• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

Card Range To Study

through

image

Play button

image

Play button

image

Progress

1/88

Click to flip

Use LEFT and RIGHT arrow keys to navigate between flashcards;

Use UP and DOWN arrow keys to flip the card;

H to show hint;

A reads text to speech;

88 Cards in this Set

  • Front
  • Back
Location of Kidneys
lie on either side of vertebral column
behind the peritoneum
against deep muscles of the back
Left is higher than the Right b/c of liver
Functions of the Kidneys
remove wastes from the blood to form urine
regulates:
F/E
Acid Base Balance
Produces hormones (Renin, Aldosterone)
Functions of the Ureters
transport urine from the kidneys to bladder
The bladder function:
holds urine until the urge to urinate develops
Urine is transported by what process?
And through what structure?
Peristaltic Waves (spurts)
urethra
Compare the Urethra from the male and female
Male has 2 functions:
passageway for cells/secretions of reproductive organs & urinary elimination
longer (20 cm; 8")
Female 1 function:
urinary elimination
Shorter (4-6.5cm; 1.5-2.5")
Functions of the Prostrate:
Adds seminal fluid
neutralizes PH (acid) in vagina
supplies fructose to the sperm
What is the pressure within the bladder?
Why?
low
protects against infection
Pts w/ altered kidney function can't produce what hormone and are prone to what disease?
Erythropoietin (acts within the bone marrow to stimulate RBCs)
Anemia
What are the nerve centers for Micturition?
Brain & Spinal cord (cerebral cortex, thalmus, hypothalmus & brain stem)
the bladder holds as much as _____ ml of urine

We are able to sense the desire to urinate when the bladder has ___ to ___ ml of urine
600
200-300 (3 cups)
when patients urinate frequently what can they develop?
urinary retention
UTI
What are the characteristics and color of urine first thing in the morning?
concentrated (1.025)
Amber -dark yellow
5 factors effecting Micturition?
Fluid balance
Activity
Age
Cultural
Developmental
Disease
surgical procedures
(triggers general adaptation syndrome--3 stage process of stress-SNS (alarm reaction, resistance stage & exhaustion stage)
Give 3 Physiological changes in elderly:
kidneys inability to concentrate urine
decreased (detruser muscles)capacity to hold urine leads to incontinence b/c the bladder decreases contractility leading to urinary retention
Immobility (muscle hyperatrophy)
Protate size increases due to Benign Prostate Hypertrophy
Causes of UTIs in Women:
poor perineal hygiene
Inadequate hand washing
failure to wipe front to back
frequent sexual intercourse
What stimulates stretch receptors which trigger the response to empty the bladder?
urine volume (200-300 ml)
2 sphincters:
internal (involuntary)
external (voluntary)
define pneumaturia:
bubbles within the urine (air)
caused by: connections between the colon & bladder --fistulas or punctures that lets air in
What are the terms used for the process of emptying the bladder?
voiding
urination
micturition
What is the frequency of voiding?
it is variable (every 4 hours)
Define hesitancy?
difficulty initiating the stream
Define Pyuria?
Pus in the urine
Inability to void?
The bladder can hold up to ___ - ___ ml
urinary retention
3000-4000
After a UTI develops and the infections worsens what are the signs?
fever, chills, nausea, vomitting & malaise
What is an irritated bladder called?
Name symptoms?
Cystitis
frequent and urgent sensation of the need to void
What is the appearance of the urine in the presense of an infection?
concentrated
cloudy b/c of WBCs or bacteria
What is it called if an infection spreads to the upper urinary tracts (kidneys)?
What signs are common?
pyelonephritis
flank pain, tenderness fever & chills
Name urinary diversions:
Urinary stoma (directs urine from the kidneys directly into the abdominal surface d/t trauma, ca of the bladder, radiation, fistulas, or chronic cystitis)

Ileal loop or conduit (separates a loop of ileum w/ it's blood supply, the ureters are implanted into the segment of ileum and the remaining ileum is reconnected to the digestive tract

Continent Pouch (provides urinary storage in leakproof pouch)
Catheterization requires what type of hygiene?

Perineal care or examination of the genitalia require?
sterile technique (urinary tract is sterile)


Medical asepsis, including hand hygiene
Define Glycosuria?
sugar in the urine
Fever and diureses cause the kidney to?
conserve fluid
concentrate urine
What medications are known to be pehrotoxic?
ASA, NSAIDS, gentomycin, lasix (iv push), ibuprophin, chemotherapy
Tranquilizers inhibit the ___ for ____?
reflex for voiding
Antihystamines cause urinary ____.
retention
(men: prostrate enlargement)
Name certian foods that have a diuretic effect?
alcohol
caffeine
What is the normal color and clarity of urine?

