Urination T4 Flashcards
Color
Expected:
pale yellow to deep amber
Variation:
color is light or clear due to high fluid intake
Color is darker due to fluid loss or decreased intake
Color is affected by diet and medications
pH
Normal:
5-9 with an average of 6
Variations:
pH is alkaline if client eats more dairy, citrus fruits, or is vegetarian
pH is acidic if client eats high protein or consumes cranberry juice
What does the pH indicate?
The kidneys ability to help maintain balanced hydrogen ion concentration in the blood
Specific Gravity
Normal:
1.002- 1.030
Variations:
SG raises with limited fluid intake, dehydration, and kidney disease
SG lowers with increase in fluid intake
What does specific gravity indicate?
The kidneys ability to concentrate the urine
Clarity
Normal:
Urine should be translucent on a fresh sample
Variations: Cloudiness of a fresh sample, this indicates - bacteria - RBC - WBC - Sperm or Vaginal discharge - prostatic fluid
Odor
Normal:
Urine has a scent
Variations:
Certain foods cause odor such as asparagus, onion, or garlic
Bacteria gives ammonia like smell
Sweet/syrup smell is from congenital metabolic disorder
Protein
Normal
<20mg per day
Variations: Protein increases with -diabetic nephropathy -glomeruloephritis -nephrosis -toxemia of pregnancy Benign proteinuria with -stress -exercise
What does protein in urine indicate?
Renal failure
Glucose
Normal:
None
Variations:
Glucose present with elevated blood sugar and diabetes
Keystones
Normal:
None
Variations: Commonly found with -diabetes -fever -fasting/ starvation -high protein diet -vomiting -Post anesthesia
What do keytones in urine indicate
Impaired carbohydrate metabolism
Hemoglobin
Normal:
Negative on dipstick
<5 on microscopic exam
Variations: Infection may be present Bladder disease Trauma Glomeruloneohritis Pyelonephritis Nephrolithiasis
Bilirubin
Normal
None
Variations:
Increased levels
What does bilirubin indicate
Liver disease
Urobilinogen
Normal
Up to 1mg/dL
Variation Increased with -Cirrhosis -Heart failure -Liver disease -Malaria -Anemia -infectious mononucleosis
Nitrite
Normal
None
Variations
Increased with
-bacteriuria
-presence of nitrite-forming bacteria
Leukocyte Esterase
Normal:
Negative
<5 WBC on microscopic exam
Variations: Increased with -bacteria -calculus formation -fungal or parasitic infection
Renal Cells
Normal:
None
Variations:
Presence indicates damage to tubular network
Transitional Cells
Normal:
None
Variations:
Seen with infection, malignancy, and trauma
Where are renal cells found?
The lining of collection ducts
Where are transitional cells found?
Line the bladder, ureter, pelvis, and proximal urethra
Squamous Cells
Normal:
None
Variations:
If found typically in significant
Where are squamous cells found?
Vagina and distal urethra
Normal BUN level
8-20 mg/dL
Normal Creatine Level
0.5-1.1 mg/dL
How much using do kidneys produce per hour
50-60 mL
Urinary Diversions
Ureterostomy (ideal conduit)
Nephrostomy
Kock pouch
Neobladder
Ureterostomy
Attachment of one or both ureters to the abdominal wall via a stoma
Nephrostomy
Attachment of a tube from the renal pelvis to the abdominal wall
Kock pouch
Used for a continent patient, the ilium is turned to a reservoir
Emptied every 3 hours by straight cath
Neobladder
Attachment of ureters and urethra to urethra forming a new bladder
To void patient uses abdominal muscles
When do children achieve full bladder control
Age 4-5
What is a bedside sonogram with bladder scan
Noninvasive ultrasound measuring bladder volume and residual volume after voiding
Intravenous pyelogram
Injection of iodine to view urinary tract
Cystoscopy
Use of lighted instrument to view treat and obtain specimens from urethra and bladder
Urodynamic testing
Tests bladder muscle function by filling bladder with air or saline
Stress incontinence
Loss of small amounts of urine during something strenuous
Urge incontinence
Sudden urge to void or inability to stop urine flow to reach a toilet
Overflow incontinence
Overdistention and frequent loss of small amounts due to obstruction or impaired detrusor muscle
Reflex incontinence
Involuntary loss of moderate amount of urine without warning Caused by impaired CNS -stroke -MS -spinal cord lesion
Functional incontinence
Loss of urine due to factor that interfere with responding to the need to void
- cognitive
- mobility
- environmental barriers
Transient Incontinence
Reversible incontinence due to
- UTI
- temporary cognitive impairment
- hyperglycemia
- medications
How much water should a person drink per day
2-3 Liters
Men should drink 3 or more
