Ch. 33
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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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