C9- Elimination Urinary System

Question 1

Anuria

Answer 1

24 hour urine output is less than 50mL

Question 2

Dysuria

Answer 2

Painful or difficult urination

Question 3

Frequency: urinary problems definition

Answer 3

Increased incidence of voiding

Question 4

Glycosuria

Answer 4

Presence of sugar in the urine

Question 5

Hematuria

Answer 5

Blood in the urine

Question 6

Nocturia

Answer 6

Awakening at night to urinate

Question 7

Oliguria

Answer 7

Scanty or greatly diminished amount of urine voided in a given time

24hr output is less than 400mL

Question 8

Polyuria

Answer 8

Excessive output of urine

Question 9

Proteinuria

Answer 9

Protein in the urine, indication of kidney disease

Question 10

Pyuria

Answer 10

Pus in the urine

Urine appears cloudy

Question 11

Urgency

Answer 11

Strong desire to void

Question 12

Urinary incontinence

Answer 12

Involuntary loss of urine

Question 13

Stress incontinence

Answer 13

Increase Intra-abdominal pressure
-sneeze, cough, laugh, physical activity
-pregnancy, menopause, obesity, chronic constipation

Question 14

Urge incontinence

Answer 14

Gotta go!! Frequent urge
-loss of urine before reaching toilet
-cause:
-infection
-loss of bladder tone d/t catheter

Question 15

Overflow incontinence

Answer 15

Overdistention and overflow of bladder
-signal to empty may be absent
-bladder fills, dribbling occurs
-Causes:
-2nd to drugs
-fecal impactions
-neuro problems

Question 16

Reflex Incontinence

Answer 16

Bladder empties without sensation of need to void

Causes:
-spinal cord injury

Question 17

Functional incontinence

Answer 17

Loss of urine d/t inability to reach bathroom
-environmental barriers
-physical limitations
-loss of memory
-disorientation

Question 18

Total Incontinence

Answer 18

Continuous, unpredictable loss of urine
Causes:
-surgery
-trauma
-anatomical abnormality

Question 19

Normal Urine volume

Answer 19

Average output= 1500-3000mL/day

SHOULD BE EQUIVALENT TO INTAKE

Question 20

Normal Urine appearance/turbidity

Answer 20

Clear or translucent

Cloudiness is abnormal- d/t cells or particulate

Question 21

Normal Urine color

Answer 21

Pale yellow

Abnormal=
-straw colored
-amber colored
-depends on the concentration

Question 22

Normal urine odor

Answer 22

Aromatic

Ammonia odor is due to bacterial action

Question 23

pH of normal urine

Answer 23

Range of 4.6-8.0. = NORMALLY AROUND 6

Acidic urine blocks bacterial growth and caluli

Question 24

Specific gravity of normal urine

Answer 24

Normal range is 1.015-1.025

Question 25

Normal protein levels in urine

Answer 25

Negative or trace amounts Positive = renal disease

Question 26

Normal glucose in urine

Answer 26

Negative If positive = diabetes mellitus DM

Question 27

Normal ketones in urine

Answer 27

Negative Ketonuria= diabetic Kerosins or starvation

Question 28

Specific gravity test

Answer 28

Compares the density of urine to the density of water The higher the number = the more dehydrated

Question 29

Dark amber urine cause

Answer 29

Dehydration

Question 30

Brown urine cause

Answer 30

Liver/gallbladder disease

Question 31

Red-brown urine cause

Answer 31

Blood in urine

Question 32

Orange, green, blue urine cause

Answer 32

Medications, dyes

Question 33

>3000mL abnormal urine output cause

Answer 33

Diuretics Diabetes High fluid intake

Question 34

<400mL urine output cause

Answer 34

Kidney dysfunction Excessive fluid loss Low fluid intake

Question 35

Urinalysis (UA) Tests:

Answer 35

Color, odor, RBC’s/WBC’s, pH, glucose, ketones, protein, nitrates, bacteria

Question 36

BUN (blood urea nitrogen) normal range

Answer 36

7-20 mg/dL

Question 37

Serum Creatinine normal range

Answer 37

0.8-1.4 mg/dL Elevation indicates renal insufficiency

Question 38

Physical assessment for urinary complications

Answer 38

Weigh client -best indicator of fluid status Assess I & O Vital signs Assess mucous membrane moisture Assess skin turgor Bladder assessment

Question 39

Order of nursing physical assessment (nursing)

Answer 39

Inspection -abdomen (note distention if any) Palpating -tenderness distention, height of bladder -urinary retention Bedside bladder scanner -ultrasound image of bladder -urine volume present (PVR of <50mL= normal bladder emptying) (PVR of >100mL = not emptying correctly)

Question 40

Inspection urinary nursing assessment

Answer 40

Abdomen Urinary meatus and genitalia -inflammation, discharge, tissue integrity Perineum and scrotum -skin integrity -edema -Prolapse of bladder or uterus -loss of pelvic muscle tone -incomplete emptying of bladder

Question 41

Palpation urinary nursing assessment

Answer 41

Tenderness Distention Height of bladder (Urinary retention)

Question 42

Bedside bladder scanner nursing assessment

Answer 42

Ultrasound image of bladder -urine volume present Assess postvoid residual -PVR of <50mL= normal bladder emptying -PVR of >100mL= abnormal bladder emptying (not emptying completely)

Question 43

Promoting Normal Urination

Answer 43

Maintain /develop voiding habits Promote fluid intake Strengthen muscle tone -pelvic floor muscle training Stimulate urination -prevent retention Assist with toileting

Question 44

Continence/bladder training

Answer 44

Timed voiding based on log Set ties Voiding every 2hrs Assist with toileting

Question 45

Kegel exercises

Answer 45

Stress incontinence Strengthen pelvic floor muscles

Question 46

Crede’s maneuver

Answer 46

Overflow incontinence During voiding: -lean forward -apply light pressure over bladder to complete emptying

Question 47

Cutaneous triggering

Answer 47

Reflex incontinence lightly stroke pubic or thigh skin

Question 48

Delayed urination

Answer 48

Urge incontinence when urge occurs, hold 5mins before voiding gradually lengthen time eventually 3-4hrs

Question 49

Anticolinergics

Answer 49

Relax smooth muscle of bladder Decrease bladder muscle contraction May increase capacity and decrease urge

Question 50

Cutaneous ureterostomy

Answer 50

Ureters directed through abdominal wall and attached to opening in skin Usually permanent

Question 51

Ileal conduit

Answer 51

Ureters drain from stoma created from intestine Ostomy bag continuously draining urine

Question 52

Continent rivalry diversion CUD

Answer 52

Ureters diverted into a segment of ileum and cecum uses section of intestine to create internal reservoir that holds urine Catheterizable stoma needs to be done at regular intervals