Urinary elimination (Chapter 41)

Question 1

Healthy adults eliminate approx how many mL of urine daily?

Answer 1

1400 mL

Question 2

The urinary system controls the consumption of blood by removing ________ and _________ and conserving useful substances.

Answer 2

Urea; creatinine

Question 3

These organs filter liquid waste from the blood, balance electrolytes in the blood, regulate blood volume and pressure, produce erythropoietin for red blood cell formation, synthesize vitamin D to help control calcium levels, and maintain acid-base balance.

Answer 3

Kidneys

Question 4

Urine is formed by tiny filtering units called ____ which are the functional units of the kidney.

Answer 4

Nephrons

Question 5

Urine formation is a result of what 3 processes?

Answer 5

Filtration
Reabsorption
Secretion

Question 6

This process of urine formation occurs in the glomerulus as fluid moves across a membrane as a result of a pressure difference.

Answer 6

Filtration

Question 7

This process of urine formation occurs in the renal tubule as most of the filtrate moves back into the blood.

Answer 7

Reabsorption

Question 8

This process of urine formation involves the end result of urine formation. Urea, water, and other waste form urine as they pass through the nephrons down the renal tubules.

Answer 8

Secretion

Question 9

The failure of the kidneys to produce or excrete urine, can occur as a result of any process that limits the effective blood flow through the kidneys.

Answer 9

Anuria

Question 10

When a person has anuria, they cannot filter waste products and artificial filtering may be necessary with renal _________

Answer 10

Dialysis

Question 11

Technique by which fluids and molecules pass through an artificial semipermeable membrane and are filtered by means of osmosis.

Answer 11

Dialysis

Question 12

This is defined as reduced urine volume, less than 500 mL/day in adults. Symptoms my include pt being breathless, pale, clammy skin, low blood pressure, edema, anemia, changes in heart rhythm, hepatomegaly, and hypertension may be present.

Answer 12

Oliguria

Question 13

When an excessive volume of urine is formed and excreted each day, more than 2500 mL in adults.

Answer 13

Polyuria

Question 14

Excessive urination at night that can disrupt sleep cycle. Commonly seen in men with benign prostatic hyperplasia and in post menopausal women because of decreased bladder tone, also can be due to diuretics, UTIs, cystitis, and diabetes.

Answer 14

Nocturia

Question 15

Painful urination that can result from UTIS, bladder infection, STIs, yeast infection, kidney/bladder stones, prostatic enlargement, malignancy, reaction to soaps condoms or tampons.

Answer 15

Dysuria

Question 16

The abnormal presence of red blood cells in the urine. Color of urine does not reflect degree of blood loss.

Answer 16

Hematuria

Question 17

The inability to control the passage of urine

Answer 17

urinary incontinence

Question 18

Loss of urine control during activities that increase intraabdominal pressure such as coughing, sneezing, laughing, or exercise.

Answer 18

Stress incontinence

Question 19

Involves a sudden strong urge to void followed by rapid bladder contraction.

Answer 19

Urge incontinence

Question 20

The lack of urine control in the absence of any abnormalities of the urinary tract. When some physical limitation in functioning occurs right before voiding occurs.

Answer 20

Functional incontinence

Question 21

Seen in patients who are unable to empty the bladder completely resulting in a constant dribbling of urine or increased frequency of urination.

Answer 21

Overflow incontinence

Question 22

Occurs in association with factors such as severe constipation, infections in the urinary tract or vagina, or medication usage.

Answer 22

Temporary incontinence

Question 23

The inability of the bladder to empty, caused by an obstruction in the urinary tract or by a neurologic disorder.

Answer 23

Urinary retention

Question 24

The involuntary passage of urine that may be structural or pathologic although may be related to nonurinary problems such as constipation, stress, and illness.

Answer 24

Enuresis

Question 25

Which factors affect urine elimination? DPFMMSP

Answer 25

Developmental factors Psychosocial factors Fluid/food intake Medications Muscle tone Surgical/diagnostic procedures

Question 26

These are caused by the result of bacteria in the urine. E. coli usually invade the urethra and multiply.

Answer 26

Urinary tract infections UTIs

Question 27

A surgical procedure performed when bladder function is impaired owing to trauma or disease involving the bladder, the distal ureters, or the urethra. Urine exits the body through a stoma created on the abdomen.

Answer 27

Urinary diversion

Question 28

Color of urine is influenced by what 3 things?

Answer 28

Food Medication Pathologic conditions

Question 29

Severe dehydration can cause urine to range between _______ and _______ color.

Answer 29

dark yellow-orange; tea

Question 30

Patients with hypercalcemia may have what color urine

Answer 30

Blue-green urine

Question 31

Adult urinary output of about _______ is considered normal.

Answer 31

0.5 to 1.5 mL /kg/hr

Question 32

What tests are used to evaluate urinary function? BSU

Answer 32

Blood Urea Nitrogen (BUN) Serum creatine Urinalysis 24 hour urine collection

Question 33

Normal values for BUN in the blood are __________

Answer 33

10-20 mg/dL

Question 34

Normal values of serum creatinine are _________.

