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NUR 333: > Urinary Elimination > Flashcards

Urinary Elimination Flashcards

(52 cards)

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1
Q

bacteremia

A

presence of bacteria in blood stream

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2
Q

bacteriuria

A

presence of bacteria in the urine but no symptoms
- e coli most common, often health care associated

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3
Q

catheter associated UTI

A

develop with presence of indwelling cath (break sterility on insertion)
- can be costly w no reimbursement
- can be reasonably prevented
- focus on early recognition and prompt treatment

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4
Q

catheterization

A

putting a catheter into the urinary tract

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5
Q

cystitis

A

inflammation of the bladder caused by bladder infection

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6
Q

dysuria

A

pain, burning, discomfort when urinating

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7
Q

hematuria

A

presence of blood in someones urine

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8
Q

micturition

A

to urinate
- complex process that involves the bladder, urinary sphincters, CNS

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9
Q

nephrostomy

A

an opening between the kidney and skin to allow for the removal or urine

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10
Q

pelvic floor muscle training

A

repeated contracting and relaxing of muscles to help with urination

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11
Q

postvoid residual

A

the amount of urine left in the bladder after a void

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12
Q

proteinuria

A

high levels of protein in the urine

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13
Q

pyelonephritis

A

kidney infection

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14
Q

suprapubic catheter

A

placed in the bladder through the abdominal wall
- sutured in place
- used when blockage or urethra or indwelling causes irritation

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15
Q

urinary incontinence

A

involuntary loss of urine
- urgency, stress, overflow
- often multifactorial

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16
Q

ureterostomy

A

surgery to create a urinary diversion
- have stoma for ureter or kidney
- urine bypasses bladder and exits through stoma

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17
Q

voiding

A

bladder contraction and urethral sphincters and pelvic floor muscles
- impulses sent from brain
- external sphincter relaxes and bladder empties

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18
Q

factors that influence urinary elimination

A
  • growth and development
  • sociocultural factors
  • psychological factors
  • personal habits
  • fluid intake
  • pathological conditions (nervous system)
  • surgical procedures (post op, abdomen area)
  • diagnostic examinations
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19
Q

urinary changes in older adults

A

decreased
- amount of nephrons
- bladder muscle tone
- bladder capacity
- time btw initial desire and becomes urgent
increased
- bladder irritability
- bladder contractions during bladder filling
- risk of urinary incontinence

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20
Q

common urinary problems

A
  • urinary retention
  • UTI
  • incontinence
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21
Q

urinary retention

Study These Flashcards
A

inability to partially or completely empty bladder
- acute or chronic
- diagnose w bladder scan (postvoid residual)
- incontinence considered overflow incontinence

22
Q

bladder scanner

Study These Flashcards
A
  • independent nursing intervention
  • should be done after post void
  • can lead to i and o cath before full cath
23
Q

risk factors for UTI

Study These Flashcards
A
  • presence of indwelling catheter
  • any instrumentation of urinary tract
  • urinary retention
  • urinary or fecal incontinence
  • poor peri care
  • female
  • frequent sexual intercourse
  • uncircumcised pts
24
Q

