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Intro to Nursing Exam 2 > Chapter 46 > Flashcards

Chapter 46 Flashcards

1
Q

The last step in the removal & elimination of excess water and by-product of body metabolism

A

Urinary elimination

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2
Q

Protein in urine

A

Proteinuria

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3
Q

Blood in urine

A

hematuria

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4
Q

Normal range of urine production

A

1-2 L a day

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5
Q

Factors that influence the production of urine

A

fluid intake and temperature

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6
Q

Stimulates red blood cell production

A

erythropoietin

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7
Q

renin function

A

convert angiotensinogen into angiotensin ii

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8
Q

what does angiotensin ii cause

A

vasoconstriction

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9
Q

Patients with kidney impairment can have these medical problems

A

anemia, hypertension, and electrolyte balance

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10
Q

Areas of the brain involved in bladder control

A

cerebral cortex, thalamus, hypothalamus, and brainstem

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11
Q

Psychosocial conditions influencing urination

A

Social expectation (school, recesses, work breaks)

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12
Q

physiological factors influencing urination

A

Anxiety & stress (increase) and depression (decrease)

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13
Q

Medications affecting urination. Patients hold on to water

A

Diuretics (increase)

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14
Q

Urinary retention

A

The inability to partially or completely empty the bladder

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15
Q

Postvoid residual (PVR)

A

amount of urine left in the bladder after voiding and is measured by ultrasound or straight catheterization.

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16
Q

Most common cause of UTI

A

Escherichia coli

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17
Q

Cystitis symptoms

A

Urgency, frequency, incontinence, suprapubic tenderness, and foul-smelling cloudy urine.

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18
Q

sign of UTI in older adult

A

delirium

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19
Q

UTI in upper urinary tract

A

pyelonephritis

symptoms: fever, chills, diaphoresis, and flank pain

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20
Q

Urinary diversions

A

when patients have had the bladder removed b/c of cancer or bladder dysfunction, and the urine is diverted to the outside of the body through an opening of the abdominal wall called a stoma.

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21
Q

Two types of urinary diversions

A

Continent urinary diversion: distal part of the ilium and proximal part of the colon
orthotopic neobladder: uses an ileal pouch to replace the bladder.

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22
Q

6 month old infant who weighs 13-15lbs will excrete how much urine a day

A

400-500 ml a day

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23
Q

Best position to examine the female genitalia

A

dorsal recumbent position to provide full exposure to the genitalia

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24
Q

retracted foreskins can cause dangerous swelling called

A

Paraphimosis

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25
Assessment of I&O is a way you assess
bladder emptying, renal function, and fluid and electrolyte balance
26
although I&O is often a written order, it can also be....
placed by the nursing judgement
27
Output measurement includes
Urine, vomitus, gastric drainage tubes, and wound drains
28
A change in urine can be an indicator of
fluid imbalance, kidney dysfunction, decreased blood volume.
29
if urinary output falls below 30 mL/hr, the nurse should do what first
assess for signs of blood loss and notify the health care provider.
30
How long should a nurse wait to evaluate for urinary retention if a client has had fluid and is not voiding urin
3-6 hr
31
Normal urine color
Pale straw color to amber, depending on its concentration
32
Patients taking diuretics urine will look
diluted in color while medication is active.
33
Bleeding from kidneys causes urine to look
dark red
34
Bleeding from the bladder or urethra causes urine to look
bright red
35
Urine will look bright orange if a patient is taking
Phenazopyridine
36
What foods cause red urine
Beets, rhubarb and blackberries
37
patients with liver disease could have what color urine
Dark amber, as a result of high concentrations of bilirubin.
38
Clarity of urine should be
transparent
39
Renal disease causes urine to appear (consistency)
cloudy because of protein concentration. Could also look thick because of bacteria and white blood cells
40
Foods that change the odor of urine
asparagus and garlic
41
proper label for all specimen collections
PT name, date, time, and type of collection
42
To obtain urine that is fresh and up to policy, what must the patient do
PT must double void | second voided specimen is the one sent to the laboratory
43
A patient with normal renal function who does not have heart disease or alterations requiring fluid restrictions should have an output of
30 ML/kg of weight or 0.5 ounces/lb/day
44
Indwelling
remains in place over a period of time
45
Intermittent
one-time cathertization for bladder emptying
46
Indwelling catheterization can last as little or as long as?
2 weeks to more than a month
47
Difference in catheters
- number of catheter lumens - the presence of a balloon to keep the catheter in place - the shape of the catheter - a closed drainage system
48
Single-lumen catheters are used for
intermittent/straight catheterization
49
Double-lumen catheters are used for
indwelling catheters | one lumen for the urinary drainage and one used to inflate the balloon to keep the catheter in place.
50
Triple-lumen catheters
continuous bladder irrigation or when it is necessary to instill medication into the bladder.
51
A health care provider chooses a catheter based on
- latex allergy - history of catheter encrustation - anatomical factors - susceptibility to infection
52
indwelling catheters are made of
latex or silicone (good for patients who require a lot of changes, due to encrustation
53
Intermittent/straight catheters are made of
rubber or polyvinyl chloride
54
Most common adult size of indwelling catheter
14-16 Fr
55
Infant indwelling catheter size
5-6 Fr
56
Children indwelling catheter size
8-10 Fr
57
young girls indwelling catheter size
12Fr
58
Indwelling catheter balloon sizes
3mL (children) 10 mL (adult) 30 mL
59
Why should the drainage system never be separated?
It can introduce the system to pathogens
60
When a patient ambulates, it is important to
carry the bag below the level of the patients bladder, and use a leg bag if necessary.
61
The only drainage bag that does not need to be kept dependent to the bladder is a
Specially designed drainage bag (belly bag)
62
Patients should receive catheter care how often?
Every 8 hours
63
What can an overfull drainage bag do?
create tension and pulling on the catheter, resulting in trauma to the urethra and/or urinary meatus.
64
In the presence of no urine drainage, what should the nurse assess first?
Check to make sure there are no kinks or obvious occlusions of the drainage tubing or catheter.
65
How long should all patients have their voiding monitored after catheter removal?
For at least 24-48 hours
66
Symptoms requiring intervention after a catheter has been removed and the first few urinary voids are complete
- Abdominal pain & distention - A sensation of incomplete emptying - Incontinence - Constant dribbling of urine - Voiding in very small amounts
67
What catheter increases the risk of a UTI
Indwelling catheter
68
After catheter is removed, how many days until symptoms of infection develop?
2-3 or more
69
What are the 2 alternatives to urethral catheters
Suprapubic catheterization & External catheter (condom catheter)
70
Suprapubic catheter is
A urinary drainage tube inserted surgically into the bladder through the abdominal wall above the symphysis pubis.
71
How does a suprapubic catheter stay in place
- sutured to the skin - secured with adhesive material - retained in the bladder with a fluid-filled balloon
72
External catheter is
A condom-like sheath that fits over the penis, providing a safe noninvasive way to contain urine.
73
Medications to treat urgency, frequency, nocturia and urgency UI
Antimuscarinics - derifenacin - oxybutynin - solifenacin - fesoterodine - tolterodine - tropsium
74
Adverse effects of antimuscarinics
dry mouth, constipation and blurred vision
75
Common irritants that increase symptoms of frequency, urgency, and incontinence
artificial sweeteners, spicy food, citrus products, and caffeine.
76
Pelvic floor muscle training
kegels
77
Factors influencing urination
growth and development, sociocultural factors, psychological factors, personal factors, personal habits, fluid intake, pathological conditions, surgical procedures, medications, diagnostic examinations

Intro to Nursing Exam 2 (6 decks)

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