Urinary elimination

Question 1

Factors that influence urination

Answer 1

Age-decreased bladder compacity, loss of muscle tone, leakage, incontinence
Medical condition-UTIs, diabetes, neurological disabilities
Diet/Exercise- odor, color, alcohol, caffeine
Meds-diuretics
Fluid intake- inadequate hydration
Muscle tone-leakage
Psychosocial- stress, anxiety, privacy

Question 2

Kidneys

Answer 2

Two bean shaped organs
Below rib cage
Filter 120-150 quarts of blood to produce 1-2 quarts of urine
Bladder can hold about 2 cups of urine

Question 3

Measuring urinary output

Answer 3

Continent- hat in toilet, urinal, bed pan
Incontinent- foley, pure wick, condom catheter, weight incontinent pads
Less than 30 mL/hr for more than 2 hours should be reported to Dr

Question 4

Anuria

Answer 4

24-hour urine output is less than 50mL

Question 5

Dysruia

Answer 5

Painful/difficult urination

Question 6

Frequency

Answer 6

Increased incidence of voiding

Question 7

Glycosuria

Answer 7

Presence of glucose in the urine

Question 8

Nocturia

Answer 8

Awakening at night to urinate

Question 9

Oliguria

Answer 9

24-hour urine output is less than 400mL

Question 10

Polyuria

Answer 10

Excessive output of urine

Question 11

Proteinuria

Answer 11

Protein in the urine

Question 12

Pyuria

Answer 12

Pus in the urine

Question 13

Urgency

Answer 13

Strong desire to void

Question 14

Urinary incontinence

Answer 14

Involuntary loss of urine

Question 15

Stress incontinence

Answer 15

Increased pressure on bladder from any physical activity
Laughing, coughing, sneezing

Question 16

Urge incontinence

Answer 16

Strong need/desire to void, but leaking occurs before they make it to the bathroom

Question 17

Reflex incontinence

Answer 17

Urinary leakage as a result of nerve damage

Question 18

Overflow incontinence

Answer 18

Incomplete bladder emptying that results in the bladder overfilling when full, leakage

Question 19

Functional incontinence

Answer 19

Physical inability to reach the toilet in time
Immobile, arthritis, wheelchair

Question 20

Nocturnal enuresis

Answer 20

Nighttime bed wetting, consumption of caffeine/alcohol, or meds

Question 21

Management techniques for incontinence

Answer 21

Bladder training
Kegals
Tighten pelvic floor
Check and change at least every 2 hours
Barrier creams
Warm water
No soap
Peri care

Question 22

Urinary retension

Answer 22

The bladder does not fully empty with urination
Increased risk of UTI
Causes- obstruction, cancer, neuro issue, meds, infections
Treatments- determine severity, catheterizations, surgery, meds, avoid caffeine/alcohol

Question 23

Age (risk factor)

Answer 23

Young children, older adults (decreased bladder elasticity, UTIs

Question 24

Gender (risk factor)

Answer 24

Females are more prone to UTIs
Males over 40 at risk for BPH
Uncircumcised males

Question 25

Diet (risk factor)

Answer 25

Avoid irritables: chocolate, alcohol, caffeine Water and cranberry juice!

Question 26

Psychosocial stress (risk factor)

Answer 26

Time and place Lack of privacy Needing assistance

Question 27

Meds (risk factor)

Answer 27

Diuretics increase urine Always give in morning

Question 28

Dehydration

Answer 28

Loss of fluid in body, caused by diarrhea, sweating, or decrease fluid intake Causes dry mouth, dark urine, fatigue Older=more at risk

Question 29

UTI

Answer 29

Can cause worse infections like the kidney Females avoid-> bubble baths, and always pee after sex Catheter use, diabetes Painful urination and urgency

Question 30

Kidney stones

Answer 30

Collection of minerals in kidneys Males more at risk Obstruction of urine flow, bleeding Sharp back pain, blood in urine Treatment: increase fluid intake, meds, surgery (big)

Question 31

Kidney failure

Answer 31

Loss of 15% of expected kidney function Reduced urine production, joint pain, increased BP, heart disease, anemia, and itching (toxins in skin) Risk- diabetes, hypertension, heart disease, family Hx, obesity Interventions- hemodialysis, peritoneal dialysis, kidney transplant

Question 32

Prostate enlargement

Answer 32

BPH- benign prostatic hyperplasia Age, male Testosterone decreases, estrogen and DHT increase Frequency, urgency, nighttime urination, weak/slow stream, incontinence, retention Can cause UTI, bladder/kidney damage, bladder stones Interventions depend -> meds, surgery

Question 33

Urinary catheterization

Answer 33

Allows urine to drain, flexible tube through urethra or abdomen Super pubic-> long-term

Question 34

Ureteral stent

Answer 34

Thin tube to keep urethra open, temporary, prevents blockage and backup Used for tumor compression, trauma, kidney stones

Question 35

Urostomy

Answer 35

Surgically created using a part of the small intestine, repositioning it to ureter and wall of abdomen Stoma is created to allow urine to pass through to a pouch

Question 36

Nephrostomy

Answer 36

Surgically created by attaching a tube from the renal pelvis to abdominal wall Located on the back Drains directly from kidneys No stoma

Question 37

Continent urinary diversion

Answer 37

New bladder Attached to ureters and urethra Using part of bowel Can not be emptied on its own

Question 38

Cystostomy

Answer 38

Catheter is inserted to bladder Bag attached at abdomen More invasive than indwelling catheter

Question 39

Urinalysis (UA)

Answer 39

Evaluate UTIs, bladder infections, kidney infections Clarity, color, odor, pH, glucose, protein, etc

Question 40

Urine culture

Answer 40

BEFORE antibiotics Evaluates bacteria Needs to be clean catch Microscopic look

Question 41

24 hour urine test

Answer 41

Kidney function Urine is collected over 24-hour time after discarding first void Kept cold (ice/fridge)

Question 42

Urinal/bedpan

Answer 42

Used for patient with limited immobility Bedpan- regular, fracture, bariatric Call light w/in reach Check skin breakdown

Question 43

Lifestyle changes

Answer 43

Diet Avoid bladder irritants Encourage fluid intake Avoid/adjust meds Quit smoking Maintain healthy weight Pelvic floor exercises

Question 44

Bladder training

Answer 44

Redoing natural schedule Slowly add more time in between voiding Maintain new schedule Teach bladder when its full

Question 45

Bladder scanning

Answer 45

Ultrasound Determines volume of bladder

Question 46

Catheterization

Answer 46

Foley Super pubic Straight Peri care!

Question 47

External catheter-male

Answer 47

Condom catheter 2-3 cm at end 24 hours

Question 48

External catheter-female

Answer 48

Pure wick Continuous suction 8-12 hours