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NURS 402: Lecture > Urinary elimination > Flashcards

Urinary elimination Flashcards

1
Q

Job of Kidneys and Ureters

A
  1. Maintain composition and volume of body fluids
  2. Filter and excrete blood constituents not needed; retain those that are needed
  3. Excrete waste product (urine)
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2
Q

What do nephrons do to excrete waste product (urine)

A

The nephrons maintain and regulate fluid balance through the mechanisms of selective reabsorption and secretion of water, electrolytes, and other substances

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3
Q

Where do urine from nephrons empty?

A

Urine from the nephrons empties into the kidneys

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4
Q

What is the bladder made up of?

A

Smooth muscle sac innervated by ANS

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5
Q

What does bladder serve as?

A

Serves as a temporary reservoir for urine

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6
Q

What is the bladder composed of?

A

Composed of three layers of muscle tissue called detrusor muscle

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7
Q

What are the three layers the bladder is made up of

A

Composed of three layers of muscle tissue called detrusor muscle

The inner longitudinal layer, the middle circular layer, and the outer longitudinal layer

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8
Q

What opens between urinary bladder and sphincter

A

Sphincter guards opening between urinary bladder and urethra

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9
Q

What does Urethra do?

A

Urethra conveys urine from bladder to exterior of body

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10
Q

How are male urethras?

A

Male urethra functions in excretory and reproductive systems

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11
Q

How are women urethras?

A

No portion of female urethra is external to the body

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12
Q

Act of urination is also called?

A

Act of Urination (Micturition, Voiding)

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13
Q

Steps to emptying the bladder: What do detrusor, internal sphincters and urine do?

A

Detrusor muscle contracts, internal sphincter relaxes, urine enters posterior urethra

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14
Q

Steps to emptying the bladder: what do muscles perineum and external sphincters do?

A

Muscles of perineum and external sphincter relax

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15
Q

Steps to emptying the bladder: what do muscles abdominal wall do?

A

Muscle of abdominal wall contracts slightly

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16
Q

Steps to emptying the bladder: What does diaphragm do?

A

Diaphragm lowers, micturition occurs

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17
Q

Factors Affecting Micturition

A

Developmental considerations
Food and fluid intake
Psychological variables
Activity and muscle tone
Pathologic conditions
Medications

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18
Q

What is included in development considerations affecting micturition

A

Toilet training
Effects of aging

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19
Q

More specific developmental considerations having to do with children?

A

Toilet training 2 to 3 years old, enuresis

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20
Q

More specific developmental considerations having to do with effects of aging?

A

Nocturia
Increased frequency
Urine retention and stasis
Voluntary control affected by physical problems

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21
Q

Diseases Associated with Renal Problems

A

Congenital urinary tract abnormalities
Polycystic kidney disease
Urinary tract infection
Urinary calculi
Hypertension
Diabetes mellitus
Gout
Connective tissue disorders

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22
Q

Effects of Medications on Urine Production and Elimination: Three medications to consider

A
  1. Diuretics
  2. Cholinergic meds
  3. Analgesics and tranquilizers
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23
Q

Diuretics:

A

prevent reabsorption of water and certain electrolytes in tubules

24
Q

Cholinergic medications:

A

stimulate contraction of detrusor muscle, producing urination

25
Q

Analgesics and tranquilizers:

A

suppress CNS, diminish effectiveness of neural reflex

26
Q

Medications Affecting Color of Urine

A

Anticoagulants:
Diuretics:
Pyridium:
The antidepressant amitriptyline or B-complex vitamins:
Levodopa:

27
Q

Nursing History for urinary elimination

A

Usual patterns of urinary elimination
Recent changes in urinary elimination
Aids to elimination
Present or past occurrence of voiding difficulties
Presence of urinary diversion

28
Q

Physical Assessment of Urinary Functioning: What parts of the body are focused on

A

Kidneys:
Urinary bladder:
Urethral orifice:
Skin:
Urine:

29
Q

Physical Assessment of Urinary Functioning: Kidneys

A

Palpation of the kidneys is usually performed by an advanced health care practitioner as part of a more detailed assessment