incontinence of risk factors

Study These Flashcards
A
  • more common in women and elderly
  • obesity
  • multiple pregs / vaginal birth
  • neurological disorders (parkinsons, CVA, spinal cord, MS)
  • med therapy: diuretics, opioids, anticholinergics, Ca channel blockers, sedatives, hypnotics
  • confusion
  • dementia
    -immobility
  • depression
25
assessment of pts w urinary problems
- assess understanding and expectations of treatment - be professional - assess ability to perform necessary behaviors associated w voiding - assess for any culture or personal considerations - past medical and surgical hx - med use - normal bowel and urinary elimination patterns - sleep, activity, nutrition
26
focused assessment for urinary incontinence
- focused urinary and abdominal - looking at kidneys, bladder, external genitalia, meatus, urethra, perineal skin
27
pattern of urination
- frequency and times - normal amount w each void - hx of recent changes
28
assessment: nursing hx
- pattern of urination - symptoms of urinary alterations - urination, dysuria, freq, hesitancy, polyuria, oliguria, nocturia, dribbling, hematuria, retention
29
CVA
costovertebral angle - checks for kidney infection
30
assessing urine
- input and output - characteristics of urine
31
intake and output assessment
- evaluates bladder emptying - renal function - fluid and electrolyte balance - can be HCP or nurse decision to measure
32
normal urine output rate
more than 30 mls for every hour
33
characteristics of urine
- color - clarity - odor
34
color
normal - pale straw color to amber abnormal - hematuria - color changes
35
clarity
normal - transparent to void - urine that sits could become cloudy - thick and cloudy can indicates bacteria and WBC - early morning voids can look like cloudy
36
odor
normal - odorless - ammonia smell abnormal - offensive, may indicate UTI - some foods can alter smell - fruity indicates acetone
37
strict i and os
must have a catheter - often used for people with kidney disease, heart failure
38
urinalysis info
- collect freshly voided urine - cant take out of catheter bed - sometimes can use reagent strips - send to lab w/in 30 mins - use sterile specimen cup
39
urinalysis normal results
- clear, amber, yellow - aromatic - ph 4.6-8.0 - protein 8 mg/100 mls - glucose, bacteria, ketones all negative - specific gravity 1.005-1.030 - RBC up to 2 - WBC 0-4
40
abdominal x-ray
determines size, shape, symmetry, location of structures of urinary track - detects and measures urinary calculi - no special prep like NPO
41
nursing problems for urinary elimination
- impaired urinary elimination - urinary retention - incontinence - impaired comfort and pain - impaired skin integrity or risk for impaired skin integrity - knowledge deficit - body image disturbance - risk for infection
42
health promotion and pt education
- promote self care practices - maintain normal routine - promote healthy nutrition and fluid intake - avoid smoking and constipation - strengthen pelvic floor muscles - be aware of mens prostate - report changes in urinary tract
43
maintaining adequate fluid intake
- 2300 mls/day (if no renal function problems, no heart disease) - helps flush solutes to limit bladder irritability - if fluid needs to be inc, schedule times to drink, identify preferences, high fluid fruits, stop drinking about 2 hrs before bed
44
urinary retention
- assess and monitor urine output, bladder distention - assess for normal elimination position - run water or flush commode - apply cold compress - encourage double voiding - around the clock voiding - crede method (applying manual pressure, not recommended) - intermittent cath, cath
45
preventing infection
- follow hospital protocol - assess for s/s of infection - preform peri care - void at regular intervals - adequate fluid intake - female considerations (wiping, solutions for leakage, inc pelvic floor strength)
46
incontinence care
- be respectful of feelings - pelvic floor muscle training - lifestyle changes - bladder retention - toilet schedule - inter cath - meticulous skin care - absorbant pads and catheters - electrical stimulation - meds (anticholinergic) - interventional therapies - surgery
47
skin care do
- identify and treat early - use skin risk assessment tool - use appropriate skin barrier problems - ensure adequate hydration - consult wound
48
skin care donts
- use traditional soap and water - double padding the bed - leave soiled pads
49
types of catheters
- single lumen - indwelling cath - 3 lumen - coude tip - suprapubic external
50
nursing catheter care
- regular peri care - secure cath to prevent movement - empty drainage bag when 1/2 full - ensure no kinks - bag below bladder - drainage bag cant touch floor - maintain closed system - accurate monitoring - timely removal
51
before cath insertion
- peri care (front to back, uncircumcised) - can delegate to assistant - CHG or castille wipes (done before insertion, daily/qshift) - follow algorithm for removal
52
post cath removal
- pt should void w/in 6-8 hrs - monitor ability to void and empty - measure accurate urine output - check for retention - pt education like firrst void can cause discomfort)

NUR 333: (10 decks)

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