What is the clarity in urine with renal disease?
pale, straw to amber color
transparent

cloudy or foamy b/c of high protein
thick & cloudy b/c of bacteria/wbc
bleeding from the kidneys or ureters cause the urine to become what color?

Bleeding from the bladder turns urine?

Pyridium?

Bilirubin
dark red

bright red

bright orange
Dark amber
Characteristics of the odor of urine:
Stagnant:
Acetone or acetoacetic acid
ammonia
sweet or fruity (by products of fat metabolism) seen in diabetes mellitus or starvation
The type of test determines the method of collection--label all specimens with:
clients name
date
time of collection
transport with in 30 min (or refridgerate up to 2 hours)
Name types of specimen collections?
random
clean voided
midstream
sterile
timed specimen
Random collection is used for what type of urine testing?
collection process:
storage of urine specimen
routine urinalysis
normal voiding
indwelling catheter or urinary diversion collection bag
clean specimen cup
Clean voided or midstream is used for what type of urine testing?
culture (microorganism)/sensitivity(antibiotic)
Sterile Specimen is used for what type of urine testing?
from a?
collection process?
culture/sensitivity
indwelling catheter
sterile specimen by aseptic technique thru sampling port found on side of catheter
Clamp tubing below the port allowing fresh uncontaminated urine to collect in tube.
After wiping the port w/ alcohol swab, insert a sterile syringe hub and withdraw 3-5ml of urine
Timed urine specimen measures?

List times:
timed period begins after the client:
and ends:
levels of adrenocortical steroids or hormones, creatine, or protein quantity tests
2-, 12-, or 24 hour
urinates
ends w/ final voiding at the end of time period
Urinalysis should be examined?
and using what kind of specimen?
a/s/a/p, within 2 hours
first voided
abnormal values in urinalysis?
protein (8-100/ml) indicates renal disease d/t damage to glomeruli or tubules which allows protein to enter urine
Glucose indicates diabetes mellitus
Ketones indicates diabetes mellitus d/t breakdown of fatty acids
crystals are result of food metabolism (uric acid or calcium phosphate result in renal calculi)
Specific gravity (1.010-1.030)
List disease processes that effet Urine Elimination and why?
Diabetes Mellitus (< bladder tone & effects nerve function)
Prostate enlargement (benign prostrate hypertrophy causing UR)
Cardiac Disease (CHF leads to < UO, nocturia)
Uremic Syndrome (nitrogenous waste/blood)
Alzheimers (<LOC, don't process urge)
End stage renal disease
Fever/diaphoresis (kidneys conserve fluid &urine production <
Multiple sclerosis (change in nerve function, loss of bladder control)
Surgeries (pts fast prior to causing depressed CNS and UO is <)
Post surgery (delayed voluntary control of voiding)
Name the symptoms of retention?
difficulty urinating -initiating the flow
discomfort in pubic area
output <than intake
retention w/ overflow (bladder is full, but voiding in small quantities)
Nursing Interventions for Urinary Retention?

Assess for:

Fluid intake should be:

Lab work:
Call physician (get an order for cath test)
Straight catheter (one time use to assess residual)
Bladder scanner (no physican order/less invasive)

characteristics
urine in foley (abnormalities)
odor

2000 ml
BUN, creatine, hematocrit, urine specific gravity
Explain use for Foley Catheter:

Straight catherter:
long term, urinary retention
short term, one time use for incontinence
Purposes for catheterization:
relieve retention
obtain sterile specimen
measure residual
keep bladder empty
bypass obstruction
administer meds (not common)
Diagnostic Examinations:
2 approaches for visualization:
direct or indirect
noninvasive
ab roentgenogram (no bowel prep)

CT scan (bowel cleansing)

IVP (IV pyelogram) bowel cleansing
Ultrasound Renal (no bowel prep)
Bladder (just fluid prep)
Urodynamic testing (uroflowmetry)
Diagnostic Examinations:
2 approaches for visualization:
direct or indirect
invasive
Endoscopy-cystoscopy (bowel prep)

Arteriogram (angiography) fluids only
Nursing responsibilites for diagnostic examinations:

Nursing responsibilites following the study:
consent
iodine allergy r/t to dye (pyelogram)
diet (clear liquids) or NPO

