Urinary Elimination Flashcards
(57 cards)
Major structures of the urinary system
kidneys
ureters
bladder
urethra
Primary functions of the kindey
- filter metabolic wastes, toxins, access ions, and water from the bloodstream and secret them as urine.
- They also help to regulate blood volume, blood pressure, electrolyte levels, and acid-base balance by selectively reabsorbing water and other substances
secondary functions of the kidneys
- produce erythropoietin
- secrete enzyme rennin
- activate vitamin d3 (calcitrol)
Role of ureters, bladder and urethra in urinary elimination
- ureters transport urine from the kidneys to the bladder
- the bladder stores urine until it is excreted
- urethra transports urine from the urinary bladder to the body exterior
What quantity of urine in the bladder will stimulate the urge to void
200-450 of urine in adults (50-200ml in children) are sufficient to stimulate urination.
three methods for knowing if hydration is adequate and output is normal
- person voids 1500mL in 24 hours in 5-6 voids
- an infant has 8-10 wet diapers in a day
- pale clear urine indicates adequate hydration
What medication increases amount of urine voided
diuretics
what type of medication are associated with urinary retention
anticholinergic effects may lead to urinary retention
What conditions and surgeries are associated with high incidence of altered urination
surgeries with pathology involving the genitourinary tract have a high incidence of altered urination
what should you discuss with a patient during a focused history
- normal urination pattern
- appearance of urine
- changes in urination habits or urine appearance
- history of urination problems
- use of urination aids
- lifestyle questions
- presence of urinary diversions if any
Key elements of a physical assessment
- kidneys: examine the kidneys by assessing for costovertebral angle tenderness
- bladder: asses the bladder with inspection, palpation and percussion.
- Urethra: asses the urethra by inspecting the urethral orifice. Look for erythema, discharge, swelling or odor. These are all signs of infection, trauma, or inflammation.
- perineal area: inspect the skin in the perineal area for signs of breakdown or irritation
What activities promote normal urination patterns
- Privacy
- Assist with positioning: preferred position
- facilitate toilet routines
- promote adequate fluid and nutrition: 8 to 10 large glasses a day
An instrument used to measure specific gravity
refractometer
the application of gentle, manual pressure over the bladder to promote bladder emptying
crude’s maneuver
a urinary diversion that involves implanting the ureters into a small segment of the small intestine, which is then brought to the abdominal wall where a stoma is created
conventional urostomy or ill conduit
involuntary urination after the age of 5 or 6 is sometimes this condition
enuresis
During chemotherapy what labs should be checked
serum blood urea nitrogen and serum creatinine
what is frequently responsible for UTIs
esherichia coli
specific gravity
is the measure of resolved solutes in a solution. high gravity means the person is dehydrated and low gravity may mean the kidney is not concentrating the urine enough
signs of UTI
back pain bladder spasms chills dysuria edema fever foul0smelling urine hematuria sauce and vomiting pyuria urgency urinary frequency
reasons for urinary retention
obstruction inflammation and swelling neurological problems medications anxiety
urge incontinence
involuntary loss of larger amounts of urine accompanied by a strong urge to void. its is often referred to as overactive bladder.
stress incontinence
is an involuntary loss of small amounts of urine with activities that increase intra-abdominal pressure. etiological factors include pregnancy, childbirth, obesity, chronic constipation and straining at stool. activities that produce leakage of urine also include exercise, laughing sneezing and coughing
mixed incontinence
is a combination of urge and stress incontinence
