Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
elimination
| Question | Answer |
|---|---|
| bladder capacity of the infant | from 50cc-250 cc. |
| specific Gravity of their urine is around | 1.008 |
| what color is an infants urine | PALE YELLOW, straw-colored—almost odorless |
| an infants Patterns of voiding | should void within 48 hours after birth, then 5-25X/24 hr, or 25 mL/kg/day |
| Infection in newborns is usually due to | structural problems, such as Obstructions or Malformations, and infection due to proximity of urethra to anus in female infants. |
| Preschoolers capacity of the bladder increases to | ~250 mL |
| Urinary control usually occurs between the ages of | 2-5. This should NEVER be a punitive process |
| Girls MUST be taught to wipe from | front to back |
| The #2 cause of infection in children is | UTI |
| School Age children The size of the child’s kidney | Doubles |
| from age 5-10 voiding _____ times per day | 6-8 |
| enuresis | “involuntary urination after control should be established” |
| Nocturnal Enuresis | episodes of bed wetting |
| Elders Bladder tone: | Bladder more fibrous (Less elastic) |
| Nephrons begin to diminish after the age of | 40—if otherwise healthy, |
| no functional issues until | 80’s or 90’s, but renal function of 85-yr-old only 50% of 30-yr-old! |
| Salt: Causes the body to and why | retain fluid Why….to maintain homeostasis normal concentration of Na+ and KCL. |
| Fluids that contain caffeine | increase urine production |
| Intake. Alcohol _________ output (diuretic) but also _______ the body by _________ the production of ___ | increases dehydrates inhibiting ADH |
| Beets may cause your urine to have a ___ cast | Red |
| Asparagus makes your urine smell really ___ | Bad |
| Foods high in carotene can deepen the _______ color. | Yellow |
| Loop diuretics | work in the Loop of Henle by blocking reabsorption of sodium & chloride |
| Thiazide diuretics | work on the distal tube to block sodium reabsorption & increase potassium & water excretion |
| Potassium-sparing diuretics | work in the distal tubule to allow sodium excretion, while restoring much of the K+ to the body, avoiding the potassium depletion seen with other types of diuretics Also miscellaneous diuretics carbonic anhydrase inhibitors & osmotic diuretics |
| when on diuretics you need to watch for: | hydration & electrolyte balance, vital signs (especially for hypotension d/t fluid loss), BUN, creatinine, electrolytes, & other pertinent values. Avoid salt substitutes with K+-sparing diuretics |
| _____makes your urine Orange | AZO Also pyridium |
| Some chemo drugs can cause what color of urine. | red or green |
| It is important to know which Medications cause | retention. |
| what medications can cause retention | Sudafed, Benadryl, atropine, B/P meds, opioids |
| Changes in the client’s ____ system especially the _______ can affect the production of urine | renal nephrons |
| spme surgeries can cause | Swelling, anesthesia, Post-Op Bleeding, Sometimes spinal anesthesia may alter a patient’s ability to feel the need to void. |
| Pelvic muscle tone affects | urination—poor in pts who have had catheters recently, or for longterm |
| Polyuria | Diuresis –May be several liters more than usual output. |
| Polydipsia | This is often associated with Diabetes and Nephritis. |
| Polydipsia can lead to: | dehydration & Weight Loss |
| Anuria | No urine production; almost always due to renal disease |
| Oliguria | Low output < 30 mL/hr, or 500 mL/24 hours hours in adult |
| Polyuria can: | ↑thirst, dehydration, wt loss |
| Dialysis: Hemodialysis | is the exchange of body wastes across a semipermeable membrane via vascular catheters; |
| Peritoneal Dialysis | Fluids are instilled into the abdomen & the fluid & molecules exchange, then drain out through an abdominal catheter. |
| Nocturia | > 2 times at night |
| Frequency | > 6 times per day (UTI, Diabetes, Pregnancy, Stress) |
| Urgency | --“Gotta go NOW”, from irritation, poor sphincter control, bladder spasms, stress |
| Dysuria | Pain or burning with urination (UTI, stricture, or stone accompanied by Hesitancy |
| Hesitancy | Difficulty starting urinary stream |
| Neurogenic Bladder | Incontinence, overfilling, or incomplete emptying of bladder |
| Intake and Output | Change in I & O is a significant indicator of fluid alterations or kidney disease |
| Order: | Will read I & O- measure everything that goes in and everything that comes out |
| Measurement red flag is | hourly- an output of less than 30 ml for more than 2 hours |
| Volume: | 1200-1500 Less than 1200; |
| Color | clarity: Straw to Amber Transparent |
