Urinary Elimination

Question 1

_____ is the release of urine from the urinary bladder through the urethra to the outside of the body.

_____ describes an overwhelming need to get to a restroom immediately. It may be accompanied by pain or discomfort in the bladder or urinary tract.

_____ is the involuntary leakage of urine.

_____ is a condition in which one cannot empty all the urine in the bladder.

Answer 1

1. Urination/ Micturation/ Voiding
2. Urgent urination
3. Urinary incontinence
4. Urinary retention

Question 2

Factors that Influence Urinary Elimination

1. Developmental Factors
2. Psychosocial Factors
3. Fluid and Food Intake
4. Medications
5. Muscle Tone
6. Pathologic Conditions
7. Surgical and Diagnostic Procedures

Question 3

Factors that Influence Urinary Elimination

Developmental Factors

1. Newborns & Infants (0-2 years): “Tiny & Uncontrolled”

Kidneys: Immature, can’t concentrate urine well.
Urination: Up to 20 TIMES A DAY, colorless, odorless, low specific gravity.
Control: No control at birth; develop between 2-5 YEARS (daytime first).
Key takeaway: Frequent, dilute urine; no bladder control yet.

2. Preschoolers (3-5 years): “Learning the Ropes”

Toileting: Can toilet independently.
Hygiene: Need teaching on handwashing, flushing, and wiping (girls: front to back!).
Key takeaway: Gaining independence, but need hygiene guidance.

Question 4

3. School-Age Children (6-12 years): “Maturing System”

Kidneys: Double in size (5-10 years), system matures.
Urination: 6-8 TIMES A DAY
Problems:
_____: Involuntary urination past age 5 when control should be established.
_____: (Bed-wetting) Involuntary urination during sleep. Not a “problem” until after age 6. Occurs because child doesn’t wake up when bladder is full.
Key takeaway: System matures, but enuresis/bed-wetting can still be an issue.

4. Older Adults (65+ years): “Aging Challenges”

Kidney Function: Diminishes with age (reduced blood flow, fewer nephrons), but usually not to abnormal levels unless disease is present.
Risks:
Higher risk of medication toxicity due to decreased kidney function.
Fluid imbalance issues (e.g., during illness/surgery).
Key takeaway: Kidneys less efficient; increased risk for drug toxicity and fluid issues.

Answer 4

SCHOOL AGE
- Enuresis
- Nocturnal Enuresis

Question 5

Altered Urine Production

_____ - refers to the production of abnormally large amounts of urine by the kidneys, often several liters more than the client’s usual daily output.
- can cause excessive fluid loss, leading to intense thirst, dehydration, and weight loss.

_____ - low urine output, usually less than 500 mL a day or 30 mL an hour for an adult.

_____ - refers to a lack of urine production.

Answer 5

1. Polyuria/diuresis
2. Oliguria (Little/Less Urine)
3. Anuria (lack)

Question 6

Altered UrinaryElimination

1. _____: voiding at frequent intervals, that is, more than four to six times per day.
2. _____: voiding two or more times at night.
3. _____: is the sudden, strong desire to void.
4. _____: voiding that is either painful or difficult.

Answer 6

1. Urinary frequency
2. Nocturia
3. Urgency
4. Dysuria

Question 7

5. _____: involuntary urination in children beyond the age when voluntary bladder control is normally acquired, usually 4 or 5 years of age.

• _____ often is irregular in occurrence and affects boys more often than girls.
• _____ may be persistent and pathologic in origin. It affects women and girls more frequently.

6. _____: involuntary leakage of urine or loss of bladder control, is a health symptom, not a disease.

a. Transient (Acute)
- usually arrives suddenly, lasts 6 months or less, and has reversible causes.

b. Established (Chronic)

Answer 7

5. Enuresis
   - Nocturnal enuresis
   - Diurnal (daytime) enuresis
6. Urinary incontinence

Question 8

7. _____: When emptying of the bladder is impaired, urine accumulates and the bladder becomes over distended
8. _____: Results from impaired neurologic function

Answer 8

Urinary Retention
Neurogenic bladder

Question 9

• NANDA International (2009) includes two general diagnostic labels for urinary elimination:
• _____: dysfunction in urine elimination
• _____: A pattern of urinary functions that is sufficient for meeting elimination needs and can be strengthened.

Answer 9

Impaired Urinary Elimination

Readiness for Enhanced Urinary Elimination

Question 10

• Risk for Infection if the client has urinary retention or undergoes an invasive procedure such as catheterization or cystoscopic examination.
• Situational Low Self-Esteem or Social Isolation if the client is incontinent.
• Risk for Impaired Skin Integrity if the client is incontinent. Bed linens and clothes saturated with urine irritate and macerate the skin. Prolonged skin dampness leads to dermatitis (inflammation of the skin) and subsequent formation of dermal ulcers.
• Toileting Self-Care Deficit if the client has functional incontinence.
• Risk for Deficient Fluid Volume or Excess Fluid Volume if the client has impaired urinary function associated with a disease process.
• Disturbed Body Image if the client has a urinary diversion ostomy.
• Deficient Knowledge if the client requires self-care skills to manage (e.g., a new urinary diversion ostomy).
• Risk for Caregiver Role Strain if the client is incontinent and being cared for by a family member for extended periods.
• Risk for Social Isolation if the client is incontinent.

Question 11

Maintaining Urinary Elimination:

Drink fluids: Stay hydrated to keep urine flowing.
Void regularly: Maintain normal bathroom habits.
Assist with toileting: Help others get to the bathroom when needed.

Preventing UTIs
Promoting Healthy Urination:

• Drink 8 glasses of water daily: Flushes out bacteria.
• Void frequently (every 2-4 hours) and after sex: Prevents bacteria from settling.
• Avoid irritants: No harsh soaps, powders, or tight clothing in the perineal area.
• Wear cotton underwear: Allows for better air circulation.
• Girls/Women: Always wipe front to back and consider showers over baths if prone to UTIs.