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NUR 104 Chpt 41

Urinary Elimination

QuestionAnswer
A combination blood and urine test that measures the rate at which the kidneys clear creatinine from the blood. A decreased clearance value indicates renal impairment. Creatinine clearance
Actively and passively reabsorbes substances that the body wants to retain including varying amounts of water and electrolytes as well as glucose and amino acids. tubule / reabsorption
n adult senses the need to urinate when the bladder has how many ml? 250-400
An involuntary loss of urine that occurs at somewhat predictable intervals when a specific bladder volume is reached. reflex incontinence
Catheterized clients should drain a minimum of ____ mL of urine per hour. Less than this may indicate inadequate blood flow to the kidneys. 30
Caused by microorganisms normally found in the GI tract. Most commonly E. coli, Klebsiella, and Proteus which gain access to the urinary system by way of the urethral meatus. Voiding becomes painful and more frequent. UTI
Diminished urinary output in relation to fluid intake (less than 500mL in 24 hours) Could be caused from excessive vomiting diarrhea, diaphoresis, burns, or bleeding. Oliguria
During a physical assessment, what do you look at? Skin and mucous membranes, kidney flank, bladder, urethral meatus, I&O, Urine Characteristics.
Feeling of the need to void urgency
Helpful for detecting malformations in the size or shape of the kidney, ureters, or bladder and the presence of any stones that could obstruct urine flow. Kidney Ureters Bladder (KUB -Flat plate of the abdomen)
In addition to reabsorbing substances, the tubules ______ some substances to rid them from the body including H+ and K+ ions as well as ammonia, creatinine, uric acids and other metabolites. secretion
Inability of to empty the bladder of urine urinary retention
Involuntary voiding, with no pathophysiologic origin, after the age in which bladder control id usually achieved. Enuresis
nvolves insertion of a tube into the bladder for the purpose of direct visualization. A light at the end allows the MD to look for abnormalities like tumors, stones, & structural probs. Can also remove stones or take biopsies. Signed consent required Cystoscopy
Involves the inability or unwillingness of a person with normal bladder and sphincter control to reach the bathroom in time to void. Functional incontinence
Is urine draining from the the ureters to the bladder sterile? yes
Measures the amount of certain substances such as glucose, protein, or ketones in the urine. Also tests the pH and presents of occult blood. Reagent strips
Noninvasive technology that can estimate the volume of urine in the bladder. Also can be used to measure post-void residual. Bladder Ultrasound (BUS)
Occurs when the bladder, as soon as it is stretched to a certain degree, contracts reflexively, resulting in loss of urine. reflex voiding - condition: reflex neurogenic bladder
Painful or difficult urination. Dysuria
Preformed on urine to identify any microorganism causing a UTI and to determine which antibiotics can kill the organism. Urine culture and sensitivity
Provides data about the color, turbidity, pH, and specific gravity of the urine and indicates the presence of protein, glucose, ketones, RBC's, WBC's bacteria or casts. Voided morning specimen is preferred urinalysis
Radiologic procedure that visualizes the urinary sys with the use of radiopaque/contrast dye that is injected intravenously. X-ray films are taken to visualize the dye as the kidneys excrete it, empty it into the ureters & deposit it into the bladder. Intravenous Pyelogram (IVP)
Several hormones, the most important being ______, play a significant roll in the reabsorption of water in the tubules of the nephron. antidiuretic hormone (ADH)
The continuous, involuntary, unpredictable loss of urine from a non-distended bladder total incontinence
The involuntary loss of urine after strong feeling of the need to urinate. These person is unable simultaneously to perceive a full bladder and to hold urine until reaching the bathroom. R/T factor could be consumption of alcohol, caffeine urge incontinence
The major nitrogenous end waste product of metabolism. Diet, infection, gout and excessive breakdown of protein stores can also elevate its levels. urea
The micturition reflex occurs at the ____ level of the spinal cord. sacral
The sudden, involuntary loss of small amounts (less the 50mL) of urine that accompanies a sudden increase in the intra-abdomnal pressure. Examples of activities that increaseintra-abdomnal pressure are coughing, sneezing, laughing, lifting, and jumping stress incontinence
The total amount of urine voided during a 24-hour period usually ranges between ____and____mL. Each void should contain a minimum of approximately 200mL and a maximum of 500mL. 1,200-1,500
The waste product formed from the breakdown of skeletal muscle tissue. Diets & other factors do not influence its formation. Damage of a large # of nephrons prevents efficient excretion & cause accumulation in blood-ivdicative of impaired renal fx creatinine - is an accurate measure of the kidney's glomerular filtration abilities.