30
Q

Physical Assessment of Urinary Functioning:Urinary bladder:

A

Palpate and percuss the bladder or use a bedside scanner

31
Q

Physical Assessment of Urinary Functioning:Urethral orifice:

A

Inspect for signs of infection, discharge, or odor

32
Q

Physical Assessment of Urinary Functioning:Skin:

A

Assess for color, texture, turgor, and excretion of wastes

33
Q

Physical Assessment of Urinary Functioning:Urine:

A

Assess for color, odor, clarity, and sediment

34
Q

Additional Assessment Techniques

A
  1. Measuring urinary output
  2. Routine urinalysis
35
Q

Measuring urinary output

A

Continent patients
Incontinent patients
Indwelling catheter

36
Q

What is included in routine urinalysis

A

Clean-catch or midstream specimen
Sterile specimen
Urinary diversion specimen
24-hour specimens

37
Q

Measuring Urine Output: What do you ask pt to void in?

A

Ask the patient to void into a bedpan, urinal, or specimen container in bed or bathroom

38
Q

Measuring Urine Output: After pt pees what do you do?

A

Put on gloves. Pour urine into the appropriate measuring device

39
Q

Measuring Urine Output: How do you measure it?

A

Place the calibrated container on a flat surface and read at eye level

Note amount of urine voided and record on the appropriate form

40
Q

Measuring Urine Output: What do you do with urine after measuring?

A

Discard urine in the toilet unless specimen is needed. If a specimen is required, pour the urine into an appropriate specimen container

41
Q

Patient Health Problems having to do with urine

A

Urinary functioning as the problem

Urinary functioning as the etiology

42
Q

Urinary functioning as the problem

A

Incontinence
Pattern alteration
Urinary retention

43
Q

Urinary functioning as the etiology

A

Anxiety
Caregiver role strain
Risk for infection

44
Q

Promoting Urinary Elimination

A
  1. Maintaining regular voiding habits
  2. Promoting fluid intake
  3. Strengthening muscle tone
  4. Assisting with toileting
45
Q

Planned Patient Goals:

A

Produce 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
Demonstrate appropriate self-care behaviors

46
Q

Patients at Risk for UTIs

A

Sexually active people with female genitalia

People who use diaphragms for contraception

Postmenopausal people

People with indwelling urinary catheter in place

People with diabetes mellitus
Older adults

47
Q

Types of Urinary Incontinence

A

Transient:
Mixed:
Overflow:
Functional:
Reflex:
Total:
Stress:

48
Q

Types of Urinary Incontinence: Transient

A

appears suddenly and lasts 6 months or less

49
Q

Types of Urinary Incontinence: Mixed:

A

urine loss with features of two or more types of incontinence

50
Q

Types of Urinary Incontinence: Overflow:

A

overdistention and overflow of bladder

51
Q

Types of Urinary Incontinence: Functional:

A

caused by factors outside the urinary tract

52
Q

Types of Urinary Incontinence: Reflex:

A

emptying of the bladder without sensation of need to void

53
Q

Types of Urinary Incontinence: Total:

A

continuous, unpredictable loss of urine

54
Q

Types of Urinary Incontinence: Stress:

A

involuntary loss of urine related to an increase in intra-abdominal pressure

55
Q

Reasons for Catheterization

A

Relieving acute urinary retention

Obtaining a sterile urine specimen when patient is unable to void voluntarily

Accurate measurement of urinary output in critically ill patients

Assisting in healing open sacral or perineal wounds in incontinent patients

Emptying the bladder before, during, or after select surgical procedures and before certain diagnostic examinations

Providing improved comfort for end-of-life care

Prolonged patient immobilization

56
Q

Types of Catheters

A

Intermittent urethral catheters

Indwelling urethral catheter

Suprapubic catheter

57
Q

Nursing Interventions

A

Urethral catheter insertion and care for patients with an indwelling catheter

Caring for a patient with a urologic stent

Caring for a patient with a urinary diversion

Caring for a patient receiving dialysis

NURS 402: Lecture (17 decks)

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