Ch 43 Urinary Elimination

Front 1

How long is the Male urethra and how many parts are there?

Back 1

5½″ to 6¼″ (13.7 to 16.2 cm) long and consists of three parts: the prostatic, the membranous, and the cavernous portions

Front 2

The ______________ function is to convey urine from the bladder to the exterior of the body

Back 2

urethra

Front 3

The process of emptying the bladder is known as _______________ voiding, or urination.

Back 3

Micturition

Front 4

The person feels a desire to void, usually when the bladder fills to about _________ to ______ in an adult.

Back 4

150 to 250mL

Front 5

Any involuntary loss of urine that causes such a problem is referred to as ______________

Back 5

Urinary Incontinence

Front 6

______________ occurs when urine is produced normally but is not excreted completely from the bladder.

Back 6

Urinary retention

Front 7

Anticoagulants may cause _____________or a pink or red color.

Back 7

Hematuria

Front 8

________ can lighten the color of urine to pale yellow

Back 8

Diuretics

Front 9

________________ a urinary tract analgesic, can cause orange or orange-red urine

Back 9

Pheazopyridine (Pyridium)

Front 10

The antidepressant _____________ or _________can turn urine green or blue-green.

Back 10

amitriptyline (elavil) or B complex vitamins

Front 11

____________, an antiparkinson drug, and ______________ lead to brown or black urine.

Back 11

Levodopa (I-dopa), Injectable iron compounds

Front 12

A woman who notices an involuntary loss of urine following a coughing episode is most likely experiencing what types of incontinence?

Back 12

Stress Incontinence

Front 13

Measurement of residual urine by catheterization after voiding verifies what?

Back 13

Urinary retention

Front 14

This catheter is used to drain a patient bladder for short periods ( 5 to 10 mins)

Back 14

Straight catheter

Front 15

You should keep this in mind when considering catheterization?

Back 15

The bladder is normally sterile cavity.

Front 16

Between what ages do children develop voluntary control of urine.

Back 16

2 and 5 yrs (Bridget lecture Notes)

Front 17

Voluntary control of the urethral sphincters occurs between _________ and ________ of age

Back 17

18 and 24 months

Front 18

Toilet training usually begins at about ______________

Back 18

2 to 3 yrs of age

Front 19

Toilet training should not begin until the child is able to?

Back 19

Hold urine for 2 hours

Recognize the feeling of bladder fullness

Communicate the need to void and control urination until seated on the toilet

Front 20

Intentional or involuntary urination into bed or clothes that occurs after an age when continence should be present is termed ___________

Back 20

Enuresis

Front 21

Enuresis is estimated to occur in What % of 3-year-old children and is not seen as a medical problem until the child reaches 6 years of age.

Back 21

40%

Front 22

What are the physiologic changes that accompany normal aging may affect urination in older adults

Back 22

The diminished ability of the kidneys to concentrate urine may result in nocturia.

Decreased bladder muscle tone may reduce the capacity of the bladder to hold urine, resulting in increased frequency of urination.

Decreased bladder contractility may lead to urine retention and stasis, which increase the likelihood of urinary tract infection.

Neuromuscular problems, degenerative joint problems, alterations in thought processes, and weakness may interfere with voluntary control and the ability to reach a toilet in time.

Front 23

Caffeine-containing beverages, such as cola, coffee, and tea, have a _______ effect, increasing urine production.

Back 23

Diuretic

Front 24

Pathologic conditions, such as congestive heart failure, may lead to_____________ and ____________ urine output.

Back 24

Retention and decreased

Front 25

High blood glucose levels, such as with diabetes mellitus, may lead to an _______________ in urine output secondary to an osmotic diuretic effect.

Back 25

Increase

Front 26

What are 6 self care behaviors of elimination.

Back 26

1. Maintain a normal voiding pattern and volume.

2. Respond as soon as possible to the urge to void.

3. Drink 8 to 10 glasses of water daily.

4. Avoid foods that contain excess sodium.

5. Monitor use of caffeine, alcohol, or medication schedules that promote voiding and may interfere with sleep.

6. Seek medical assistance for any change in the characteristics of urine or presence of pain on urination.

Front 27

Kidneys can be damaged due to excessive use of Ibuprofen is known as?

