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104 Cards in this Set

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A PERSONS URINARY PATTERNS DEPEND ON?
DEPENDS ON SOCIAL CULTURE, PERSONAL HABITS, AND PHYSICAL ABILITIES.
MOST PEOPLE IN NORTH AMERICA ARE ACCUSTOMED TO WHAT WHILE THEY URINATE?
ACCUSTOMED TO PRIVACY AND CLEAN (EVEN DECORATIVE) SURROUNDINGS.
PERSONAL HABITS REGARDING URINATION ARE AFFECTED BY WHAT?
THE SOCIAL PROPRIETY OF LEAVING TO URINATE, THE AVAILABILTY OF A PRIVATE CLEAN FACILITY, AND INITIAL BLADDER TRAINING.
URINARY ELIMINATION DEPENDS ON EFFECTIVE FUNCTIONING OF FOUR URINARY TRACT ORGANS. WHAT ARE THEY?
KIDNEYS,URETERS, BLADDER, AND URETHRA.
THE FUNCTIONAL UNITS OF THE KIDNEYS, THE NEPHRONS, DO WHAT?
NEPHRONS OF THE KIDNEY, FILTER THE BLOOD AND REMOVE METABOLIC WASTES.
IN THE AVERAGE ADULT, HOW MUCH BLOOD PASSES THROUGH THE KIDNEY EACH MINUTE?
1200 ML OF BLOOD OR ABOUT 21% OF THE CARDIAC OUTPUT, PASS THROUGH THE KIDNEYS EVERY MINUTE.
EACH KIDNEY CONTAINS APPROXIMATELY HOW MANY NEPHRONS?
1 MILLION
EACH NEPRON HAS A _________?
GLOMERULUS
WHAT IS A GLOMERULUS?
A TUFT OF CAPILLARIES SURROUNDED BY BOWMANS CAPSULE.
WHAT IS GLOMERULAR FILTRATE MADE UP OF?
WATER, ELECTROLYES, GLUCOSE, AMINO ACIDS, AND METABOLIC WASTES.
WHAT SIZE ARE THE URETERS?
ARE FROM 25 TO 30 CM (10 TO 12 IN) LONG IN THE ADULT AND ABOUT 1.25 CM (0.5 IN) IN DIAMETER.
THE LOWER ENDS OF THE URETERS ENTER THE BLADDER WHERE?
AT THE POSTERIOR CORNERS OF THE FLOOR OF THE BLADDER.
WHAT IS URINARY REFLUX?
BACKFLOW OF URINE UP THE URETERS.
WHAT IS THE URINARY BLADDER?
THE URINARY BLADDER IS A HOLLOW, MUSCULAR ORGAN THAT SERVES AS A RESERVOIR FOR URINE AND AS THE ORGAN OF EXCRETION
WHEN THE BLADDER IS EMPTY IT LIES BEHIND THE ______ ______.
SYMPHYSIS PUBIS.
IN MEN THE BLADDER LIES IN FRONT OF THE _____ AND ABOVE THE _______ _______.
IN FRONT OF THE RECTUM AND ABOVE THE PROSTATE GLAND.
IN WOMEN, THE BLADDER LIES IN FRONT OF THE _____ AND ______.
IN FRONT OF THE UTERUS AND VAGINA.
THE WALL OF THE BLADDER IS MADE OF THESE FOUR LAYERS.
INNER MUCOUS LAYER, CONNECTIVE TISSUE LAYER, THREE LAYERS OF SMOOTH MUSCLE FIBERS, AND AN OUTER SEROUS LAYER.
WHAT ARE THE SMOOTH MUSCLE LAYERS CALLED?
DESTRUSOR MUSCLE
WHY IS THE BLADDER CAPABLE OF CONSIDERABLE DISTENTION?
THE BLADDER IS CAPABLE OF CONSIDERABLE DISTENTION B/C OF THE ELASTICITY OF ITS WALLS.
WHEN THE BLADDER IS FULL, WHERE MAY IT EXTEND TO?
ABOVE THE SYMPHYSIS PUBIS, IN EXTREME SITUATIONS, IT MAY EXTEND AS HIGH AS THE UMBILICUS.
