Adn 125L - Quiz 1, Sc4

Front 1

List the factors affecting voiding.

Back 1

Developmental, Psychosocial, Fluid and Food Intake, Medications, Muscle Tone, Pathologic Conditions, Surgical & Diagnostic Procedures

Front 2

Examples of developmental factors affecting voiding are:

Back 2

Infants - have no urinary function until 2-5 years.
Elders - kidney function diminishes with age but more with disease & bladder issues.

Front 3

Examples of psychosocial factors affecting voiding are:

Back 3

Privacy, Normal Position, Sufficient Time, etc.

Front 4

Examples of Fluid & Food Intake factors affecting voiding are:

Back 4

Increased input directly relates to increased output.

Front 5

Examples of Medication factors affecting voiding are:

Back 5

Medications affecting the autonomic nervous system interfere with normal urination process--some may cause retention.

Front 6

Examples of how muscle tone factors affect voiding:

Back 6

Muscle tone is necessary to maintain stretch and contractivity of the detrusor muscle. A deficit in muscle tone could result in urine retention.

Front 7

Examples of how pathologic conditions affect voiding:

Back 7

Kidney disease, heart and circulatory disorders, shock and hypertension all affect voiding.

Front 8

Examples of how surgical and diagnostic procedures affect voiding are:

Back 8

Swelling from a cystoscopy and spinal anesthetics are two examples of procedures that affect voiding.

Front 9

Define polyuria.

Back 9

Production of large amounts of urine (diuresis).

Front 10

Define Oliguria and Anuria.

Back 10

decreased urine output or lack of urine production. Oliguria is < 500 ml/day.

Front 11

Altered Urinary Elimination:

Frequency and Nocturia

Back 11

More than 4-6 x/day. Nocturia is voiding more than 2 x/night.

Front 12

Altered Urinary Elimination:

Urgency

Back 12

Psychologic stress and irritation of the trigone and urethra, poor external sphincter control, unstable bladder contractions.

Front 13

Altered Urinary Elimination:

Dysuria

Back 13

Painful or difficult voiding (such as in a UTI or injury).

Front 14

Altered Urinary Elimination:

Enuresis

Back 14

Involutary urination (after 4-5 years of age)

Front 15

Altered Urinary Elimination:

Urinary Incontinence

Back 15

Symptom not a disease -- involuntary urination (at risk for isolation, social withdrawl).

Front 16

Altered Urinary Elimination:

Urinary Retention

Back 16

Characterized by over distended bladder from urine accumulation.

Front 17

Altered Urinary Elimination:

Neurogenic Bladder

Back 17

Doesn't perceive bladder fullness -- unable to control urinary sphincter because of neurologic deficits.

Front 18

Nursing History regarding Urinary Elimination:

Back 18

Normal voiding patterns, frequency, appearance, recent changes, past or current problems with urination, presence of ostomy, factors influencing elimination patterns.

Front 19

Assessment of Urine:

Measuring Urinary Output

Back 19

60 ml/hour or 1500 ml/day

Front 20

Assessment of Urine:

Measuring Residual Urine

Back 20

Internal Catheter--measure urine during normal voiding and cath immediately following voiding, measure urine collected from cath.

Front 21

Assessment of Urine:

Diagnostic Tests

Back 21

BUN (blood, urea, nitrogen) & Creatinine Clearance

Front 22

Nursing Diagnoses (Urinary Elimination)

Back 22

functional urinary incontinence, reflex urinary incontinence, stress urinary incontinence, total urinary incontinence, urge urinary incontinence

Front 23

Home Care Client Assessment (for urinary eliminations concerns)

Back 23

self-care abilities, current level of knowledge, assistive devices required, physical layout of toileting facilities, home environment factors interfering w/ toileting, urinary elimination problems

Front 24

Continence (bladder) Training

Back 24

time table--more control, habit training--scheduled toileting, prompted voiding--prompting and reminding when to void

Front 25

Pelvic Muscle Exercises

Back 25

Kegel's--strengthen pelvic floor muscles--control of urinary sphincter

Front 26

Maintaining Skin Integrity

Back 26

urine on skin--ammonia--wash w/ mild soap & water. Thekey is clean and dry--skin, clothing, linen--briefs, draw sheets that absorb liquid (sometimes barrier creams)

Front 27

Managing Urinary Retention

Back 27

Cholinergic Drugs for bladder contraction, Crede's Maneuver (manual pressure applied to bladder)

Front 28

Nursing interventions for cath clients

Back 28

fluids (2500 to 3000 ml/day to help decrease the risk of UTI's), dietary measures (acidity diet--red meat, tomatoes, whole grains, prunes, etc), perineal care (agency policy), changing catheter and tubing (sediment in cath tubing or collection)

Front 29

Urinary Diversions

Back 29

Continent--some control--Kock Pouch or Neobladder
Incontinent--produces urine all the time--requires use of external ostomy appliance (ureterostomy, nephrostomy, vesicostomy & ileal conduits)

Front 30

Clean Voided Specimen

Back 30

Routine UA -- 10 ml is sufficient

Front 31

Clean-catch or midstream specimen

Back 31

Used to identify specific microorganism causing UTI for antibiotic prescription

Front 32

Timed Specimen

Back 32

Void before time starts--if any is missed, start again
Concentration & Dilution of Urine, Glucose Metabolism, Specific Constituents (albumin, amylase, creatinine, urobilinogen)

Front 33

Indwelling/Retention Catheter Specimen

Back 33

drawn by syringe from self-sealing cath or port

Front 34

Specific Gravity

Back 34

measures amount of solute in urine

Front 35

pH (urine testing)

Back 35

normal is 4.5 to 8 -- tests for acidity or alkalinity

Front 36

Glucose (urine testing)

Back 36

present/not present - tests for diabetes

Front 37

Ketones (urine testing)

Back 37

present/not present - ketoacidosis (alcoholics, after fasting, high protein diets)

Front 38

Protein

Back 38

glomerulonephritis - protein is usually too large but if the glomerulus is damaged or "leaky" can spill into urine

Front 39

Occult Blood

Back 39

can be a sign of UTI or injury

Front 40

Osmolality

Back 40

more exact measurement for specific gravity

Front 41

Fluid Intake

Back 41

2500 ml/day: 1500 ml/day by liquids and another 1000 ml/day through foods

Front 42

Fluid Output

Back 42

urine, perspiration expectoration, watery feces, wound drainage, emesis, NG Tube Drainage

Front 43

Fluid Volume Deficit

Back 43

Loss: 2% is mild, 5% is moderate, 8% is severe (weight loss)
Signs: weak, rapid pulse, decreased temp, decreased BP, orthostatic hypotension

Front 44

Fluid Volume Excess

Back 44

Gain: 2% is mild, 5% is moderate, 8% is severe (weight gain)
Signs: edema which can lead to heart failure, renal failure, cirrhosis, tachycardia, full-bounding pulse, increased BP, moist crackles in lungs, dyspnea, increased central venous pressure