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Urinary Elimination


How do the kidneys regulate fluid and electrolytes excretion, reabsorption and secretion
How do the kidneys regulate acid-base balance by excreting hydrogen ions and forming bicarbonate for buffering
What role do the kidneys play in red blood cell production they secrete erythropoietin which stimulates bone marrow to produce red blood cells
What is the normal specific gravity of urine 1.003-1.030
What should the nurse assess about the urine color, clarity, amount, and odor
What should the nurse assess in patients with urinary problems urine, edema, daily weight, frequency of urination, dysuria
When doing a clean catch urine specimen, why is it important to begin voiding, stop and then void into the specimen cup This removes contaminants from the urethra that might become part of the specimen
What information can a urinalysis tell you can help determine the presence of renal calculi, infection, malignancy and diseases affecting the kidney
What urine test is done to determine the protein level in the urine 24 hour urine collection
When starting a 24 hour urine collection should the first urine be counted? The patient should void and discard that urine, document the time, and then measure every void for 24 hours.
What does specific gravity tell us? How concentrated or dilute the urine is
What is the normal urine output per hour? per 8 hour shift? 30 mL/hr 240mL/8hours
If the patient's intake is greater than output, what are they at risk for? fluid volume overload
If the patient's output is greater than their intake, they are at risk for? fluid volume deficit
What are possible causes of urinary retention stone, enlarged prostate, pregnancy, tumor, infection, surgery, disease of the nerves, scar tissue
What are causes of residual urine bladder outlet obstruction, muscle contractibility
What are causes of nocturia ingestion of large amounts of fluid, infection, congestive heart failure, diabetes, enlarged prostate, kidney disease, medications
What is urinary retention the inability to empty or completely empty the bladder
What is hydronephrosis stretching of the renal pelvis due to obstruction of the flow of urine from the bladder
At what age are most children able to control their bladder 2-3 years old
What is stress incontinence inability to control the passing of urine due to increased pressure such as when one laughs or coughs
What is urge incontinence inability to hold urine long enough to get to the restroom usually caused by an infection, diabetes or neurological condition
What is overflow incontinence The bladder does not empty properly and it becomes overly full
What is functional incontinence unable to get to the restroom due to physical or mental conditions. Can feel the urge
Total incontinence is loss of urine with no warning
What is neuropathic incontinence nerves are not transmitting to the brain that the bladder is full
What are Kegel exercises tightening and relaxing of the pelvic floor muscles to help strengthen them
How often should incontinence briefs be changed and perineal care provided? Every 2 hours
How is bladder training done The individual should go to the restroom at set times throughout the day whether they have an urge to void or not
Prior to setting up a sterile field for urinary catheter placement the nurse should? Locate the urinary meatus
What must be maintained while placing a urinary catheter? strict sterile technique (surgical asepsis)
What is a straight catheter used for to obtain a sterile specimen or to do a one time drainage of the bladder
What is a Foley (indwelling) catheter used for may be used for accurate I & O, surgical patient, patient with skin breakdown, patient not able to get up and use the restroom
What is a triple lumen catheter used for This is used after a transurethral resection of the prostate is done. It allows for irrigation of the bladder
What is a Coude catheter used for This is used for men who have an enlarged prostate. It is curved.
What is a condom (Texas) catheter Not really a catheter but it is used for the incontinent male to minimize skin irritation
How often should the urinary drainage bag be emptied? At least every 8 hours or when getting full
Care of the urinary bag includes Don't touch the drainage spout, wipe with alcohol before closing, maintain the bag below the bladder, keep free of kinks and coils, hang of the bed frame. Do not put on the floor.
How often should catheter care be performed? At least every 8 hours and with perineal care
After removing a urinary catheter, when should the patient void The patient should void within 8 hours, maximum! If not, MD should be notified. May need a straight cath
When would a suprapubic catheter be necessary it is placed after trauma or surgery to the urethra or if an indwelling catheter cannot be placed
Name three types of urinary diversions ileal conduit, continent urostomy, orthoptic bladder substitution
What is an ileal conduit ureters are attached to a section of the small intestine used to create a pouch and a stoma
What is a continent urostomy? pouch is created from the intestine, the ureters empty into the pouch and a nipple valve is constructed
What is an orthoptic bladder substitution? part of the intestine is used to make a bladder, ureters drain into it and the urethra drains the substitute bladder
Created by: Ms. A LPNI
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