Urinary Elimination

Question 1

Micturition

Answer 1

complex process involving bladder, urinary sphincters and CNS

voiding

Question 2

What muscles are involved in voiding?

Answer 2

bladder contraction
urethral sphincter
pelvic floor muscles
impulses from brain

Question 3

What is the process of voiding by the body?

Answer 3

CNS sends response of urge
external sphincter activates
bladder empties

Question 4

Factors influencing urinary elimination

Answer 4

growth and development
sociocultural factors
psych factors
surgery
personal habits
fluid intake
patho conditions
Dx tests

Question 5

Urinary changes in OA

Answer 5

Decreased amount of nephrons, bladder control and capacity, time between desire and urgent need

Increased bladder irritability and contractions during filling, risk of incontinence

Question 6

Urinary retention

Answer 6

inability to fully or partially empty bladder

can be acute or chronic

Question 7

Dx of urinary retention

Answer 7

bladder scan post void
applying pressure watching for pain or tenderness

Question 8

Is a bladder scan an independent or dependent intervention?

Answer 8

independent

Question 9

UTI

Answer 9

most common HAI

from E. coli

Question 10

Upper UTI

Answer 10

kidney infection

Question 11

Risk factors for UTI

Answer 11

indwelling catheter use
urinary retention
incontinence
poor peri hygiene
FEMALES
sex frequently
uncircumcised males

Question 12

How do elderly present with UTI?

Answer 12

neuro problems
falls

Question 13

S/Sx UTI

Answer 13

dysuria
burning with peeing
urgency
frequency
incontinence
foul smell
cloudy, dark urine

Question 14

CAUTI

Answer 14

catheter associated UTI
major risk of in dwelling catheter

Question 15

Urinary incontinence

Answer 15

involuntary loss of urine

Question 16

Types of urinary incontinence

Answer 16

Stress **women laugh, cough, sneeze
Overflow **men with prostate issues
Urgency

Question 17

Nocturia

Answer 17

voiding at night

Question 18

Risk factors for incontinence

Answer 18

women and elderly
obesity
multiple pregnancies/vaginal births
neuro disorders
meds
confusion, dementia
immobility, depression

Question 19

What is a normal urine output?

Answer 19

> 30mL per hour

Question 20

urine color

Answer 20

normal: pale straw to amber

abnormal: hematoma color changes

Question 21

Urine clarity

Answer 21

normal: transparent

abnormal: cloudy, thick
(from sitting in bladder)

Question 22

Urine odor

Answer 22

normal: odorless, ammonia

abnormal: offensive, food, fruity (acetone)

Question 23

Measurement of urine

Answer 23

catheter
foley bag with urometer
q4-8 hours
urinals
specihat

Question 24

Normal urine pH

Answer 24

4.6-8

Question 25

Urinalysis

Answer 25

way to test urine collect during normal void fresh new urine needed

Question 26

Can urine be taken from a catheter bag for a urinalysis?

Answer 26

no

Question 27

What should be negative in a urinalysis?

Answer 27

electrolytes ketones proteins WBC

Question 28

Culture/Sensitivity

Answer 28

clean void/mia stream catheter - sterile urinary diversion must be sent within 30 min results in 24 hours

Question 29

Abdominal x-ray KUB

Answer 29

determines shape, symmetry, locations and structures of urinary tract detects and measures urinary calculus (kidney stones) no special prep

Question 30

Normal fluid intake

Answer 30

2300 mL per day if renal function is intact and no need for restrictions helps flush out solute to limit bladder irritation

Question 31

What should you do for nocturia patients before bed?

Answer 31

Stop drinking fluids 2 hours before

Question 32

Urinary catheter care

Answer 32

single lumen (I and O) indwelling (balloon) 3 lumen (meds or irrigation) coude tip (curved) suprapubic (thru abdominal wall) external (condom or pure wick)

Question 33

When should you empty a urine bag?

Answer 33

1/2 full

Question 34

Can peri care before catheter insertion be delegated?

Answer 34

yes

Question 35

How soon should patients void after removal of catheter?

Answer 35

6-8 hours

Question 36

When doing an I and O catheter, should you use the same catheter each time?

Answer 36

No, use a different one each time

Question 37

What output is necessary post surgery or catheter removal?

Answer 37

30mL/hr

Question 38

What are labs to assess kidney function?

Answer 38

Creatinine BUN AST ALT

Question 39

What condition can place a patient at risk for UTI?

Answer 39

diabetes mellitus

Question 40

What kind of catheter should be used for a male with an enlarged prostate?

Answer 40

coude tip catheter

Question 41

Who is more likely to experience stress urinary incontinence?

Answer 41

women