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73 Cards in this Set
- Front
- Back
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functional units of the kidneys
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nephrons
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nephrons
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filter and remove metabolic wastes
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glomerulus
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a tuft of capillaries
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ureter
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ducts that carry urine from the kidneys to the urinary bladder.
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urethra
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is a tube which connects the urinary bladder to the outside of the body.
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urinary bladder
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organ that collects urine
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T/F Urine enters the bladder via the ureters and exits via the urethra.
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true
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trigone
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The trigone is a triangular shaped area on the postero-inferior wall of the bladder
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what causes stress incontinence?
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Stress incontinence is essentially due to pelvic floor muscle weakness
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stress incontinence
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It is loss of small amounts of urine with coughing, laughing, sneezing, exercising or other movements that increase intrabdominal pressure and thus increase pressure on the bladder
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what are some of the causes of stress incontinence?
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Physical changes resulting from pregnancy, childbirth, and menopause often cause stress incontinence, and in men it is a common problem following a prostatectomy
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urge incontinence
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Urge incontinence is involuntary loss of urine occurring for no apparent reason while suddenly feeling the need or urge to urinate.
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The most common cause of urge incontinence is?
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involuntary and inappropriate detrusor muscle contractions
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functional incontinence
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People with functional incontinence may have problems thinking, moving, or communicating that prevent them from reaching a toilet.
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Transient incontinence
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is a temporary version of incontinence
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detrusor muscle
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smooth muscle layers of the bladder
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T/F the urethra extends from the bladder to the urinary meatus (opening)
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true
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oliguria
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low urine output, usually less than 500 ml a day or 30 ml and hour.
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anuria
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lack of urine production
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urinary retention
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when the emptying of the bladder is impaired, urine accumulates and the bladder becomed overdistended.
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neurogenic bladdder
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neurologic function interferes w/ normal mechanisms of elimination, resulting in neurogenic bladder.(may not perceive bladder fullness, unable to control sphincters.
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how do u measure urine output?
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1. wear clean gloves.
2. client voids in clean urinal , bedpan, commode, or collection device (hat) 3. instruct client to keep urine separate from feces and to avoid putting toilet paper in the urine collection container. 4. pour the urine into a calibrated container. 6. hold at eye level, read amt in container. (usually have scale on container). 7. Record amt on the fliud intake/output sheet. 8. Rinse collection container w/ cool water and store appropriately. 9. Remove gloves/wash hands 10. Calculate/document total output at the end of each shift of 24 hrs on clients chart. |
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how to measure the amount of residual urine after voiding?
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the nurse catheterizes client immediately after voiding. The amount of urine voided and the amount obtained by catheterization are measured and recorded
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bladder training
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requires that the client postpone voiding, resist or inhibit the sensation of urgency, and void according to a timetable rather than according to the urge to void.
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delayed voiding provides _____ voided volumes and ____ intervals b/n voiding.
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larger, longer
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habit training
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referred to as timed voiding or scheduled toileting, attempts to keep clients dry by having them void at regular intervals.(NO ATTEMPT TO DELAY VOIDING IF THE URGE OCCURS).
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Prompted voiding
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encouraging the client to try to use the toilet and reminding the client when to void.
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flaccid bladder
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weak bladder muscles
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crede's maneuver
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manual pressure on the bladder to promote bladder emptying
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urinary catheterization
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introduction of a catheter through the urethra into the urinary bladder
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the common size of balloons for retention catheters are what?
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5ml-30ml.
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how long should u use a plastic catheter?
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short periods ( 1 week or less).
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How long should u use a rubber or silastic catheter
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for periods of 2 or 3 weeks
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how long should u use silicone catheters
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for long term use ( 2-3 months b/c they create less encrustations at the urethral meatus-but are expensive.
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How long to use PVC catheters
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4-6 week periods- they soften at body temp and conform to the urethra.
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what size catheter length would you use on an adult female client?
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22-cm
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what size catheter length would u use on an adult male client?
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40-cm
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T/F the smaller balloons allow more complete bladder emptying.
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true
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what size balloons do you use for children
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3-ml
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what size balloon do you use on adults
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5-ml
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what type of catheter is used for closed catheter or irrigation?
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a three way or triple lumen catheter
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what type of catheter is used for an open catheter or irrigation?
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double lumen indwelling catheter
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what is a urinary diversion?
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the surgical rerouting of urine from the kidneys to a site other than the bladder.
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what is the most common urinary diversion?
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the ileal conduit or ileal loop
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what is a suprapubic catheter?
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catheter inserted through the abdominal wall above the symphysis pubis into the urinary bladder.
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The nurse recognizes that urinary elimination changes may occur even in healthy elders because a. the bladder distends and its capacity increase; b elders ignore the need to void; c. urine becomes more concentrated, d. the amount of urine retained after voiding increases.
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D. the amt of urine retained after voiding increases
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T/F the correct condom catheter nursing care requires that u check the penis for adequate circulation 30 minutes after applying.
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true
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What should u do if the straight catheter slips into the vagina?
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leave the catheter in place and get a new sterile catheter.
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T/F Soaking in warm tub bath may ease the irritating feeling from having a catheter?
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false
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T/F urine is formed in the nephron?