THE URETHRA EXTENDS FROM THE ____ TO THE URINARY ______ (OPENING).
URETHRA EXTENDS FROM THE (BLADDER) TO THE URINARY (MEATUS)
THE URETHRA ONLY SERVES AS WHAT IN FEMALE?
THE URETHRA SERVES ONLY AS A PASSAGEWAY FOR THE ELIMINATION OF URINE.
THE MALE URETHRA IS HOW LONG?
ABOUT 20 CM (8IN) LONG.
WHAT DOES THE MALE URETHRA SERVE AS?
SERVES AS A PASSAGEWAY FOR SEMEN AS WELL AS URINE.
THE MALE MEATUS IS LOCATED WHERE?
AT THE DISTAL END OF THE PENIS.
THE EXTERNAL SPHINCTER MUSCLE IS UNDER _____ CONTROL.
VOLUNTARY CONTROL, ALLOWING THE INDIVIDUAL TO CHOOSE WHEN THE URINE IS ELIMINATED.
WHEN DO YOU START TO FEEL PRESSURE FROM THE STRETCH RECEPTORS?
WHEN THE BLADDER CONTAINS ABOUT 250 AND 450 ML OF URINE. ( 50-200 ML IN CHILDREN)
CHILDREN WILL DEVELOP URINARY CONTROL AT WHAT AGE APPROXIMATELY?
BETWEEN 2-5 YRS OF AGE.( DAY TIME CONTROL PRECEDES NIGHT TIME CONTROL)
THE KIDNEYS DOUBLE IN SIZE AT WHAT AGE?
B/N 5 AND 10 YRS. ( DURING THIS TIME THE CHILD URINATES 6-8 TIMES A DAY.
WHAT IS ENURESIS?
INVOLUNTARY PASSAGE OF URINE WHEN CONTROL SHOULD BE ESTABLISHED ( ABOUT 5 YRS OF AGE).
WHAT IS NOCTURNAL ENURESIS?
BED WETTING
T/F WITH AGE, THE NUMBER OF FUNCTIONING NEPHRONS DECREASE TO SOME DEGREE, IMPAIRING THE KIDNEYS FILTERING ABILITIES.
TRUE
T/F. THE DECREASE IN KIDNEY FUNCTION PLACES THE ELDERLY AT HIGHER RISK FOR TOXICITY FROM MEDICATIONS IF EXCRETION RATES ARE LONGER.
TRUE.
WHAT ARE SOME COMMON CHANGES IN MEN AND WOMEN THAT PERTAIN TO URGENCY AND FREQUENY TO URINATE?
IN MEN THESE CHANGES ARE OFTEN DUE TO AN ENLARGED PROSTATE GLAND.IN WOMEN, WEAKENED MUSCLES SUPPORTING THE BLADDER OR WEAKNESS OF THE URETHRAL SPHINCTER.
WHAT ARE SOME OF THE PSYCHOSOCIAL FACTORS THAT HELP STIMULATE THE MICTURATION REFLEX?
PRIVACY, NORMAL POSITION, SUFFICIENT TIME, RUNNING WATER.
WHAT MAY HAPPEN IF YOU IGNORE THE URGE TO VOID?
INCREASES THE RISK OF URINARY TRACT INFECTIONS.
T/F INFANTS ABILITY TO CONCENTRATE URINE IS MINIMAL AND THEREFORE MAY APPEAR LIGHT YELLOW
TRUE
IN CHILDREN WHEN DOES KIDNEY FUNCTION REACH MATURITY?
BETWEEN THE FIRST AND SECOND YR OF LIFE. ( URINE IS CONCENTRATED EFFECTIVELY AND APPEARS A NORMAL AMBER COLOR.
IN ADULTS, THE KIDNEYS REACH MAXIMUM SIZE AT WHAT AGE?
B/N 35 AND 40 YRS OF AGE
WHAT AGE DOES THE KIDNEYS DIMINISH IN SIZE?
AFTER 50, MOST SHRINKAGE OCCURS IN THE CORTEX OF THE KIDNEYS AS INDIVIDUAL NEPHRONS ARE LOST.
