Urination Flashcards

1
Q

What artery brings blood to glomerulus of each nephron

A

Renal artery

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2
Q

When blood filters through glomerular capillary. Where is it moved to?

A

Bowmans Capsule

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3
Q

Fluid filtered through the glomerulus is what?

A

Glomerular filtrate

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4
Q

What is the fluid of the glomerulus made up of?

A

Water electrolytes and glucose

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5
Q

True or False: Every 30 minutes the total body volume passes through the kidneys?

A

True

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6
Q

What is the purpose of the ureters

A

Pass urine from the kidney to the bladder

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7
Q

What nervous system is the bladder associated with?

A

Autonomic Nervous system

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8
Q

What part of the autonomic system does the bladder control

A

Sympathetic: Bladder relaxed urine kept in bladder
Parasympathetic: Relaxation of internal sphincter=Urination

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9
Q

Where does reabsorption process for urine?

A

Proximal tubules, Loop of Henle, Distal tubules into collecting tubules

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10
Q

How much does a person reabsorb fluid?

A

99%

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11
Q

What molecules does the body not like present?

A

H+, K+, ammonia, creatinine, uric acid and other metabolites

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12
Q

What does GFR stands for?

A

Glomerular Filtration Rate

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13
Q

What does GFR do?

A

Water and dissolved substances are filtered out of the blood and into the kidneys

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14
Q

What is a normal GFR in adults at rest?

A

125 mL/min from the filtrate removed from the blood

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15
Q

How many layers of muscle tissue is the bladder made up of?

A

3 layers

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16
Q

Is voiding conscious or unconscious?

A

Conscious

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17
Q

How often does an adult void?

A

6-8x a day or every 3-4 hours

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18
Q

How much fluid volume should an individual produce a day?

A

1200-1500ml/day

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19
Q

When should you be concerned when fluid output is low?

A

30ml in an hour

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20
Q

how often does newborns void

A

30-40x a day

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21
Q

Are the kidneys fully developed for newborns?

A

Reabsorption and filtration are inadequate

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22
Q

True or False: Pink urine may be seen in first void of newborn?

A

True: due to accumulation of uric acid crystals

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23
Q

what are normal ranges for urine output for lifespans?

A
Newborn-2 = 500-600 ml
2-5  500-800ml
5-8  600-1200ml
8-14 1000-1500ml
14 and over  1500ml
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24
Q

When does a child have control over voiding?

A

18-24 mos

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25
Q

Enuresis

A

Involuntary passing of urine when control should be established (5 you)

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26
Q

Nocturnal enuresis

A

Bed wettings

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27
Q

Is nocturnal enuresis genetic?

A

Yes

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28
Q

Are older women more prone to urinary incontinence then men?

A

Yes 2x greater due to estrogen and weakened pelvic muscles

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29
Q

What are psychological factors affecting urine

A

Thinking of voiding
running water
pour over thigh - hands in cold/warm water
stress - increase or unable to go
Social - need for privacy, own home, afraid to be wet

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30
Q

What diseases are associated with renal problems?

A
Congenital urinary Tract abnormalities
Polycystic kidney disease
UTI
Urinary calculi
Hypertension
DM
Gout Connective tissue disorders
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31
Q

Hydronephrosis

A

Dilation of renal pelvis

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32
Q

What does PKD do?

A

inherited disorder in which clusters of cysts develop primarily within your kidneys

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33
Q

If there is less than 30 ml of urine for 2 consecutive hours what happens?

A

Decrease perfusion to vital organs

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34
Q

When does the bladder become flaccid?

A

Occurs after stroke or spinal injury

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35
Q

When does micturition occur when your bladder is flaccid?

A

Reflex voiding when slightly stretched

neurogenic bladder fills w/o ability to respond to stretch retention

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36
Q

What does diuretics do to the body?

A

Prevents reabsorption of water and certain electrolytes in tubles

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37
Q

What does cholinergic meds do to the body?

A

Stimulate contraction of detrusor muscle, producing urination

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38
Q

Antispasmodics

A

Muscle relaxation for overactive bladders

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39
Q

Anticholinergics

A

Urinary retention b/c block parasympathetic response

40
Q

Analgesic and tranquilizers

A

Suppress CNS, diminish effectiveness or neural reflex

41
Q

What meds affect urine color?

A
Anticoagulants: Red urine
Diuretics: Pale yellow
pyridium: orange to orange-red
elavil: green or blue-green 
levodopa: brown  or black
42
Q

What is the leading cause of systemic infections in older adults

A

UTI

43
Q

Is Urine sterile or unsterile?

A

Urine is sterile

44
Q

What pt are at risk for UTI?

A
Sexually active women
diaphragms for contraception
postmenopausal women
indwelling urinary catheter
DM
older adults
45
Q

Symptoms of Urosepsis?