| Bad colors are | Dark cloudy, Orange, red or brown thick or obvious sediment |
| Odor: | Faint aromatic; some foods change the smell of urine such as asparagus |
| Bad odor | Offensive smell Urine high in glucose may have a sweet smell: |
| pH | 4.5-8.0 the pH may indicate the client’s diet or state of nutrition. |
| Ketone bodies | None; Presence of Ketones is highly indicative of uncontrolled diabetes or starvation; |
| Specific gravity | 1.010-1.025 –density compared to water (1.0) The higher the concentration the higher the SG |
| Color: Renal Bleeding | dark red (older blood) |
| Color Bladder bleeding | bright red |
| Color High concentration- | dark amber |
| why do we need to Get specimens to lab ASAP or refrigerate | Clear at time of voiding- May become cloudy as it sits |
| Renal disease | may look cloudy or foamy due to the high protein conc |
| Bacteria- | thick and cloudy |
| Odor of stagnant urine | Stagnant urine has ammonia odor-common with incontinence. |
| Cystoscope | Use conscious sedation to decrease anxiety-direct examination for structural abnormalities (going into bladder with a light and camera) |
| Noninvasive Procedures | KUB (kidneys, ureters, bladder x-ray) -IVP (intravenous pyelogram—dye) -CT scan -Renal scan - Ultrasound (like radar) |
| Retention | Urinary retention may be due to poor contractility of the bladder, changes in outflow: Prostate enlargement, medications, and surgery |
| Functional: | Inability of Continent people to reach the toilet in time—can’t respond to need to void—dementia, impaired mobility, diuretics, sedation, depression, regression (physical, environmental, psychosocial causes) |
| Reflex: | Urine loss occurs when a certain volume is reached |
| Stress: | Urine loss with increased abd. Pressure (cough, sneeze, lifting, laughing) decreased urethral resistance, weak muscles & weak urethra |
| Total: | Complete inability to hold urine; loss of control in all situations & positions |
| Urge: | Inability to hold urine after the urge to void is noticed—”overactive bladder”—strong urge to void—detrusor muscle hyperactive |
| Overflow (with retention): | can’t empty bladder—frequent loss of small amounts urine (25-50 mL) |
| D.I.A.P.E.R.S. | D- Delirium I- Infection A- Atrophic P- Psychological E-Endocrine R- Restricted Mobility. S- Stool |
| Congenital disorders: epispadias | (absence upper wall urethra), |
| Congenital disorders: meningomyelocele | (neural tube defect; spinal cord protrudes through vertebral column |
| Acquired disorders: | CNS system, spinal cord trauma; stroke |
| Chronic disorders: | MS, Parkinson’s disease |
| Tofranil | control smooth muscles of bladder neck for mild stress incontinence |
| estrogen therapy | post-menopausal atrophic vaginitis |
| oxybutynin-Ditropan | urge incontinence—drugs to inhibit detrusor muscle contractions, ↑ bladder capacity anticholinergic |
| tolterodine—Detrol | antimuscarinic agents |
| Ditropan & Detrol | can be taken once or twice daily & have fewer side effects than other anticholinergic agents. Contraindicated for pts with glaucoma (increased pressure in eyes). Urinary retention is potential side effect |
| Fluid intake of at least | 1.5-2L/day; better to be 2-3 L daily, but ↓ in evening |
| ↓ consumption of beverages containing (all bladder irritants) | caffeine citrus juices, artificial sweeteners with NutraSweet & ↓ alcohol |
| Use behavioral techniques such as | scheduled toileting, habit training, bladder training (↑’ing intervals gradually to ↑ capacity. Resist urge to void more freq (to 300 mL/void) |
| When bladder contains 250-450 mL, signal to | CNS of need to void. Can consciously inhibit this urge (as nurses often do at work) |
| Voluntary urinary retention | failure to respond by voiding when bladder contains > 300 mL can stretch detrusor muscle & cause loss of muscle tone, and can lead to overfilling. |
| Continent Stoma | Kock Pouch Neobladder |
| incontinent stoma | Ureterostomy Nephrostomy Vesicostomy Ileal conduit |
| Ureterostomy | Bringing the end of one or both ureters to the abdominal surface |
| Catheterization: | Introducing a rubber or plastic tube through the urethra and into the bladder |
| Intermittent Catheterization: | Relief of discomfort Obtaining sterile specimen Assessment of residual Long-term management |
| Indwelling Catheterization: | Obstruction of urine outflow Surgical repair of urinary tract Measurement of strict U/O Bladder irrigation Severe retention |
| Kegel exercise | Strengthening Pelvic Floor Muscle- |
| Bladder Retraining- | Increase interval between voids |
Created by:
ED.
Popular Nursing sets