AN ESTIMATED _____% OF NEPHRONS ARE LOST BY AGE 80?
30%
WHAT IS RENAL FAILURE?
KIDNEYS VIRTUALLY STOP PRODUCING URINE ALTOGETHER
T/F HEART AND CIRCULATORY DISORDERS SUCH AS HEART FAILURE, SHOCK, OR HYPERTENSION CAN AFFECT BLOOD FLOW TO THE KIDNEYS, INTERFERING W/ URINE PRODUCTION.
TRUE.
WHAT CAN BLOCK URINE FLOW FROM THE KIDNEY TO THE BLADDER
A URINARY STONE (CALCULUS) MAY OBSTRUCT A URETER, BLOCKING URINE FLOW FROM THE KIDNEY TO THE BLADDER.(HYPERTROPHY OF THE PROSTATE GLAND, COMMON CONDITION AFFECTING OLDER MEN, MAY OBSTRUCT THE URETHRA, IMPAIRING URINATION AND BLADDER EMPTYING.
HOW MANY TIMES A DAY DO MOST PEOPLE VOID?
ABOUT 5 TIMES/DAY
WHEN DO PEOPLE USUALLY VOID?
WHEN THEY FIRST WAKE UP IN THE MORNING, BEFORE THEY GO TO BED, AND AROUND MEALTIMES.
WHAT IS POLYURIA (DIURESIS)
PRODUCTION OF ABNORMALLY LARGE AMOUNTS OF URINE BY THE KIDNEYS, OFTEN SEVERAL LITERS MORE THAN THE CLIENTS DAILY OUTPUT.
POLYDIPSIA
EXCESSIVE FLUID INTAKE
WHAT CAN POLYURIA CAUSE?
CAN CAUSE EXCESSIVE FLUID LOSS, LEADING TO INTENSE THIRST, DEHYDRATION, AND WEIGHT LOSS.
OLIGURIA
LOW URINE OUTPUT, USUALLY LESS THAN 500 ML A DAY OR 30 ML AN HOUR.
WHAT MAY OLIGURIA INDICATE?
OFTEN INDICATES IMPAIRED BLOOD FLOW TO THE KIDNEYS OR IMPENDING RENAL FAILURE.
ANURIA
REFERS TO A LACK OF URINE PRODUCTION
DIALYSIS
TECHNIQUE BY WHICH FLUIDS AND MOLECULES PASS THROUGH A SEMIPERMEABLE MEMBRANE (FILTERS THE BLOOD)
HEMODIALYSIS
CLIENTS BLOOD FLOWS THROUGH VASCULAR CATHETERS, PASSES BY THE DIALYSIS SOLUTION IN AN EXTERNAL MACHINE, AND THEN RETURNS TO THE CLIENT.
PERITONEAL DIALYSIS
DIALYSIS SOLUTION IS INSTILLED INTO THE ABDOMINAL CAVITY THROUGH A CATHETER, ALLOWED TO REST THERE WHILE THE FLUID AND MOLECULES EXCHANGE, AND THEN REMOVED THROUGH THE CATHETER. BOTH KINDS OF DIALYSIS MUST BE PERFORMED AT FREQUENT INTERVALS UNTIL THE CLIENTS KIDNEYS CAN RESUME THE FILTERING FUNCTION.
WHAT IS THE AVERAGE DAILY URINE OUTPUT FOR A 1-3 YR OLD?
500-600 ML
WHAT IS THE AVERAGE URINE OUTPUT FOR A 5-8 YEAR OLD?
700-1000 ML
URINARY FREQUENCY
VOIDING AT FREQUENT INTERVALS, THAT IS, MORE OFTEN THAN USUAL.
WHAT ARE SOME CAUSES OF URINARY FREQUENCY OF SMALL QUANTITIES?
UTI, STRESS, AND PREGNANCY CAN CAUSE FREQUENT VOIDING OF SMALL QUANTITIES (50-100ML)
NOCTURIA
VOIDING 2 OR MORE TIMES AT NIGHT
URGENCY
THE FEELING THAT THE PERSON MUST VOID.
COMMON IN YOUNG CHILDREN WHO HAVE POOR EXTERNAL SPHINCTER CONTROL.
