What is the functional unit of the kidney that forms the urine?
Nephron
__________ is the presence of large amounts of protein in the urine.
Proteinuria
What functions within the bone marrow to stimulate red blood cell production?
Erythropoietin
What enzyme converts angiotensinogen into angiotensin I?
Renin
What is a reflux of urine from the bladder into the ureters?
Micturition
What is another name for kidney stones?
Renal calculus
What is the involuntary loss of urinary control
Reflex incontinence
1. Pathophysiological conditions
2. Sociocultural factors
3. Psychological factors
4. Fluid balance
5. Surgical and diagnostic procedures
Factors that influence urination
What is a surgical formation (temporary or permanent) that bypasses the bladder and has a stoma on the abdomen to drain the urine?
Urinary diversion
What is an accumulation of urine resulting from an inability of the bladder to empty properly?
Urinary retention
What can happen as a result of a catheteriztion or surgical manipulation with Escherichia coli being the most common pathogen?
Hospital-acquired UTI
1. Dysuria
2. Fever
3. Chills
4. Nausea
5. Vomiting and malaise
6. Cystitis
7. Hematuria
8. WBCs or bacteria in the urine
Signs or symptoms of UTI
What occurs when intraabdominal pressure exceeds urethral resistance?
Stress incontinence
What is a sudden, involuntary contraction of the muscles of the urinary bladder resulting in the urge to urinate?
Urge incontinence
For a/an _______________, ureters are implanted into the isolated segment of the ileum and used as a conduit for continuous draining. The patient wears a stomal pouch continuously.
Ileal conduit
For a/an _______________, a tube is placed directly into the renal pelvis to drain urine directly from one or both of the kidneys.
Nephrostomy
1. Pattern of urination
2. Symptoms of urinary alteration
3. Factors affecting urination
Factors to be explored during a nursing history in regards to urinary elimination
What is the feeling of the need to void immediately?
Urgency
What is painful or difficult urination?
Dysuria
The ____________ of urination increases with increased fluid intake, pregnancy, and diuretics.
Frequency
Urinary ____________ can be caused by prostate enlargement, anxiety, or urethral edema.
Hesitancy
____________ is large amounts of urine being voided.
Polyuria
______________ is diminished urinary output relative to intake.
Oliguria
_____________ is nighttime voiding often caused by coffee or alcohol.
Nocturia
____________ may be caused by stress incontinence.
Dribbling
_____________ is caused by the loss of pelvic muscle tone, fecal impaction, or overactive bladder.
Incontinence
_____________ is blood in the urine.
Hematuria
______________ is an accumulation of urine in the bladder with the inability to empty fully.
Retention
_____________ is greater than 100 mL of urine remaining after voiding.
Residual urine
1. Skin
2. Mucosal membranes
3. Kidneys
4. Bladder
5. Urethral meatus
Structures assessed during nursing urinary examination
1. Pale
2. Straw-colored
3. Amber-colored
Range of urine color
The __________ of urine changes from being transparent after voiding to becoming more cloudy on standing in a container.
Clarity
Urine has a characteristic odor, the more _____________ the urine, the stronger the odor.
Concentrated
A ____________ urine specimen is collected during normal voiding from an indwelling catheter or urinary diversion collection bag and should be collected with a clean specimen cup.
Random
A ____________ urine specimen must be collected using clean technique by cleaning the labial and vulvular area in females front to back or by cleaing the tip of the penis prior to collecting the urine in midstream.
Clean-void
A ____________ urine specimen uses aseptic technique by inserting a sterile syringe hub into a sampling port on an indwelling catheter and transfering to a sterile container.
Sterile
A ___________ urine specimen has a patient void into a clean container for a specific time period.
Timed
What analyzes urine for pH, protein, glucose, ketones, blood, specific gravity, RBCs, WBCs, bacteria, and crystals.
Urinalysis
What is the weight or degree of concentration of a substance compared with an equal volume of water?
Specific gravity
A urine ___________ is performed on a sterile or clean voided sample of urine and can report bacterial growth in 24 to 48 hours.
Culture
A/an _____________ radiography determines the size, shape, symmetry, and location of the kidneys.
Abdominal
___________ views the collecting ducts and renal pelvis and outlines the ureters, bladder, and urethra. A special intravenous injection that converts to a dye in urine is injected intravenously.
IVP
A ____________ obtains detailed images of structures within a selected plane of the body. The computer reconstructs cross-sectional images and thus allows the health care provider to view pathologic conditions such as tumors ad obstructions.
CT scan
Renal and bladder _____________ identifies gross renal and bladder structures and structural abnormalities in using high frequency, inaudible sound waves.
Ultrasonography
______________ is used for direct visualization, specimen collection, or treatment of the interior of the bladder or urethra.
Endoscopy.
____________ visualizes the renal arteries and their branches to detect narrowing or obstruction.
Angiography
_____________ determines bladder muscle function and is indicated to evaluate causes of urinary incontinence.
Urodynamic testing
1. Disturbed body image
2. Urinary incontinence (Functional, stress, urge)
3. Pain (Acute, chronic)
4. Risk for infection
5. Self-care deficit, toileting
6. Impaired urinary elimination
7. Urinary retention
8. Social isolation
Potential or actual nursing diagnoses related to urination elimination
1. Patient will void within 8 hours
2. Urinary output of 300 mL or greater will occur with each voiding
3. Patient's bladder is not distended to palpation
Goals appropriate for a patient with urination elimination problems
1. Normal positioning
2. Running water
3. Stroking the inner aspect of the thigh
4. Warm water over the patient's perineum
Techniques that may be used to stimulate the micturation reflex
1. Clothing modifications
2. Environmental alterations
3. Scheduled toileting
4. Absorbent products
Interventions for functional incontinence
1. Pelvic floor exercises (Kegel)
2. Surgical interventions
3. Biofeedback
4. Electrical stimulation
5. Absorbent products
Interventions for stress incontinence
1. Antimuscarinic agents
2. Behavioral interventions
3. Biofeedback
4. Bladder retraining
5. Pelvic floor exercises
6. Lifestyle changes (smoking cessation, weight loss, fluid modifications)
7. Absorbent products
Interventions for urge incontinence
A/an ______________ catheter is used to for the relief of discomfort of bladder distention and provision of decompression.
Intermittent
A/an _________________ catheter is used when there is an obstruction to urine flow, after surgical repair of the bladder, urethra, and surrounding structures.
Short-term indwelling
A/an _________________ catheter is used for severe recurrent urinary retention episodes of UTI.
Long-term indwelling
How many times a day should a nurse perform personal hygiene on a patient with an indwelling catheter?
3
Catheter care requires special care 3 times a day and after ____________.
Defecation
How much fluid should be taken in by a patient per day if permitted?
2000-2500 mL
To maintain the patency of an indwelling catheter it may be necessary to irrigate or flush with sterile ___________.`
Saline
What kind of catheter is surgically placed through the abdominal wall above the symphysis pubis and into the urinary bladder?
Suprapubic
What kind of catheter is used for incontinent or comatosed men who still have complete and spontaneous bladder emptying?
Condom
What kind of exercise consists of repetitive contractions of muscle groups and are effective in treating stress incontinence, overactive bladder, and mixed caused of urinary incontinence?
PFEs (Pelvic floor exercises)
What is used to reduce the voiding frequency and to increase the bladder capacity, specifically for patients with urge incontinence related to overactive bladder?
Bladder retraining
_________ training benefits patients with functional incontinence by improving voluntary control over urination.
Habit