Urinary Elimination

Question 1

What does micturition mean?

Answer 1

peeing

Question 2

What is the average urinary output every day?

Answer 2

1500 mL

Question 3

What factors affect your need of Urinary Elimination?

Answer 3

Age
Diet
Fluid Balance
Sociocultural (culture, gender)
Physchosocial (anxiety, privacy)
Medication
Pelvic muscle tone
illness and disease
surgery

Question 4

Whta are dangerously low levels of urine output?

Answer 4

Anything below <30 ml/hr

Question 5

What are some characteristics of normal urine?

Answer 5

sterile
can hold up to 600mL
feel the urge to void at 250-450mL
color = transparent pale yellow
faint aroma
PH=4.5-8
Gravity= 1.010-1.025
Glucose, ketones, and blood = negative

Question 6

why is urinary elimination important?

Answer 6

to remove waste products

Question 7

What is polyuria?

What is Oliguria?

What is anura?

What is frequency?

What is nocturia?

What is urgency?

What is dysuria?

What is enuresis?

and what causes each?

Answer 7

Polyuria-High urine amount (high intake of liquids)

Oliguria-Low urine amount (dehydration)

Anura-No peeing (kidney failure)

Frequency-Increased voiding (UTI)

Nocturia- Up at night to void (high mL before bed)

Urgency - Must void now (bladder infection)

Dysuria - Painful urination (UTI)

Enuresis-Involuntary voiding (bedwetting)

Question 8

Describe the different types of Urinary Intontinence:

1. Transient Urinary incontinent
2. Urgency UI
3. Stress UI
4. Mixed UI
5. Functional UI
6. UI associated with chronic retention (previously overflow UI)

Answer 8

1. Transient Urinary incontinent - temporary infection (UTI)
2. Urgency UI - urgent need to pee
3. Stress UI - pressure on the bladder
4. Mixed UI - stress and urgency
5. Functional UI - cant find bathroom
6. UI associated with chronic retention - overactive bladder with retention (from a UTI)

Question 9

What is a urinary tract infection?

Answer 9

infection in the urinary system (any part)

Question 10

What is nocturia?

Answer 10

waking up in the night one or more times to urinate

Question 11

What is urinary retention?

Answer 11

Accumulated pee in the bladder because it won’t fully empty

Question 12

What is urinary diversion?

Answer 12

A surgical change in the normal path of urine due to bladder dysfunction or removal (J-pouch)

Question 13

What is renal failure?

Answer 13

Kidneys lose their ability to filter waste

Question 14

What is neurogenic bladder?

Answer 14

A bladder problem caused by nerve damage and patient cant control their urination

Question 15

can you give me one nursing intervention for each of these?

• Normal Elimination Management
• **Urinary Incontinence care
• **Prompted Voiding
• **Urinary Habit Training
• Urinary Retention Care
• **Pelvic Floor Muscle Exercises

Answer 15

• Normal Elimination Management - drink 6-8 glasses of water daily
• **Urinary Incontinence care - Provide regular skin care and barrier creams to prevent breakdown
• **Prompted Voiding - Set a timer to remind the patient to attempt toileting every 2 hours
• **Urinary Habit Training - Develop a toileting schedule
• Urinary Retention Care - Perform a post-void bladder scan to assess residual urine volume
• **Pelvic Floor Muscle Exercises - Teach and coach the patient to perform Kegel exercises

Question 16

What are the 4 steps to perform pelvic floor muscle exercises?

Answer 16

1. Position – sitting, lying or standing
2. Contraction - pull upward and inward (inside) rectum, urethra and vagina
3. Timing - Hold for count of 3-5 seconds & relax for 3-5 seconds
4. Repeat - contractions 10 times in a row, 5 times daily

Question 17

According to the RNAO Best Practice Guidelines, what 3 things do they recommend to promote continence with prompted voiding?

Answer 17

1. Monitoring - asking and taking patient to bathroom at regular intervals
2. Prompting - reminding/ encouraging to go to void
3. Praising - giving positive feedback for maintaining bladder control

Question 18

What is dysuria?