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true
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A client comes to the doctor's office with the complaints of going to the bathroom all the time, pain on urination, small amounts of urine being passed when voiding, and a foul smell to the urine. A urine specimen has been sent for analysis. Based on the signs and symptoms expressed by the client, which of the following health problems would be anticipated?
A.Acute renal failure B.Renal stone C.Urinary tract infection D.Chronic renal failure |
C. Urinary tract infection
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An appropriate health goal for clients with urinary elimination problems would include:
A.Ignoring normalization of voiding pattern. That the patient has the ability to void is the most important aspect of care. B.Encouraging the client to follow measures to show a larger than normal urine output to flush to kidneys C.Always assisting the client with toileting activities in order to monitor amount D.Preventing associated risks, such as infections and fluid and electrolyte imbalances. |
D.Preventing associated risks, such as infections and fluid and electrolyte imbalances.
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Which nursing assessment in the home care environment for clients with urinary elimination problems is inappropriate?
A.Client self-care abilities B. Distance and barriers to accessing the bathroom C. Need/use of ambulatory aids as required D. No dietary restrictions needed |
D. No dietary restrictions needed
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You are requested to perform teaching to a client in the Emergency Department related to the diagnosis of an urinary tract infection. An intervention to be followed by the client includes:
A.Avoid tight-fitting pants or clothing B.Drink six glasses of water per day C.Type of soap when bathing has no significance in this area. D.Voiding pattern in the course of the day has no significance with this problem. |
A.Avoid tight-fitting pants or clothing
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Urinary incontinence is not a normal part of aging. An intervention used by nurses to assist clients to regain or maintain continence with individuals suffering from this problem would not include:
A.Bladder training B.Habit training C.Prompted voiding D.Fluid restriction |
D.Fluid restriction
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Urinary catheterization is carried out for clients only when absolutely necessary. Which of the following candidates/situations would not warrant the need for this procedure?
(A).A client having abdominal surgery (B).A client who is completely paralyzed (C).A client in need of decompression of the bladder (D).To collect a random urine specimen for evaluation |
D.To collect a random urine specimen for evaluation
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The goal of nursing care of the client with an indwelling catheter and continuous drainage is largely directed at preventing infection of the urinary tract and encouraging urinary flow through the drainage system. Which of the following interventions encouraged by nurses working with these clients would not be appropriate in meeting this goal?
A.Having the client drink up to 3000mL per day B.Encouraging the client to eat foods that increase the acid in the urine C.Routine hygienic care D.Changing indwelling catheters every 72 hours. |
D.Changing indwelling catheters every 72 hours.
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A urinary diversion is the surgical rerouting of urine from the kidneys to a site other than the bladder. Which type of client would this type of procedure be performed on?
A.An abdominal trauma victim B.A renal failure client C.A client with kidney stones D.An individual suffering from a urinary tract infection |
A.An abdominal trauma victim
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A practice guideline for nurses to use in preventing catheter-associated urinary infection includes which of the instructions listed below?
A.Maintain clean technique when inserting the catheter into the client. B.Disconnect the catheter and drainage tubing once a shift to rinse the unit in cleaning the device. C.Since you are wearing gloves, it is not necessary to wash your hands. D.Prevent contamination of the catheter with feces in the incontinent client. |
D.Prevent contamination of the catheter with feces in the incontinent client.
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You are counseling a young mother who complains of having stress incontinence continuing for three months after her pregnancy. It has been recommended that she practice pelvic muscle exercises to strengthen her bladder muscles. What action would the nurse recommend to this client in order to perform this activity correctly?
A.Stopping urination midstream B.Standing tall and stretching out her arms and touching her toes C.Emptying her bladder completely D.Moving her bowels |
A.Stopping urination midstream
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What is irrigation?
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flushing or washing out w/ a specified solution.
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Why is irrigation carried out?
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to wash out the bladder and sometimes to apply a medication to the bladder lining;
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What is the preferred technique for catheter or irrigation ?
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the closed method is preferred b/c it is associated w/ a lower risk of UTI.
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What type of catheter is generally used for a closed irrigation?
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A three-way, or triple lumen catheter is generally used for a closed irrigation.
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Why is an open irrigation occasionally used.
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Occasionally an open irrigation may be necessary to restore catheter patency
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What are the risks for using an open irrigation?
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the risk for injecting microorganisms into the urinary tract is greater w/ open irrigations.
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What type of catheter is used for open irrigation?
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The open method of catheter or bladder irrigation is performed w/ double lumen indwelling catheters.
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What is a urinary diversion?
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a surgical rerouting of urine from the kidneys to a site other than the bladder.
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When are urinary diversions usually created?
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when the bladder must be removed, for example.
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What is the most common urinary diversion?
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the ileal conduit or ileal loop. ( the ileal stoma is more readily fitted w/ an appliance than ureterostomies b/c of its larger size.
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When is a continent vesicostomy formed?
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when the bladder is left intact but voiding throught the urethra is not possible.
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What is a suprapubic catheter?
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is inserted throught the abdominal wall above the symphisis pubis into the bladder.
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Whay is a suprapubic catheter used?
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placed for temporary bladder drainage until the client is able to resume normal voiding or may be a permanent device.
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