- Maintain skin integrity
- Maintaining Normal Voiding Habits
- Promoting Fluid Intake
What is nessessary to Maintaining Normal Voiding Habits
• Maintaining Normal Voiding Habits
- Schedule
- Urge to Void
- Privacy
- Position
- Hygiene
What is nessessary to Promoting Fluid Intake
• Promoting Fluid Intake
- 8-10 8oz glasses a water a day is recommended for healthy adults
- Provide fluids of preference to bedbound patients
- Remind confused patients to drink
- Monitor fluid intake for excessive amounts of caffeine beverages, high sodium beverages, and high sugar beverages
Credé’s maneuver.
Credé’s maneuver. The Credé maneuver is a technique used to void urine from the bladder of an individual who, due to disease, cannot do so without aid. The Credé maneuver is executed by exerting manual pressure on the abdomen at the location of the bladder, just below the navel.
Define the different types of urinary incontinence.
• Transient-
• Transient- appears suddenly lasts for 6 months or less caused by treatable factors illness, infection or medical treatment
Define the different types of urinary incontinence.
• Stress-
• Stress- occurs due to increase of intra-abdominal pressure (laughing sneezeing physical activity metophase childbirth obesity)
Define the different types of urinary incontinence.
• Mixed-
• Mixed- features of two or more types of incontinence
Define the different types of urinary incontinence.
• Overflow-
• Overflow- AKA chronic retention of urine associated with overdistention, overflow of bladder the feeling of needing to go may be absent may be due to drugs or neurological condition
Define the different types of urinary incontinence.
• Functional-
• Functional- Inability to reach toilet due to barriers, physical limitations, or memory loss
Define the different types of urinary incontinence.
• Reflex-
• Reflex- experiencing emptying of the bladder without the need to void
Define the different types of urinary incontinence.
• Total-
• Total- continual unpredictable loss of urine due to surgery physical trauma or malformation
Types of catheters Indwelling catheter (Foley)-
Indwelling catheter (Foley)- remains in place for continuous drainage
Types of catheters
Suprapubic catheter-
Suprapubic catheter- long term continuous drainage; surgically inserted
Types of catheters
External Catheter/Condom Catheter-
External Catheter/Condom Catheter- Used in male patients and fits over the penis and attaches to drainage bag
