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Ch. 33

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Question
Answer
Normal range of urine production and components   show
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What are the functioning parts of kidneys   show
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show protein in urine, not supposed to be there. If present then faulty glomerulus  
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What is micturition?   show
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Three factors affect urination   show
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show inability to store or fully empty urine from bladder from impaired bladder funx, obstruction to urine flow, not voluntarily control  
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show urine drains through artificial opening (stoma) on abd wall  
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What is urinary retention?   show
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What is over flow incontinence   show
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What is residual urine   show
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Bacteriuria   show
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What is urinary incontenence (UI)   show
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show prevent reabsorption of h2o, incr. urination  
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show continent urinary reservoir (ureters embedded in reservoir) and orthotopic neobladder(use ileal pouch to replace bladder)  
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four types of urinary incontinence   show
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What is total urinary incontinence and cases and symptoms   show
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show unpredictable passage of urine in pxt with mental/physical disability. Causes: fistula b/n bladder/vagina, change in env. Sx: strong urge to void, with loss before reaching bathroom  
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show incr abd pressure cause leaks Cause: cough/laugh/vomit, obesity, 3rd trimester, weak muscles Sx: dribbling, urgency, freq.  
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show involuntary void after strong sense of urgency Cause: decr bladder capacity, alcohol/caffeine, incr fluid Sx: urgency, bldr contracture/spasm, nocturia  
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show involuntary voiding at somewhat predictable intervals Cause: upper/lower spinal cord injury Sx: not aware bldr fills, no urge to void  
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What is CAUTI's   show
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In acute and long term care settings catheters are always done in what technique?   show
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show bladder scanner, toileting schedule  
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show renal or cardiovascular disease or cystitis  
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Important factors in pxt history for urination   show
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What is pyelonephritis   show
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show painful or difficult urination, bladder inflammation, trauma of urethra  
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what is polyuria   show
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What is oliguria   show
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what is hematuria   show
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Measuring I/O for what physiological problems. What is a danerous I/O amount   show
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Assessment of urine - characteristics   show
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Collection of urine, steps to follow   show
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What does a urinalysis screen for?   show
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show female- clean from meatus to rectum, use sep. wipe each stroke Male- clean meatus in circular motion from center out, 3x discard initial stream  
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show Unless specimen is first urine into new sterile bag  
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show pH = 4.6-8.0 Protein = up to 8mg/100mL glucose = not Ketones = not, dehydration/starve blood = up to 2 RBC Specific gravity = 1.01 - 1.03, measures concentration of urine  
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What do you keep/discard when collecting 24 hr sample   show
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show plain film, KUB(kidney,ureter,bladder), assess gross structures Useful in visualizing stones/tumors  
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show view entire urinary system, IV injection of radiopagque dye  
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Noninvasive procedures Computerized Axial Tomography   show
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show see organs with telescope/fiberoptic imaging, painful procedure  
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Invasive procedures Urodynamic Testing   show
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Difference between stress and urge incontinence   show
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show putting pressure on suprapubic area to relieve urinary retention  
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Specific interventions   show
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show Bethanochol - incr bladder contraction and improve emptying  
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Alpha adrenergic drugs   show
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show propantheline - reduce incontinence by blocking contractility of bladder  
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Types of catheterization   show
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show 1. immed. relief of bladder distention 2. long term mgmt 3. obtain sterile specimen 4. assess for residual urine 5. instill a medication  
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show 1. obstuction to outflow 2. surgical procedures 3. blood clot prevention 4. record O in comatose/critical 5. provide continuous irrigation  
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show q8h, remove secretions/encrustation at site, cleanse first 4 inches of tube, going away from urethra  
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Must replace catheter if...   show
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show surgically inserted in bladder thru abd, short periods, can void naturally Condom catheter - coma, low risk for infection, remove daily  
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Sites at risk for infection   show
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