DYSURIA
VOIDING THAT IS EITHER PAINFUL OR DIFICULT.
URINARY HESITANCY
A DELAY AND DIFFICULTY IN INITIATING VOIDING
ENURESIS
INVOLUNTARY URINATION IN CHILDREN BEYOND THE AGE WHEN VOLUNTARY CONTROL IS NORMALLY ACQUIRED USUALLY 4 OR 5 YRS OF AGE.nOCTURNAL AFFECTS BOYS MORE OFTEN AND DIURNAL AFFECTS GIRLS MORE OFTEN.
URINARY INCONTINENCE
INVOLUNTARY URINATION, IS A SYMPTOM NOT A DISEASE.
CLIENTS AT HIGHER RISK FOR DEVELOPING INCONTINENCE ARE?
THOSE W/ A HISTORY OF URINARY TRACT INFECTIONS, SURGERY, OR TRAUMA, STD, MULTIPLE VAGINAL BIRTHS, MUSCULOSKELETAL, ENDOCRINE, OR NEUROLOGICAL DISORDERS.
FACTORS AFFECTING VOIDING IN INFANTS AND CHILDREN?
UTI
ASSOCIATED FACTORS FOR POLYURIA
INGESTIONS OF FLUIDS CONTAINING CAFFEINE AND ALCOHOL, DIURETIC, DIABETICS
OLIGURIA, ANURIA- ASSOCIATED FACTORS
DECREASE IN FLUID INTAKE, SIGNS OF DEHYDRATION,HISTORY OF KIDNEY DISEASE
NOCTURIA-ASSOC FACTORS
PREGNANCY, INCREASE FLUID INTAKE, UTI
URGENCY-ASSOC FACTORS
PRESENCE OF PSYCHOLOGICAL STRESS, UTI
DYSURIA-ASSOC FACTORS
UTI, HESITANCY
ENURIA-ASSOC FACTORS
HOME STRESSES, DIFF ACCESS TO FACILITY
INCONTINENCE-ASSOC FACTORS
COGNITIVE IMPAIRMENT, LEAKAGE, MOBILITY IMPAIRMENT
RETENTION-ASSOC FACTORS
DISTENDED BLADDER, PUBIC DISCOMFORT, RECENT ANESTHESIA, MEDS PRESCRIBED.
ASSESSMENT OF CLIENT W/ URINARY ELIMINATION PROBLEMS
1.HOW MANY TIMES DO YOU URINATE IN 24 HR PD 2.HAS PATTERN CHANGED RECENTLY 3.DO U URINATE AT NIGHT 4. HOW OFTEN,COLOR OR CLARITY, AMOUNT, PAINFUL 5. IS IT DIFFICULT TO START URINATING 6.DO U DRIBBLE, LEAK WHEN COUGHING OR LAUGHING 7.PAST UTI OR PAST URINARY PROBLEMS.
PHYSICAL ASSESSMENT OF THE URINARY TRACT INCLUDES WHAT?
PERCUSSION OF THE KIDNEYS TO DETECT AREAS OF TENDERNESS, PALPATION AND PERCUSSION OF BLADDER ARE ALSO PERFORMED.URETHRAL MEATUS OF BOTH MALE/FEMALE ARE INSPECTED FOR SWELLING/DISCHARGE/INFLAMMATION.ALSO ASSESS SKIN COLOR, TEXTURE, AND TISSUE TURGOR AS WELL AS EDEMA
ASSESSING URINE
NORMAL URINE CONSISTS OF 96% WATER AND 4% SOLUTES.organic solutes(UREA, AMMONIA,CREATININE, AND URIC ACID. inorganic solutes SODIUM, CHLORIDE, POTASSIUM, SULFATE, MAGNESIUM, AND PHOSPHORUS.
HOW MUCH URINE DOES THE KIDNEYS PRODUCE PER HOUR/ DAY
NORMALLY THE KIDNEYS PRODUCE URINE AT A RATE OF APPROX. 60 ML/HR OR ABOUT 1500ML/DAY
URINARY OUTPUT BELOW 30 ML/HR MAY INDICATE WHAT?
