Urine Flashcards
Functions of Kidneys
- Filter blood to pull out waste products
- Produce urine
- Help to manage BP
- Regulate fluids
How many mL an hour do the kidneys produce?
30-60mL/hr
How much urine does the average adult produce a day?
1000-2000mL/day
Nephrons
Basic filter unit of the kidneys
Glomerulus
Capillary network that filters the blood in the kidneys
Glomerular Filtration Rate (GFR)
How much blood the nephrons filter every minute
How much blood do nephrons filter a minute?
125mL/min
Ureters
Transport urine from the kidneys to the bladder through peristalsis
Bladder
Storage container for urine (max cap. 1000mL)
How do you know when you need to urinate?
As your bladder fills, nerves in the bladder wall send a message to the brain that it is time to void
Urethra
Transports urine to the outside of the body
Why are females more likely to get UTIs?
They have a shorter urethra than men. Men: 7-8inch, women 1-1.5 inches
How does your bladder work when urinating?
Detruser muscles in your bladder contract while urinating and your pelvic floor muscles relax
Food and Fluid Intake Influencing Urine
- Some foods cause an odor (Asparagus)
- Citrus/Spicy foods can be irritating to the bladder
- Tea, caffeine, alcohol can have a diuretic affect
- Green leafy veggies cause alkaline urine
- Adequate water intake can dilute urine
How do psychological variables influence urine?
- Anxiety/stress can increase frequency
- Shy bladder
Activity and muscle tone influencing urine
- Elderly have poor muscle tone = weak bladder
- Kegal exercises can strengthen bladder muscles
Pathologic conditions influencing urine
- Hypertension
- Kidney disease
- Obesity puts pressure on your bladder
- Diabetes
Medications influencing urine
- Diuretics - increased output
- Antibiotics/anticoagulants can change the color
- Nephrotoxic meds are toxic to the kidneys so monitor kidney function in patients
- Aspirin/Ibuprofen abuse
Anuria
Absence of urine, <50mL/hr
Dysuria
Difficulty or painful urinating
Glycosuria
Sugar in urine
Nocturia
Frequently waking up in the night to urinate
Oliguria
Small amounts of urine, <400mL in 24 hrs
Polyuria
Excess amounts of urine
Proteninuria
Protein in the urine -> kidney disease
Pyuria
Puss in urine
Nursing Assessment for Genitourinary System
-Past medical/family history
- Current meds
- Elimination patterns to establish baseline
- Changes/problems (hematuria, nocturia, etc)
- Aids: Commode, urinal, running water, etc
- Inspection: Fluid overload, signs of inflammation, skin taut, edema, abdomen distention, peri area hygiene, incontinence
- Palpation: Have patient empty bladder first, listen first then palpate; bladder should not be palpable when empty
What does a bladder scan do?
You can see how much urine is in the bladder
Post Void Residual
Amount of urine left in the bladder after urinating
PVR for adult and elderly
Adult: <50-75mL
Elderly: <100mL
Clean Catch Urine Specimen
- Have patient wipe with alcohol first
- Patient starts to urinate
- Collect urine in cup
- Take cup away
- Finish urinating
Urinalysis
Analysis of the physical, chemical, and microscopic components of urine
24 Hour Urine Test
- Used to look at the amount of calcium, uric acid, and electrolytes in the urine
- Have patient empty bladder before the time starts
- Keep on ice/cold
Normal pH of urine
4.6-6.8
How do you test the pH and specific gravity of urine?
Dipstick test
Normal range for specific gravity
1.005-1.035
Specific Gravity
Concentration of all chemical particles in urine
BUN
The amount of urea nitrogen in the blood
Normal range for BUN
10-20mL/dL
Creatinine
The waste left over from muscle energy processes
Normal range for creatinine
.5-12mg/dL
Turbidity
Clarify of urine
Constituents
Things in urine that may affect the turbidity; puss, blood, sediment
Elimination habits common in the elderly
- Nocturia
- Increased frequency
- Urine retention (UTIs)
- Decreased control (cognition, mobility)
Interventions for the elderly
- Incontinent devices
- Easy assess to bathroom: clear pathway
- No restrictive clothing (belts, buttons)
- Cut off fluids one or two hour before bed
- Assistive devices: Walker/cane, risers on toilet, safety bars on the wall