What is polyuria?

What is oliguria?

What is hematuria?

Answer 18

Dysuria - pain/ burning when urinating

Polyuria - peeing large amounts

Oliguria - peeing small amounts

Hematuria - blood in urine

Question 19

what are diuretics?

Answer 19

things making you pee more.
Example: coffee, alcohol, medication

Question 20

How can you manage urinary incontinence?

Answer 20

-Continence Bladder Training
-Bladder Training
-Habit Training
-Prompted Voiding

Question 21

When doing an evaluation you should always ask questions or observe if goals are:

Answer 21

met
not met
partially met

Question 22

How could onset of urinary incontinence affect a patient?

a. The patient may feel the incontinence is part of getting older and
decide not to seek help.
b. The patient may worry that the incontinence could cause urinary
tract infections.
c. The patient is not bothered at all by these changes in his urinary
function and control.
d. The patient feels that all these symptoms are related to not being
circumcised at birth.

Answer 22

A

Question 23

Prostate enlargement can contribute to lower urinary tract issues
in which of the following ways?

a. By causing stress urinary incontinence
b. By causing urinary frequency and possibly retention
c. By causing a change in the colour and odour of urine
d. By increasing the acidity of the urine

Answer 23

B

Question 24

Nocturia is “the number of times urine is passed during the main
sleeping period.” What factors can contribute to nocturia?

a. Weak pelvic floor muscles after radical prostatectomy
b. Obesity and the number of vaginal deliveries
c. Peripheral edema and obstructive sleep apnea
d. Long-time use of an in-dwelling urinary catheter

Answer 24

C

Question 25

The normal urine output for an adult is: a. 1 000 mL/day b. 1 500 to 1 600 mL/day c. 3 000 to 3 200 mL/day d. 4 000 mL/day

Answer 25

B

Question 26

A patient has to rush to the bathroom when he experiences an urge to urinate and he leaks urine on the way. This is most likely urge incontinence. Which factors can contribute to urge incontinence? a. Prostate cancer and radical prostatectomy surgery b. Obesity, number of deliveries, ethnicity c. Kidney failure treated with peritoneal dialysis d. Central nervous system disorders and outflow obstruction

Answer 26

D

Question 27

What history should the nurse consider that could be contributing to a patients lower urinary tract symptoms of urgency, frequency, and nocturia? a. Whether he has had micturition syncope associated with dehydration b. Whether he had issues with toilet training and bedwetting as a young child c. Whether he had radical prostatectomy surgery for prostate cancer d. Whether he has an elevated postvoid residual volume due to an enlarged prostate

Answer 27

D

Question 28

The nurse asks a patient to complete a 3-day bladder diary. How could a bladder diary assist the nurse in the diagnosis and treatment of incontinence? a. To evaluate lifestyle habits (e.g., fluid intake) in relation to the voiding pattern and symptoms b. To determine fluid and fibre intake and to assess and treat constipation c. To evaluate mobility and ability to dress or undress and use the toilet independently d. To evaluate how the alterations in elimination affect lifestyle and quality of life

Answer 28

A

Question 29

The day Harjit is being discharged home, he shares with his nurse that he still is having to rush to the bathroom to urinate and he can leak urine on the way. What would be an appropriate lifestyle modification that the nurse could discuss with Harjit to help with this urge incontinence? a. Decrease his total fluid intake to 1 000 mL per day b. Avoid caffeine and to strengthen his pelvic floor muscles c. Use a condom catheter and a leg bag d. Urinate every hour to avoid leakage of urine

Answer 29

B

Question 30

True or false: The act of micturition, or voiding, is influenced by complex interactions between the bladder, spinal cord, and brain, involving autonomic (involuntary) and somatic (voluntary) nerves

Answer 30

True

Question 31

True or false: When collected properly, a clean-voided urine specimen does not contain bacteria.

Answer 31

True

Question 32

True or false: An increased fluid intake results in increased urine formation, which reduces the risk of urinary tract infections.

Answer 32

True

Question 33

What are the five ways incontinence is classified?

Answer 33

transient urge stress mixed functional