Urination and Faecal Elimination Terminology

Question 1

Formation of urine

Answer 1

1. Blood, waste & water enter the kidney via the renal artery
2. Filtration & reabsorption
3. Blood without waste or excess water leaves the kidney via the renal vein
4. Excess water and waste, in the form of urine, leaves the kidney via the ureter

Question 2

What is urination?

Answer 2

• Process of emptying the urinary bladder
• Also referred to as micturition or voiding

Question 3

Signs of a healthy bladder?

Answer 3

• Empties 4-8 times each day (every 3-4 hours)
  can hold up to 400-600 mL of urine (the sensation of needing to empty occurs at 200-300 mL)
• May wake you up once at night to pass urine and twice if you are older (i.e. over 65 years of age)
• Tells you when it is full but gives you enough time to find a toilet, empties completely each time you pass urine, and does not leak urine.

Question 4

Urine Characteristics

Answer 4

• Volume: 1500 mL/day;
• 0.5 - 1mL per kg per hour
• Colour: straw, amber
• Clarity: transparent
• Odour: faint
• Sterility: urine in the bladder is sterile
  pH: 4.5-8

Question 5

Urination is impacted

Answer 5

• Developmental stage
• Fluid & food intake
• Muscle tone
• Positioning
• Psychosocial factors
• Medications
• Pathologic conditions, pregnancy, surgical & diagnostic procedures

Question 6

Diuresis

Answer 6

increased or excessive production of urine.

Question 7

Polyuria

Answer 7

Passing abnormally large amounts of urine

Question 8

Oliguria

Answer 8

low urine output

Question 9

Anuria

Answer 9

Lack of urine production.

Question 10

Nocturia

Answer 10

Urinating frequently at night.

Question 11

Haematuria

Answer 11

• Blood in Urine

Question 12

Enuresis

Answer 12

Night time loss of bladder control, or bed-wetting, usually in children.

Question 13

Incontinence

Answer 13

the loss of bladder contro

Question 14

Retention

Answer 14

A condition in which you are unable to empty all the urine from your bladder

Question 15

Neurogenic bladder

Answer 15

• People who lack bladder control due to a brain, spinal cord or nerve problem

Question 16

Urine Clinical Reasoning Cy

Answer 16

• Review current information
  Patient history
  Current health problem
  Subjective data
• Gather new information
  Urinalysis
  Specimen collection, MSU
• Recall knowledge
  Risk factors
  Pathophysiology
  Urinary diversions, incontinence, catheter care

Question 17

Urinalysis

Answer 17

Leukocytes – white cells in the urine (pyuria) which is associated with urinary tract infection.
Cloudy urine – infection

Question 18

Midstream urine specimen

Answer 18

Urine culture to identify micro-organisms causing urinary tract infection (UTI)
- Clean catch specimen of urine collected in sterile jar

Question 19

Midstream urine specimen

Answer 19

• Cleaning urinary meatus
• Mid stream catch after initial flow
• Not contaminating jar/lid

Question 20

Urinary incontinence

Answer 20

• Loss of bladder control
• Stress incontinence - leakage of small amounts of urine during activities that increase pressure inside the abdomen and push down on the bladder, such as coughing, sneezing, laughing, walking, lifting, or playing sport.

Question 21

Urinary incontinence who is at risk

Answer 21

• Women in late pregnancy, or with weakened pelvic floor muscles; men who have prostate disease; people with chronic diseases such as diabetes, emphysema; obesity; constipation

Question 22

Management of urinary incontinence

Answer 22

• Fluid intake (1.5-2 litres)
• Prevent constipation
• Correct positioning on toilet
• Pelvic floor exercises
• Keep a bladder diary (3 days at least)
• Bladder training – learning to ‘hold on’
• Introduce incontinence aides/products