Answer 34

0.5-1.1 mg/dL for women 0.6-1.3 mg/dL for men

Question 35

This is a screening tool for UTI, kidney disease, and other conditions.

Answer 35

Urinalysis

Question 36

This test monitors the balance of water and solutes in urine. Normal range is 1.005 to 1.030.

Answer 36

Urinalysis for specific gravity.

Question 37

Protein in the urine may be associated with what things? FVPK

Answer 37

Fever Vigorous exercise Pregnancy Kidney disease

Question 38

Urine glucose concentration is used to screen for _______ and assess glucose tolerance.

Answer 38

diabetes

Question 39

The presence of ________ in the urine indicates that fat has broken down for energy. Large amounts in the urine may indicate ____________.

Answer 39

ketones; diabetic ketoacidosis

Question 40

In this test urine is spun in a centrifuge and sediment settles at the bottom. Sediment is then spread on a slide and checked for red or white blood cells, casts, plugs, or crystals. If crystals are present, indicates stones are present.

Answer 40

Microscopic analysis

Question 41

This urine collection is usually performed to determine the amount of creatinine cleared through the kidneys. Also used to measure levels of protein, hormones, minerals, and other chemical compounds.

Answer 41

24 hour urine collection

Question 42

An ____________ may be performed to assess the size, shape, and location of the kidneys.

Answer 42

ultrasound scan

Question 43

A diagnostic x-ray image centered on the iliac crest, typically used to investigate GI conditions such as bowel obstructions or gallstones, can also detect presence of kidney stones.

Answer 43

kidney, ureter, and bladder study.

Question 44

An x-ray study of the kidneys, bladder, ureters, and urethra. The images show the size, shape and position of the urinary tract.

Answer 44

Intravenous pyelography

Question 45

Used to diagnose kidney stones, bladder stones, or blockage of the urinary tract. Contrast media may be used to help identify blockages, growths, infections, or other diseases.

Answer 45

Computed tomography

Question 46

An examination of the bladder and urethra through a cystoscope. Procedure permits visualization of areas that do not show up well on the x-ray. Used to determine the cause of hematuria, dysuria, incontinence, frequency, urgency, or retention.

Answer 46

Cystoscopy

Question 47

This should not be used for urination if patient is unable to stand, maintained on a strict bed rest, and who independently cannot sit up safely.

Answer 47

Bedside commode

Question 48

When creating a toileting schedule for a patient, establish voiding opportunities every _______ during the day, before bedtime, and every ________ at night.

Answer 48

1-2 hours ; 4 hours

Question 49

These tips are food for the prevention of what? -wear underwear with cotton-lined crotch -avoid tight fitting clothes -urinate when the urge is felt -shower over baths -practice good perineal hygiene

Answer 49

Urinary tract infections

Question 50

What is used for these things: -obtain samples of urine for analysis -diagnose infection or kidney dysfunction -drain residual urine found through a bladder scan -empty a continent urinary diversion -drain bladder of a paraplegic or quadriplegic

Answer 50

Urinary catheterization

Question 51

These catheters are single-lumen devices, designed for one-time or short-term catheterization.

Answer 51

Straight catheter

Question 52

These catheters are double-lumen indwelling. One lumen is for filling a balloon at the tip for anchoring and the other lumen is for draining urine.

Answer 52

Foley, coude

Question 53

These catheters are used for bladder irrigation. Allows for sterile irrigation fluid to be introduced into the bladder to provide localized antibiotic treatment or to drain blood and blood clots after surgery or diagnostic procedures.

Answer 53

Triple lumen catheters

Question 54

1. Relief of acute urinary obstruction and retention 2. Preventing contamination during complex surgical procedures 3. Accurate measurement of urine in critically ill patients 4. Maintaining dry tissue during perineal or sacral wound healing in incontinent patients 5. Optimal management of patients who are immobilized for an extended period of time 6. Support of patient comfort at the end of life

Answer 54

Indications to which catheter use is appropriate

Question 55

Catheter bags should me emptied when how full?

Answer 55

2/3 full

Question 56

Newer external catheters for women use ________ material placed between the labia and gluteal folds, with tubing attached to low continuous suction to drain excreted urine.

Answer 56

Wicking

Question 57

External male catheters include __________ which are applied over the tip of the shaft of the penis.

Answer 57

condom catheters

Question 58

When urine accumulates on the skin, it is converted to _______ which causes the skin to remain moist and possibly become macerated. Patient is at risk for skin breakdown, ulceration, and infection.

Answer 58

Ammonia

Question 59

Obtaining urine specimen: patient voids into a specimen cup or into clean urinal or bedpan for which test?

Answer 59

Routine analysis

Question 60

Obtaining urine specimen: urine is collected by the clean-catch, or midstream method, using a sterile specimen cup.

Answer 60

Culture and Sensitivity testing

Question 61

Obtaining urine specimen: removal of a specimen from the tubing of an indwelling catheter or urinary diversion collection bag.

Answer 61

Straight catheterization