Urine Flashcards
Characteristics of normal urine
- bladder - holds 300-600ml; urge stimulated at 250-450ml
- frequency - 5-7 times a day
- amount - 60ml/hour or 1500ml/day; report is
Polyuria
- increased amount of output
* factors: diuretics, hx of DM, renal disease
Plight is
- decrease amount of output
* factors: decrease fluid intake, hypotension, sick, heart failure, hx of renal disease/failure
Anuria
- absence of urine
* factors: decrease fluid intake, hypotension, sick, heart failure, hx of renal disease/failure
Frequency
- increase voiding
* factors: pregnancy, increase fluid intake, UTI, stress
Nocturnal
- up at night to void
* factors: benign prostAtic hyper trophy, renal failure, increased age
Urgency
- must void now
* factors: stress, UTI, poor sphincter control
Dyslexia
- painful urination
* factors: UTI, injury, hematuria, puris
Enuresis
- involuntary voiding
* factors: family history, no access to facilities, home stress
Incontinence
- involuntary leakage of urine or loss of bladder control
* factors: UTI, pregnancy, volume overload, delirium, restricted mobility, stool impaction
Types of incontinence
- stress - occurs through laughing, sneezing or coughing
- functional - physical problems that prevent ability to reach facility
- overflow - unable to completely empty bladder
- total - total loss of urinary control (bladder unable to store)
- urge - need to void in which may not reach facility
- reflex - urge to void not felt
Nursing diagnoses
- altered urinary elimination of (- incontinence or nocturia)
- urinary retention
- risk for UTI
- low self esteem
- social isolation
- self care deficit of toileting
- risk for impaired skin integrity
- risk for fluid volume deficit/excess
- disturbed body image
- risk for care giving role strain
Goals
- maintain or restore normal voiding patterns
- regain normal urine output
- prevent risks of infection, skin breakdown, fluid and electrolyte imbalance, low self esteem
- performs toileting activities independently
Interventions
- normal elimination management
- urinary incontinence care
- promoted voiding
- urinary habit training
- urinary retention care
- pelvic floor muscle exercises (kegel)
Factors affecting need
- growth and development
- psychological factors - privacy, position, time, sight, sound
- diet - diuretics, anti diuretics, salt
- medications
- muscle tone and activity
- pathological conditions
- surgical and diagnostic procedures
Teaching for home care
- facilitating urinary elimination self care
- promoting urinary elimination
- infection prevention of UTI
- medications
- dietary alterations
- measures specific urinary problems
- referrals
- community agencies and other resources
Nursing orders
- promoting fluid intake
- maintaining normal voiding habits
- assisting with toileting
- preventing UTIs
- managing urinary incontinence
- continence bladder training
- bladder training
- habit training
- prompted voiding
- pelvic floor muscle exercises
- continence bladder training
RNAO best practice guidelines
Promoting continence using prompted voiding
• monitoring
• prompting
• praising
Teaching kegel or pelvic floor exercises
• position
• contraction - pull upward and inward
• timing - hold for 3-5sec, relax for 3-5 sec
• repeat - 10x in a row, 5x daily
