Kosier Week #8

Front 1

Micturition

Back 1

(voiding / urination) – the process of emptying the bladder (p 2)

Front 2

Polyuria

Back 2

– the excretion of abnormally large amounts of urine(may be >2,500 ml/24 hrs) can lead to excessive fluid loss and dehydration May be d/t: excessive fluid intake, diabetes, ingestion of ETOH, caffeine, chronic kidney disease, hormone imbalance, use of diuretics (p 6)

Front 3

Residual urine

Back 3

– client voids first and then is catheterized. Urine remaining in the bladder after voiding is called the “residual”. Normally = 0 – a few ml. (p 5)

Front 4

Functional incontinence

Back 4

– impairment or loss of continence d/t functional deficits, including altered mobility, dexterity, cognition, environmental barriers) (p 7)

Front 5

Total incontinence

Back 5

– the state in which the individual experiences continuous and unpredictable loss of urine d/t an extra urethral cause (p 7)

Front 6

Bladder training program

Back 6

– requires client, nurse and support person. Client voids according to a timetable. The time interval between voiding is gradually lengthened. Can only be used with alert, oriented client. Reward successes. Encouragement. (p 8)

Front 7

Cystitis

Back 7

–inflammation of the bladder. (UTI).The second most common infection. 40% of all nosocomial infections!
(p 9 & 10)

Front 8

Distention

Back 8

–the bladder becomes stretched out or swollen as a result of overfilling (3-4 L) and may be painful
(p 5)

Front 9

Hematuria

Back 9

– abnormal presence of blood in the urine. May appear pink, red or smoky. Not always visable, may be microscopic. Symptomatic of many renal diseases and disorders of the genitourinary system
(Mosby’s medical dictionary)

Front 10

Describe the process of micturition

Back 10

·Urine collects in the bladder
·Pressure stimulates sensory nerves called stretch receptors in the bladder wall (usually approximately 250-450 ml of urine)
·Stretch receptors transmit impulses to the spinal cord’s voiding reflex center in the sacral area to relax the internal sphincter
·If the time and place is appropriate, the brain sends a message via the spinal cord to release the urine from the bladder
·Conscious portion of the brain relaxes the external uretheal sphincter and urination takes place

Front 11

Describe factors that affect the volume of urine and the voiding process

Back 11

Normally people void 5 or more times/day (200 – 300 ml), usually upon awakening, at HS, and at meals. 70% of urine is eliminated during waking hours. Very young and elderly may void more frequently. (Find out a person’s normal pattern.) (p 2)

Front 12

Describe the changes that occur in urinary elimination throughout the life cycle
Developmental level / life cycle – many changes

Back 12

Infants and newborns have immature kidneys and are born without urinary control.Most will develop this between the ages of 2 and 5 years. Urine output varies according to fluid intake but gradually increases to 250 – 500 ml / day during the first year.
Preschoolers – are able to take responsibility for independent toileting.
School-age children – elimination system reaches maturity during this period. The kidneys double in size between ages 5 and 10 years. During this period,the child urinates 6 – 8 times / day.
Elders– the excretory function of the kidney diminishes with age,but usually not significantly below normal levels unless a disease process intervenes.The more noticeable changes with age are those related to the bladder.

Front 13

Psychological variables –

Back 13

(ie: privacy, time, dirty bathrooms –don’t want to use, etc)behaviors and routines. People are used to certain behaviors and conditions when voiding