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31 Cards in this Set

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Review structure and
function of urinary/
renal system
kidneys remove waste from
blood and forms urine via
the nephron. the ureters
transport urine to the bladder
leaves body thru the urethra
Define
micturition
the act of urinating
prevents reflux of urine from
the bladder into ureters
Factors that influence
urinary elimination
dz, socio-cultrual,
psychological, muscle tone,
fluid balance, surgical
procedures, meds
Expected range of
urinary output of an
adult per hour
per hour 30-300 mL
per 8 hr shift 240-2400 mL
Normal
characteristics of
urine
pale straw color to amber
depending on concentration
should be transparent
should have its own odor
normal anatomical
changes r/t fluid
waste elimination
in senior adult
Increase in age - decrease
in size/wt of kidneys. Decrease
in renal blood flow. bladder,
urethra, ureter have decrease
in elasticity/muscle tone.
urinary sphincter weakens.
Older women at risk for
irritation, infection,
incontinence. vag dry, thin
men - freq, urg, prostate
hypertrophy
Psychological
and emotional
aspects of
incontinence
Embarrassment, shamefull,
affects pts dignity, privacy
Dysuria
Frequency
Dysuria - painful/diff
urination
Frequency - increased incidence
of urinating, acutely inflammed
bladder
Urgency
Hematuria
Urgency - strong desire to
urinate, acute bacterial infec.
Hematuria - blood in urine
ca in GU tract, UTI, renal dz
Retention
Incontinence
Retention - inability to void
even though bladder seems full
s/p pelvic sx, childbirth
Incontinence - inability to
voluntarily control d/c of
urine. bladder infec, inj
to external sphincter
Stress
Incontinence
involuntary urination with
increased pressure when you
sneeze or cough for exp.
weakness of sphincter control
Nocturia
Polyuria
Nocturia - freq of urination
at night, renal dz, bladder
obstruction, chf, dm
Polyuria - large volume/amt
of urine at a given time, dm
chronic renal failure, excess
fluid intake
Anuria
Oliguria
Anuria - no urination. output
in 24 hrs < 100 mL. acute
renal failure, esrd, obstruction
Oliguria - diminished amt of
urine. severe dehydration,
shock, kidney dz, esrd
Most frequent
nosocomial
infection
hospital acquired UTI's.
due to catheterization
and surgical procedures.
most common cause e-coli
UTI
inflammation of urinary tract.
bacterial infect. most common.
can be classified as upper
or lower. complicated or
uncomplicated.
Incontinence
uncontrolled or involuntary
loss of urine that is of
sufficient magnitude to be a
problem. caused by confusion,
depression, infection, meds
Obstruction
any anatomic functional
condition that blocks or impedes
the flow of urine. may be
congenital or acquired.
diverticula, tumors, growths
Phys. exam methods
to assess
urinary tract
Inspection - changes in skin,
abd, state of health
Auscultation - abnrml murmur
over aorta or renal arteries
could indicate impaired flow
Palpation - kidneys, bladder
Percussion - tenderness in
flank area may be detected
Urinalysis
Color: pale yellow to amber
Appearance: clear to hazy
Smell: aromatic
Specific gravity 1.010-1.025
pH: average 5 and 6
* Glucose: negative
* Ketones: negative
* Blood: negative
* Protein: negative
* Nitrate for bacteria:
negative
* Leukocyte-negative
* Casts: negative
* Red blood cells
* White blood cells
24 hour urine
reveals how the kidney adjusts
to changing physiologic needs
over a long period. Substances
excreted by the
kidney are not excreted at the
same rate or in the same
amounts during different
periods of day and night
BUN
Creatinine
BUN and creatinine are waste
products filtered out of the
blood by the kidneys.
Increased concentrations in
the blood may indicate a
temporary or chronic decrease
in kidney function.
BUN 10-30
Creat 0.5-1.5
BUN/Creatinine
ratio
Potassium
bun/creat ratio 10:1
K+ 3.5-5.3, in renal dz
first electrolyte to
become imbalanced
CBC
used as a broad screening test
to check for such disorders as
anemia, infection, and many
other diseases
Hgb - amount of O2 carrying
protein in the blood.
Hct - amount of space RBC's
take up in blood
platelet count # of platelets
in a given volume of blood.
WBC
count of the actual number of
white blood cells per volume of
blood norm 4k-11k
Goals or interventions
for patient care
that promote self-care
urinary elimination
Promoting habits, normal
micturition, stimulating
micturition reflex
adequate fluid intake
complete emptying of bladder
privacy
In + out cath
straight cath, introduced
into bladder long enough
to drain bladder 5-10 min
can repeat if necessary,
but increases risk of infection
Indwelling cath
foley cath - remains in place
for a longer period of time
until a pt is able to void
completely and voluntary
Suprapubic cath
surgical placement of a cath
thru the abd wall above
the symphasis pubis and
into the urinary bladder
Plan/assessment/care
for pts with cath
prevent infection
maintain unobstructed flow
perineal hygiene
hygiene at insertion point
fluid intake
Fluid intake
clients with normal renal
function require
2000-2500 mL fluids/day
1200-1500 mL is adequate
Pelvic exercises
kegels - used to manage
stress, urgency, or mixed
urinary incontinence.
strengthens pelvic floor
muscles