Urine Elimination Flashcards
Define neurogenic bladder.
Peripheral neuropathy that affects the bladder, causing incontinence in diabetic patients.
What is the most common source of a UTI?
E. Coli
Define detrusor muscle.
Bladder muscle (responds to parasympathetic stimulation)
How many hours in between voids suggests that a patient may need a straight cath?
6 hours
Define micturation.
Urination
What is the normal range per urinary void?
300-400 mL
How often should a patient void?
Every 2-3 hours
What factors may lead to urinary retention?
Immobility, supine position, anesthesia, surgery
A UTI is diagnosed for bacterial colonies greater than _____?
10,000
What findings are most likely in a UA of a patient with a UTI?
WBCs, bacteria
Why don’t you want to raise a catheter bag above the patient?
Urine will flow back into the bladder and may cause infection
How many times should a patient wipe for a clean catch?
3
Normal UA values: pH
4.6-8.0; Acidic pH helps protect against bacterial growth
Normal UA values: protein
0-8 mg/100 mL; protein may indicate renal disease or damage to glomeruli/tubules
Normal UA values: glucose
0; glucose may indicate DM or high glucose concentrations (> 180 mg/100 mL)
Normal UA values: ketones
0; ketones in urine may indicate DM, dehydration, starvation or excessive aspirin usage
Normal UA values: blood
0; blood in urine may be a result of menstruation in women
Normal UA values: specific gravity
1.0053-1.030; high specific gravity reflects concentrated urine (dehydration, reduced renal blood flow, increased ADH secretion); low specific gravity reflects diluted urine (overhydration, early renal disease, inadequate ADH secretion)
Normal UA values: RBCs
0-2; high RBCs may indicate trauma, disease, or surgery of lower urinary tract
Normal UA values: WBCs
0-4; high WBCs may indicate UTI
Normal UA values: bacteria
0; bacteria indicate UTI
Normal UA values: casts
0; casts indicate renal alterations
Normal UA values: crystals
0; excess crystals such as uric acid or calcium phosphate result in renal stone formation
What is the purpose of a CT scan on the renal system?
To detect tumors or obstructions
What is the purpose of an IVP?
To view obstructions in the collecting ducts, renal pelvis, ureters, bladder or urethra (ex: check for kidney stones)
What is the purpose of an ultrasound on the bladder (bladder scan)?
To estimate the volume of the urine in the bladder (residual volume)
Define functional urinary incontinence.
Loss of urine caused by factors outside the urinary tract (ex: environmental barriers, immobility, cognitive/sensory function)
Define stress urinary incontinence.
Involuntary leakage of urine during increased abd pressure in the absence of bladder muscle contraction (ex: while coughing, laughing, sneezing)
Define urge urinary incontinence.
Involuntary passage of urine after a strong sense of urgency to void (ex: with bladder spasm or contraction)
Define mixed urinary incontinence.
Combination of urge and stress incontinence
Define overflow urinary incontinence.
Involuntary loss of urine at intervals without sensation of urge to void (ex: spinal cord dysfunction or peripheral neuropathy resulting in bladder overflow)
Define hyperactive/overactive bladder.
Urinary urgency associated with urinary frequency and nocturia
Normal daily urine output
1200-1500 mL
Normal daily fluid intake
2200-2700 mL
Normal values: GFR
125 mL/min
How does urinary stasis cause incontinence?
Causes decreased bladder muscle tone