The weight or concentration of urine as compared to water. Measured with a urinometer which is calibrated to float at the 1.000 mark in distilled water. The more concentrated the urine, the higher the float well rise in the tube, the higher the reading. specific gravity
These procedures measure pressure (in the bladder and urethra and within the abdomen), urinary flow, and striated muscles. Urodynamic studies (uroflowmetry, cystometrograms, and urethral pressure profile)
This reaction of the bladder stretch, leading to bladder contraction and perceived need to void is called __________, an involuntary spinal reflex. micturition reflex
Urethra (urethritis) or bladder (cystitis) infections are considered ___ UTI's and are more common lower
Urination, particularly excessive, at night. Nocturia
Voiding at frequent intervals. frequency
Voiding large amount of urine (more than 2500-3000 mL in 24 hours) Polyuria
What are accepted NANDA nursing diagnosis involving urinary elimination? Urinary incontinence: stress, Urge, Ref;ex, Functional, and Total and Urinary Retention.
What are some signs and symptoms of a UTI? Namely fever, flank pain, dysuria, frequency, urgency, pyuria, or hematuria. Symptoms may be absent in an older adult
What are terms used to say the expelling of urine from the body? Urination, micturition, and voiding.
What are the 5 types of urinary incontinence? Total, Functional, Stress, Urge, and Reflex.
What do you do when assessing a patient for urinary problems? subjective: normal pattern identification, risk identification, dysfunction identification
What factors effect urinary formation and elimination? Fluid intake, loss of body fluids, nutrition, body position, psychological factors, cognition, obstruction of urine flow, infection, hypotension, neurologic injury, decreased muscle tone:aging, multipul pregnancies, & obesity, surgery, medications
What forms the glomerulus? a cluster of capillaries
What is a sign of glomerular injury? Proteinuria.
What is bacteriuria? bacteria in the urine.
What is residual urine? urine that remains in the bladder after urination.
What is urinary incontinence? the loss of control over voiding, it is either temporary or permanent.
What is urinary retention? An accumulation of urine in the bladder because the bladder is unable to partially or completely empty
What is urosepsis? The spread of organisms into the bloodstream.
When ADH is present, the distal tubule of the nephron becomes _________ to water causing the kidney to reabsorb more. more permeable
When atrial blood pressure drops too low, the renal arteries do not have enough pressure to cause glomerular filtration hypotension
When fluid intake increases ADH release is ________. surpressed
When kidneys are diseased, they are unable to excrete urea adequately so in begins to accumulate in the blood. This test measures the amount of urea nitrogen in the blood. Diet, infection, gout & excessive breakdown of protein stores can elevate levels. Blood Urea Nitrogen (BUN)
a network of blood vessels, surrounded by Bowman's capsule, where urine formation begins glomerulus
connects the kidneys with the bladder ureters
fluid that is filtered from the glomerulus into Bowman's capsule glomerular filtrate/ filtration
functional unit of the kidney nephron
enables urine to leave the body urethra
distention of the kidney pelvis with urine secondary to the increased resistance cause by obstruction to normal urine flow. hydronephrosis
hat position are females usually placed n for catheterization? Dorsal recumbent *clients who have limited hip mobility should be placed in the side-lying position. This position is more comfortable for weak clients or ones that have trouble keeping their legs flexed and spread for long periods.
leakage of urine despite voluntary control of micturition. dribbling
urine containing blood hematuria
urine containing pus pyuria
water excretion diuresis
where urine is formed - function is to regulate the volume and composition of the body's extracellular fluid kidneys
results in contraction of the detrusor muscle and relaxation of the internal sphincter, which causes urination. parasympathetic nerve stimulation
stores the urine bladder
postoperative clients should be able to void __ hours after surgery. 8
Created by: jessicaspring