URINARY OUTPUT BELOW 30 ML/HR MAY INDICATE LOW BLOOD VOLUME OR KIDNEY MALFUNCTION
RESIDUAL URINE
URINE REMAINING IN THE BLADDER FOLLOWING THE VOIDING IS NORMALLY NOT PRESENT OR CONSISTS OF ONLY A FEW MILLILITERS.
WHY IS RESIDUAL URINE MEASURED?
TO ASSESS AMT OF RETAINED URINE AFTER VOIDING AND DETERMINE THE NEED FOR INTERVENTIONS.
WHAT ARE TESTED TO TEST FOR RENAL FUNCTION?
UREA,( THE END PRODUCT OF PROTEIN METABOLISM) AND CREATININE ( PRODUCED BY MUSCLES)
IMPAIRED URINARY ELIMINATION
DISTURBANCE IN URINE ELIMINATION
AVERAGE NORMAL FLUID INTAKE FOR ADULTS
1500ML/DAY
CLIENTS WHO ARE AT RISK FOR UTI OR URINARY STONES SHOULD CONSUME HOW MUCH FLUID DAILY?
2000-3000ML/DAILY
T/F INCREASED FLUID INTAKE MAY BE CONTRAINDICATED FOR SOME CLIENTS SUCH AS PEOPLE W/ KIDNEY FAILURE OR HEART FAILURE.
TRUE. FLUID RESTRICTION MAY BE NECESSARY TO PREVENT FLUID OVERLOAD AND EDEMA.
WHAT IS THE RATE OF UTI IN WOMEN EVERY YEAR?
20% YEARLY- ACCOUNTS FOR 40% OF ALL NOSOCOMIAL INFECTIONS.
NOCTURIA
VOIDING 2 OR MORE TIMES AT NIGHT
URGENCY
THE FEELING THAT THE PERSON MUST VOID.
URGENCY ACCOMPANIES PSYCHOLOGICAL STRESS AND IRRITATION OF THE TRIGONE AND URETHRA. ALSO COMMON IN YOUNG CHILDREN WHO HAVE POOR EXTERNAL SPHINCTER CONTROL.
DYSURIA
VOIDING THAT IS EITHER PAINFUL OR DIFICULT.
URINARY HESITANCY
A DELAY AND DIFFICULTY IN INITIATING VOIDING (ASSOCIATED W/ DYSURIA)
ENURESIS
INVOLUNTARY URINATION IN CHILDREN BEYOND THE AGE WHEN VOLUNTARY CONTROL IS NORMALLY ACQUIRED USUALLY 4 OR 5 YRS OF AGE.nOCTURNAL AFFECTS BOYS MORE OFTEN AND DIURNAL AFFECTS GIRLS MORE OFTEN.
URINARY INCONTINENCE
INVOLUNTARY URINATION, IS A SYMPTOM NOT A DISEASE.
CLIENTS AT HIGHER RISK FOR DEVELOPING INCONTINENCE
THOSE W/ A HISTORY OF URINARY TRACT INFECTIONS, SURGERY, OR TRAUMA, STD, MULTIPLE VAGINAL BIRTHS, MUSCULOSKELETAL, ENDOCRINE, OR NEUROLOGICAL DISORDERS.
FACTORS AFFECTING VOIDING IN INFANTS AND CHILDREN?
UTI
ASSOCIATED FACTORS FOR POLYURIA
INGESTIONS OF FLUIDS CONTAINING CAFFEINE AND ALCOHOL, DIURETIC, DIABETICS
OLIGURIA, ASSOCIATED FACTORS
DECREASE IN FLUID INTAKE, SIGNS OF DEHYDRATION
NOCTURIA-ASSOC FACTORS
PREGNANCY, INCREASE FLUID INTAKE, UTI
URGENCY-ASSOC FACTORS
PRESENCE OF PSYCHOLOGICAL STRESS, UTI
DYSURIA-ASSOC FACTORS
UTI, HESITANCY
ENURESIS-ASSOC FACTORS
HOME STRESSES, DIFF ACCESS TO FACILITY
INCONTINENCE-ASSOC FACTORS
COGNITIVE IMPAIRMENT, LEAKAGE, MOBILITY IMPAIRMENT