Back 27

Nephrotoxic

Front 28

Antibiotics, such as ________, can be nephrotoxic

Back 28

Gentamicin

Front 29

_______ 24-hour urine output is less than 50 mL; synonyms are complete kidney shutdown or renal failure

Back 29

Anuria

Front 30

_________ is Painful or difficult urination

Back 30

Dysuria

Front 31

_________ Increased incidence of voiding

Back 31

Frequency

Front 32

__________ Presence of sugar in the urine

Back 32

Glycosuria

Front 33

_________ Awakening at night to urinate

Back 33

Nocturia

Front 34

__________ Scanty or greatly diminished amount of urine voided in a given time; 24-hour urine output is less than 400 mL

Back 34

Oliguria

Front 35

________ Excessive output of urine (diuresis)

Back 35

Polyuria

Front 36

__________ Protein in the urine; indication of kidney disease

Back 36

Proteinuria

Front 37

______ Pus in the urine; urine appears cloudy

Back 37

Pyuria

Front 38

__________ Stoppage of urine production; normally the adult kidneys produce urine continuously at the rate of 60 to 120 mL/h

Back 38

Suppression

Front 39

_________ Strong desire to void

Back 39

Urgency

Front 40

Involuntary loss of urine

Back 40

Urinary incontinence

Front 41

A _________________ involves the surgical creation of an alternate route for excretion of urine

Back 41

Urinary Diversion

Front 42

The bladder is normally positioned below the _____________ and cannot be palpated or percussed when empty

Back 42

Symphysis pubis

Front 43

True or false

When the bladder is distended, it rises above the symphysis pubis and may reach to just below the umbilicus

Back 43

True

Front 44

What event occurs when micturition is initiated?

Back 44

Urine enters the posterior urethra

Front 45

What is the best option for collection urine from a non ambulatory male patient?

a. Specimen hat

b. Large urine collection bag

c. Bedpan

d. Urinal

Back 45

d. Urinal

Front 46

Mr. Gonos is being transferred to the hospital from a nursing home with a diagnosis of dehydration and urinary bladder infection. His skin is also excoriated from urinary incontinence.

a. Impaired skin integrity related to functional incontinence

b. Urinary Incontinence related to urinary tract infection.

c. Impaired skin integrity related to urinary tract infection and dehydration.

d. Risk for urinary tract infection related to dehydration

Back 46

a.

Front 47

Which of the following nursing interventions would be least effective when trying to maintain safety for the patient with an indewelling catheter?

a. Maintain a closed drainage system

b. Restrict fluid intake

c. Apply a topical antibiotic ointment to urinary meatus.

d. Report signs of infection immediately.

Back 47

b.

Front 48

Mrs. Babb has had four urinary tract infections in the past year. Which physiologic change of aging is likely causing Mrs. Babb's problem?

a. Decreased bladder contractility

b. Diminished ability to concentrate urine.

c. Decreased bladder muscle tone.

d. Neurologic weakness.

Back 48

a.

Front 49

Mr. Morris has a urinary obstruction and is not a candidate for surgery. Which of the following would be an appropriate intervention for this patient?

a. Insertion of an indwelling urethral catheter

b. Insertion of a supra-pubic catheter

c. Insertion of a straight catheter

d. Insertion of a urologic stent.

Back 49

d

Front 50

Which of the following statements of the following accurately describe kidney function? (select all that apply)

a. It is estimated that the total blood volume passes through the kidneys for waste removal about every 2hrs.

b. One of the most significant functions of the kidneys is to maintain the composition and volume of body fluids.

c. Urine from the nephrons empties into the urinary bladder.

d. There are approximately 1000 nephrons in each kidney.

e. The kidneys filter and excrete blood constituents that are not needed and retain those that are.

f. The basic unit of the kidney is the nephron, which removes the end of products of metabolism.

