Fundamentals: Urinary System & Elimination, Test 3
children cath size
8-10 Fr with 3mL balloon
average residual
< 50 mL
urinary diversions
surgical procedure to divert urine to outside of the body
ureters
transport urine from the kidneys to the bladder
normal RBC of urine
up to 2
permanent incontinent urinary diversion
ureterostomy
urethra
urine travels from bladder and exits through urethral meatus
orthotopic neobladder
uses ileal pouch to replace the bladder
goal for intermittent catheterization
void of 400 mL
nocturia
waking at night to void
what two things found in the urine are a sign of glomerulus injury?
-proteinuria -hematuria
99% of filtrate is reabsorbed by
-proximal convoluted tubule -loop of henle -distal tubule
infant catheter size
5-6 FR
normal WBC of urine
0-4
continent urinary reservoir
-created from distal part of the ileum and proximal part of the colon -bag is on the outside of the stomach
intravenous pyelogram
-dye injected -xray taken
condom cath
-for spontaneous and complete bladder emptying -make sure penis is free of swelling, redness or lesions
not normally present in urine
-glucose -protein -ketones -blood -bacteria -crystals -casts
adults cath size
-14-16 Fr women -16-18 Fr men -both with 10 mL balloon
indications for straight catheterization
-Bladder distention -Obtain sterile specimen -Assess residual after voiding -Spinal cord injuries, neuromuscular degeneration, incompetent bladder -Enlarged prostate
other kidney functions
-RAAS -converts vitamin D into active form
indications for indwelling catheterization
-Surgical repair of urethra or bladder -Measuring output of critically ill patient -Urinary retention -Skin conditions - wounds, ulcers, rash
normal range of fluid production
1-2 L a day
normal specific gravity of urine
1.0053-1.030
normal pH of urine
4.6-8
bladder capacity
400-600 mL
average volume voided
300-400 mL
triple lumen
CBI
A client is frustrated and embarrassed by urinary incontinence. Which of the following measures should Nurse Ginny include in a bladder retraining program? A. Establishing a predetermined fluid intake pattern for the client B. Encouraging the client to increase the time between voidings C. Restricting fluid intake to reduce the need to void D. Assessing present elimination patterns
a
Nurse Mary is inserting a urinary catheter into a client who is extremely anxious about the procedure. The nurse can facilitate the insertion by asking the client to: A breathe deeply B initiate a stream of urine C turn to the side D hold the labia or shaft of penis
a
Nurse Pete is reviewing the report of a client's routine urinalysis. Which value should the nurse consider abnormal? A Specific gravity of 1.03 B Urine pH of 3.0 C Absence of protein D Absence of glucose
b
Nurse Pippy is reviewing a client's fluid intake and output record. Fluid intake and urine output should relate in which way? A. Fluid intake should be double the urine output B. Fluid intake should be approximately equal to the urine output C. Fluid intake should be half the urine output D. Fluid intake should be inversely proportional to the urine output
b
When a female client with an indwelling urinary (Foley) catheter insists on walking to the hospital lobby to visit with family members, nurse Rose teaches how to do this without compromising the catheter. Which client action indicates an accurate understanding of this information? A. The client sets the drainage bag on the floor while sitting down. B. The client keeps the drainage bag below the bladder at all times C. The client clamps the catheter drainage tubing while visiting with the family D. The client loops the drainage tubing below its point of entry into the drainage bag
b
bladder removal called
cystectomy
Overflow UI
associated with chronic retention of urine
inflammation of bladder
cystitis
endoscopy/cystoscopy
camera inserted into bladder for direct visualization
single lumen
straight cath
urinary tract infection (UTI)
caused by catheterization, poor hygiene, retention, incontinence
assessment of skin
checks for hydration
blood stream infection
bacteremia
lower UTI
bladder
ureterostomy
brings ureters out to create stoma
Nurse Gil is aware that the following statements describing urinary incontinence in the elderly is true? A Urinary incontinence is a normal part of aging B Urinary incontinence in the elderly can't be treated C Urinary incontinence isn't a disease D Urinary incontinence is a disease
d
oliguria
decreased output of urine
alcohol does what?
decreases ADH so increases urine production
first sign of UTI in older adults
delirium
assessment of bladder
distended bladder rises above symphysis pubis
arteriogram/angiography
dying the veins and using fluorescent imaging to see it
pain while emptying
dysuria
urine intake should be greater/less/equal to output
equal
KUB and CAT scans
film of lower abdomen
assessment of kidneys
flank pain may occur with infection or inflammation
ultrasound
imaging using sound waves
collection retainer kept where during timed urine specimens?
in fridge or on ice to prevent bacterial growth
urinary retention
inability to partially or completely empty the bladder
diuretics
increase output by preventing water absorption
anticholinergics
increase urinary retention by inhibiting bladder contractility
polyuria
increased output of urine
double lumen
indwelling
suprapubic cath
inserted surgically into the bladder through the abdominal wall above the symphysis pubis
urge UI
involuntary leakage associated with urgency
urinary incontinence
involuntary leakage of urine
stress UI
involuntary loss of urine associated with effort or exertion on sneezing or coughing
assessment of urethral meatus
observe for discharge, inflammation, and lesions
micturition
occurs when the brain gives the bladder permission to empty, the bladder contracts, the urinary sphincter relaxes, and urine leaves the body through the urethra
stoma
opening in the abdomen wall through which urine flows
what is important to remember during timed specimens?
patient voids and discards first urine
upper UTI
pyelonephritis
hypnotics and sedatives
reduce the ability to act on the urge to void
kidney
removes waste from the blood via the nephrons to form urine
bladder
reservoir for urine until the urge to urinate develops
nephrostomy
sends tubes into renal pelvis to drain it