A

Fever
Tachycardia
Tachypnea
Hypotension

46
Q

Clean catch culture

A

ID’s bacterial count >100,000

47
Q

Prevention measures to avoid UTI’s

A
Avoid cath
no tight clothing - cotton undergarments
no bubble baths or irritants
plenty of fluids
Hygiene
Drink 8 oz before and after sex
void frequently every 2-3hrs after sex
blueberry/ cranberry 10oz
48
Q

Urinary incontinence

A

Involuntary loss of urine

49
Q

Transient

A

Appears suddenly and lasts 6 months or less

50
Q

Mixed

A

Urine loss with features of two or more types of incontinence

51
Q

Overflow

A

over distention and overflow or bladder

52
Q

Functional

A

Caused by factors outside the urinary tract

53
Q

Reflex

A

Emptying the bladder without sensation of need to void

54
Q

Stress incontinence

A

Involuntary loss of urine
small amounts 30-50ml
occurs w/coughing, sneezing, laughing, lifting, joggings, changing positions
increase in women
increased abdominal pressures from coughing sneezing or weak pelvic support

55
Q

Urge incontinence

A

Involuntary loss of urine occurring soon after a strong sense of urgency to void - simultaneously feels urge to void and loss of urine

56
Q

Key hole incontinence

A

Get to the door but can’t get to the bathroom - large amounts of urine loss

57
Q

Overactive bladder

A

Decreased bladder capacity, irritation of bladder

58
Q

Total incontinence

A

Continuous involuntary unpredictable loss of urine from non-distended bladder

59
Q

Urinary Diversion

A

Surgical procedure in which the normal pathway of urine elimination is altered- ureters rerouted to new outlet created in clients abdomen

60
Q

Urinary diversion permanent or temporary?

A

Both, depends on what is needed

61
Q

what is an ideal conduit

A

Cutaneous urinary diversion that involves a surgical reaction of the small intestine w/ transplantation of the ureters to the isolated segment of the small bowel

62
Q

CONTINENT URINARY DIVERSION

A

NEOBLADDER-bladder removed and pouch created from a portion of small bowel

63
Q

Dysuria

A

painful voiding

64
Q

Frequency

A

increase voiding without increase fluids

65
Q

Hesitancy

A

difficulty beginning a stream or urine

66
Q

urgency

A

Sting desire to void

67
Q

Polyuria

A

Large amounts voided at any given time/daily 2500-3000ml without any intake

68
Q

Oliguria

A

Diminished amount voided

69
Q

Anuria

A

Technically no urine

70
Q

Hematuria

A

Blood in urine

71
Q

Pyuria

A

Pus in urine

72
Q

Concentrated

A

Specific gravity>1.025

73
Q

Proteinuria

A

Protein in urine

74
Q

Suppression

A

Stoppage of urine production

75
Q

BPH

A

Benign prostatic hypertrophy

76
Q

What is objective data for Urinary elimination?

A

Har, urinal, bedpan, indwelling catheter
Color, clarity, odor, presence of blood or sediments
I/O

77
Q

Bladder ultrasound do you need a Dr. order?

A

NO, nurse can perform without dr. orders

78
Q

objective data physical assessment

A

Inspection of bladder, palpation level of umbilicus move towards symphysis pubis

79
Q

Where can the doppler bladder ultrasound be performed at ?

A

Bedside

80
Q

What is turbidity

A

Cloudiness observed in freshly voided urine, may be due to RBC, WBC, Bacteria, vaginal discharge, sperm, prostatic fluid

81
Q

Normal urine pH

A

4.6-8

82
Q

Specific Gravity

A

Measure of concentration dissolved solids in the urine. 1.015 to 1.025

83
Q

Constituents

A

Organic: Uric acid, creatinine, hippuric acid, indian, urene pigments, and undetermined nitrogen

Inorganic: ammonia, sodium, chloride, traces of iron, phosphorus, sulfur, potassium, and calcium

84
Q

BUN

A

Blood Urea nitrogen

85
Q

What does BUN test do?

A

Measures urea nitrogen in blood

86
Q

What is normal BUN

A

8-25 mg/dl

87
Q

Normal creatinine levels?

A

Male .6-1.2mg/DL

Female: .5-1.1mg/dl

88
Q

Clearance test?

A

Identify losses in kidney functions to determine amount of blood a persons kidney can clear within a given amount of time

89
Q

Ture or False: Serum creatinine should be collected immediately after test completed

A

True

90
Q

What does Creatinine test perform?

A

Measures GFR on ability to filter creatinine from the blood in ml/minute via kidney

91
Q

KUB performance?

A

Radiology test of abdomen and pelvis

92
Q

Pyelogram

A

IV injected and filtered through kidneys, ureters and bladder

93
Q

Cystoscopy

A

Examination of the bladder

94
Q

Do you need informed consent for Cystoscopy?

A

Yes. invasive procedure

95
Q

What is a goal for Urinary elimination?

A

Promote and maintain normal voiding patterns

96
Q

What implementation is necessary?

A

Promoting fluid intake of 1500-2kml/ daily
lifestyle changes
scheduled voiding regimens
habitant retraining

97
Q

Urethral canal lumens in FR?

A

children 8-12 FR
Adults 14-16
Males 18