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Urinary System 102

LU Kozier Notes

normal urinary output 1500-2000 mL each day, normally voiding 5-6 times a day. 30 mL an hour or less is reportable
Normal bladder capacity 300-600 mL of Urine
micturation (aka voiding and urination) process of emptying the bladder
enuresis involuntary passing of urine (in children generally)
nocturnal enuresis bed wetting
nocturnal frequency elders needing to void during the night more
Factors affecting voiding development, psychosocial, intake, meds, muscle tone, pathology (heart and circulatory disorders), surgical and diagnostic procedures
diuretics increase urine formation by preventing the reabsorption of water and electrolytes from the tubules of the kidney into the bloodstream
polyuria (aka diuresis) abnormally large amounts of urine
polydipsia excessive fluid intake
oliguria low urine output (less than 500mL a day or 30 mL an hour)
anuria lack of urine production
dialysis a technique by which fluids and molecules pass through a semipermeable membrane according to the rules of osmosis for filtering(hemodialysis and peritoneal dialysis)
urinary frequency voiding at frequent intervals, more than 4 to 6 times per day
nocturia voiding two or more times a night
urgency sudden strong desire to void
dysuria voiding that is painful or difficult
urinary hesitancy a delay and difficulty in initiating voiding
urinary incontinence involuntary urination, symptom not disease
Types of urinary incontinence acute, or chronic (stress, urge, reflex, retention with overflow, and functional incontinence)
urinary retention emptying of the bladder is impaired, urine accumulates and doesn't drain properly
neurogenic bladder impaired neurological function, prevents the perception of bladder fullness and ability to control urinary sphincters
normal urine pH 4.5-8
specific gravity 1.010-1.025
residual urine urine remaining in the bladder following voiding
BUN blood urea nitrogen, measuring the end product of protein metabolism. used to evaluate renal function
Creatinine clearance uses 24 hour urine or serum creatinine to determine if glomerular filtration is working. used to evaluate renal function
UTI most common type of nosocomial infection found in long term care facility. Prevention: 8 glasses of water, frequent voiding, avoid bubble bath, harsh soap etc, avoid tight fitting pants, cotton undergarments, wipe front to back, showers instead of baths
bladder training postpone voiding, resist or inhibit sensation of urgency and void on a schedule rather than by urge
habit training timed or scheduled toileting, but no delay if the urge occurs
prompted voiding reminding a patient to void
kegel exercises strengthen pelvic floor muscles
crede's maneuver manual pressure on bladder to promote emptying
inserting catheter sterile procedure, lube 1-2 in female (6-7 for male), cleanse (female front to back x3, male circular motion), slow deep breath insert as they exhale, 2 inches past urine flow, inflate balloon
measuring output patient may do if able, accurate measure important
Assessment of Caths no kinks, no tension, gravity drainage, closed, observe flow every 2-3 hours
suprapubic catheter inserted surgically through abdominal wall above symphisis pubis into bladder, care of site is sterile
Created by: 582303342