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Fundamentals of Nursing > Urinary Elimination > Flashcards

Urinary Elimination Flashcards

(103 cards)

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1
Q

if someone is fluid deficit what do we do

A

give fluids

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2
Q

when someone has urinary issues what do we want to keep an eye on

A

I&O

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3
Q

what is the main involuntary muscle of the urinary system

A

detrussor muscle

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4
Q

what is included under voluntary control

A

imitating
stoping
interrupting

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5
Q

what is the minimum normal urine output

A

30mL/hr

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6
Q

can we control the internal sphincter

A

no

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7
Q

internal sphincter is controlled by

A

neurogenic

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8
Q

external sphincter is controlled by

A

you
- able to control this one

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9
Q

how does age influence urination

A

decreased ability to concentrate urine
decreased bladder tone
decreased bladder contractility
neuromuscular/cognitive problems

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10
Q

what does it tell you that older adults have decreased ability to concentrate urine

A

frequent getting up throughout the night which is a fall risk
- able to concentrate urine allows us to not have to go at night

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11
Q

what does it tell you that older adults have decreased bladder tone and bladder contractility

A

the bladder does not empty fully so they will have statsis of urine which leads to a UTI

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12
Q

what does it tell you that older adults have neuromuscular/cognitive problems

A

they are not aware they have to do

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13
Q

how can food and fluid intake affect urination

A

decreased drinking could lead to increased sodium

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14
Q

what do we want fluid intake at

A

2-3L

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15
Q

what are some pathology that can affect urination

A

renal disease, diabetes

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16
Q

what are some medications that can increase urine output

A

diuretics

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17
Q

what should we ask about voiding history

A

how often do you go
are you routinely going

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18
Q

who might be at risk for high post void residuals

A

BPH

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19
Q

what do we use to confirm how much fluid is in post void residual

A

bladder scanner

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20
Q

what is a normal post void residuals

A

> 50mL

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21
Q

what can be an assessment of urine include

A

color
clarity
odor
volume over 24 hour period
specimens

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22
Q

UA

A

urine analysis

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23
Q

how much do we need for a UA

A

10mL

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24
Q

is a UA a gross or specific

A

gross

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25
what does a UA tell us
WBC, RBC, sugar, protein
26
if we notice a possible problem on the UA what will we order next
urine culture and sensitivity
27
how much do we need for a urine culture and sensitivity
3mL
28
CCMS
clean catch mid stream
29
how do we collect a CCMS in a patient with a catheter
specimen port
30
how do we collect a CCMS on a patient with no catheter
good peri care start stop start and collect stop finish
31
why do we want the patient to pee at first when getting a CCMS
gets rid of any contaminants
32
if we have a patient with no catheter and they cannot perform a CCMS what do we do
straight Cath for the procedure
33
how do we do a 24 hour urine sample
at the time the 24 hour starts have patient void because this urine was now produced during that 24 hour. at the end of the 24 hour collect that urine because it was produced in that 24 hour
34
what happens if we dump a void for a 24 hour urine sample
start over
35
what can a 24 hour urine sample tell us
renal function creatine clearance
36
is culture and sensitivity a sterile procedure
yes
37
BUN normal
8-23
38
what does BUN measure
can the kidneys remove urea from blood nitrogen in blood that comes out in urine how well the kidneys work
39
what is urea
protein broken in body
40
who might we see a high BUN in
decreased kidney function or dehydrated
41
is creatine a more refined or gross test
refined
42
normal creatine
0.6-1.2
43
if you have increased creatine what does that tell you about your body
decreased kidney function
44
what is the most specific test
GFR
45
what contributes to GFR
age and race
46
what is a normal GFR
90
47
what do we want the minimum of GFR to get
>60
48
if GFR is less than 60 for 3 months what does that mean
renal disease
49
GFR is a parameter for what medication
glucophage
50
what habits do we want to maintain while in the hospital
privacy position hygiene
51
how do we maintain muscle tone
kegal exercises and bladder training
52
what is kegal exercises
increase pelvic floor muscule like holding in pee
53
what is bladder training
put patient on toilet every 2 hours
54
incontince
cannot control urinary flow
55
is inconntince a normal process of aging
no
56
ilulconduit
ureter to ilum to abdomen bag
57
uretostomy
ureters to surface
58
neobladder
small intestine and make fake bladder
59
pros and cons to neobladder
no signal about going body image, no bag
60
UTI symtoms and signs
dysuria. frequency, cloudy urine and foul odor, back pain
61
how do we confirm a UTI
urine analysis and/or urine culture
62
what might we see in younger person
increase temp increase WBC
63
what is the first sign of UTI in elderly
confusion
64
what do we find out from a urine culture and sensitivity
the bacteria and what antibiotics treat the infection
65
who has an increased risk factors for UTI
females (short urethra) age (urinary statuses) indwelling catheters (CAUTI) diabetics (sugar allows bacteria to grow)
66
interventions for UTI
foley care kegal I &O wipe front to back pee after sex to clear bacteria cotton underware
67
where can biofilm be harmful
indwelling cath
68
urinary retention increased risk
age prostate
69
after foley is removed patient needs to go within
6 hours
70
diseases of what could cause urinary retention
spinal cord
71
what are some meds that cause urinary retention
anticholinergics tricyclic antidepressants calcium channel blockers narcotic analgesics anesthetic agents
72
why do anesthetic agents lead to urinary retention
paralyze internal sphincter
73
we want a urinary retention to be
less than 50mL
74
what PVR tells us there is urinary retention
150mL
75
who might a bladder scanner be inaccurate in
obesity inadequate gel improper aim moving the probe during scanning scar tissue incisions staples
76
straight cath
intermitten put in, drain, pull out
77
indwelling cath
stays in
78
suprapubic cath
long term
79
normal position for Cath insertion
dorsal recumbent
80
when will an indwelling Cath be appropriate
acute urinary retention accurate measurments periop healing of wounds prolonged immobilization end of life care large volume infusions of diuretics during surgery
81
inappropriate uses of indwelling caths
substitue for nursing care obtaining a urine culture when patient is capable prolonged postop duration
82
what is an alternative to indwelling
pirwicks
83
what is the sanitation for putting in a cath
sterile/aseptic
84
why do we secure caths
so it cannot float in
85
when is the most common time to get CAUTI
after insertion poor care after insertion
86
foley care
clean clean to dirty 6 in down tube keep off floor secure to thigh green clip on bed no dependent loops bag never higher than bladder (back flow) pericare
87
what suction is the perwicks
low
88
how often do we replace pirwicks
8-12 hours
89
how often do we change condom caths
24hr
90
how do we put a condom Cath on a patient who is uncircumsized
replace foreskin before putting Cath on
91
how much space do we leave at end of condom cath
1 inch
92
transient incontinence
appears suddenly and is usually caused by an illness or temporary problem that is short lived/treatable
93
stress
weak pelvic floor muscles and/or deficient urethral spinchter, loss of urine during increased intrabdominal pressure
94
urge
involuntary loss of urine that occurs soon after feeling an urgent need to void
95
mixed
combination of stress and urgency
96
overlfow
chronic retention of urine asscoated with overdistension and over flow
97
functional
inability to reach bathroom
98
reflex
spinal cord injuries emptying with no signal
99
how to help with stress
kegal
100
how to help with urge
bladder training
101
how to help with overflow
kegal
102
how to help with functional
bladder training
103
how to help with reflex
bladder training

Fundamentals of Nursing (23 decks)

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