I/O
characteristics of urine (color, clarity, presence of blood)
encourage fluid intake
To minimize nocturia avoid fluids...
2 hours before bed time
name foods that increase urine acidity:
and decrease bacterial adherence to the bladder
meats, eggs, whole-grain breads, cranberry juice
Types of catheters:
condom
intermittent (straight)
indwelling (foley)
types of catheters:
Triple Lumen (fill balloon 30 ml)
Double Lumen (fill balloon 5ml)
Straight Catheter (no balloon---red/rubber)
Uses of Straight "intermittent" Catheter:

Lumen:
relieves retention
obtain urine specimen
check for residual

single
Uses of Indwelling Foley Catheter:
Lumen type:
Size of Lumen for female/male:
Severe urinary retention w/UTI
Continuous drainage (irrigation)
Double or Triple Lumen
female: 14-16
Male: 18-20
Explain ports for 2 or 3 Lumen
One lumen:
Second lumen:
Third Lumen:
drains urine thu the catheter to collecting tube
carries sterile H2O to/from balloon for inflation or deflation
used to instill fluids or meds into bladder
Coude Catheter:
intermittent cath w/ a curved tip
male patients who have enlarged prostates that partly obstruct the urethra
less traumatic b/c it's stiffer and easier to control than straight tip
What is the difference in steps for inserting an indwelling and single-use catheter?
the difference lies in the procedure taken to inflate the indwelling cath balloon and secure the cath
What type of drainage system should be in place after inserting an indwelling catheter and why?
closed to minimize the risk of infection
Hang urinary drainage bags from:
Never:
bed frame or wheelchair without touching the floor
bed rails
For obtaining specimens on an indwelling cath never...

and obtain specimen from...
open the drainage system


special port in the tubing
Never raise the drainage bag above...
the level of the bladder
Name the types of urinary incontinence:
Functional (outside factors)
Stress (involuntary leakage)
Urge (involuntary passage of urine)
Mixed (combo of urge/stress)
Reflex (Involuntary loss @ intervals)
Position of female and male for catheter insertion:
female: dorsal recumbent or sims
male: supine
record I/O every ___ hours for catheterization
8-12
Removal of the indwelling catheter:
physican order
empty collection bag
deflate balloon (10 ml syringe)
have the patient deep breath and gently pull catheter out
clean the area
increase fluid intake
tell pt first voiding may burn
I/O for 24 hours
check bladder distention
Sites at risk for the introduction of microorgansims with a catheter:
catheter insertion
drainage bag
spigot
tube injection
junction of tube and bag
To maintain patency of indwelling catheters you should...

what can collect in the tubing....
irrigate or flush a catheter

blood, pus or sediment
Before you irrigate a urinary catheter you should...
assess the catheter for blockage
Suprapubic catheterization placement:

performed under:
surgical placement through the abdominal wall above the symphysis pubis and into the urinary bladder
anchored in place by sutures

local or general anesthesia
What is the maintenance of the tubing and drainage bad of the suprpubic catheter?
The same as indwelling catheter
How do you strengthen pelvic floor muscles?
Kegal exercise
start and stop the stream of urine
sit or stand w/out tensing muscle of legs, butt or ab
contract/relax circumvaginal muscles/urinary/anal sphinctors for 3-4 seconds and repeat
cycles for 10 times, 5 times/day
w/ 30 sec rest in between
maintenance: 1/2 sets a week
Kegals treats..
incontinence, overactive bladder, mixed cause of urinary incontinence
______ control from higher brain centers and _____ control from the spinal cord influence the act of micturition
voluntary
involuntary
Symptoms common to urinary disturbances include:
frequency, urgency, dysuria, polyuria, oliguria, incontinence, and difficulty in starting the urinary stream
lubricate the length of the catheter tip for male and female
male: 5-7", 12.5-17.5cm
female: 1-2", 2.5-5cm
when collecting urine specimen how much mls are required?
20-30ml
In general a 5ml balloon requires of many ml of fluid for inflation?
10ml
Where do you secure the tubing with a female patient?
inner thigh w/ nonallergic tape and allow slack for movement
Where do you secure the tubing with a male patient?
thigh or lower abdomen w/ penis directed toward chest, allow slack for movement coiled on bed
documenting insertion of catheter:
type and size of catheter inserted
amount of fluid used to inflate balloon
characteristics of urine
amount of urine
reasons for catheterization
specimen collection if necessary
patients response to tx
teaching topics
Explain to the patient what they should feel during catheter insertion that is normal?
burning/or pressure sensation