Back 50

b, e, f

Front 51

When collection a urine specimen for urinalysis the nurse should be aware of which of the following facts? (select all that apply)

a. Sterile urine specimen may be obtained by catheterizing the patients bladder.

b. A sterile urine specimen is required for a routine urinalysis.

c. If a women is menstruating a urine specimen cannot be obtained for urinalysis.

d. Strict aseptic technique must be used when collecting and handling urine specimens.

e. Urine should be left standing at room temperature for a 24hr period before being sent to the laboratory.

f. A clean catch specimen of urine may be collected in midstream.

Back 51

a, d, f

Front 52

You are preparing a female patient for catheterization. Which of the following are appropriate steps in this procedure? (select all that apply)

a. Place the patient in the dorsal recumbent position.

b. Explain to the patient that the procedure is painless and should cause no discomfort.

c. Place the patient on a soft surface preferably a soft mattress or pillow.

d. Clean the genital and perineal area with antiseptic solution.

e. Place a fenestrated sterile drape over the perineal area, exposing the labia.

f. Insert the catheter tip into the meatus 7 to 10cm or until the urine flows.

Back 52

a, e

Front 53

Some foods can alter the color; for example, ________ can cause urine to appear red.

Back 53

beets

Front 54

This is a measure of the concentration of dissolved solids in the urine. The normal range is ___________ to ___________

Back 54

1.005 to 1.025.

Front 55

A woman who notices an involuntary loss of urine following a coughing episode is most likely experiencing which of the following types of incontinence?

a. Stress incontinence

b. Urge incontinence

c. Overflow Incontinence

d. Functional incontinence

Back 55

a.

Front 56

Measurement of residual urine by cauterization after voiding which of the following conditions?

a. Urinary tract infaction

b. Urinary retention

c. Urinary incontinence

d. Urinary suppression

Back 56

b

Front 57

This is a delay or difficulty in initiating voiding

Back 57

hesitancy

Front 58

This is the involuntary loss of urine associated with an abrupt and string desire to void

Back 58

Urge incontinence

Front 59

Urine loss caused by factors outside the lower urinary tract such as chronic impairments of physical or cognitive functioning

Back 59

Functional incontinence

Front 60

The process of emptying the bladder

Back 60

Micturition

Front 61

Involuntary urination that occurs after but not appropriately excreted from the bladder

Back 61

Enuresis

Front 62

Occurs when urine is produced normally but not appropriately excreted from the bladder

Back 62

urinary retention

Front 63

The involuntary loss of urine associated with over distention and overflow of the bladder

Back 63

Overflow incontinence

Front 64

Continuous and unpredictable loss of urine resulting from surgery trauma or physical malformation

Back 64

Total incontinent

Front 65

Voiding by reflex only

Back 65

Autonomic bladder

Front 66

Occurs when there is an involuntary loss of urine related to an increase in intra-abdominal pressure during coughing sneezing laughing or other physical activities

Back 66

Stress incontinence

Front 67

Symptoms of urge and stress Incontinence are present although one type many predominate

Back 67

Mixed incontinence

Front 68

Levodopa turns urine this color

Back 68

Brown or black

Front 69

Diuretics turn urine this color

Back 69

Pale yellow

Front 70

Elavil turns urine this color

Back 70

Green or green blue

Front 71

B complex vitamins turn urine this color

Back 71

Green or green blue

Front 72

Pyridium turns urine this color

Back 72

Orange, orange red

Front 73

Inject-able iron compounds

Back 73

brown or black

Front 74

Anticoagulants turn urine this color

Back 74

Red

Front 75

What actions are appropriate when conduction a physical assessment of a patients urinary function?

Back 75

1. The nurse should palapete the kidneys only under supervision.

2. The nurse checks for costovertebral tenderness by placing one palm flat over the costovertabral angle and striking the back of the hand with the other fist.

3. To examine the meatus the female patient should be placed in a dorsal recumbent position.

4. The nurse may use a bedside scanner to assess the bladder.