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166 Cards in this Set
- Front
- Back
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The ____ filter and excrete blood constituents that are not needed and retain or hold onto the things that are needed.
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kidneys
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The smooth muscular tubes that connect the kidneys to the bladder are called ______.
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ureters
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The _____ moves urine fromt he bladder to the exterior of the body.
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urethra
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Normal urine output for a healthy adult is _____mL/cc.
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1200-1500
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Normal urine color is
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straw or light amber colored
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Urine should be (clarity) _____.
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clear/transparent
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The odor of urine should be _____.
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faint
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Cloudy urine could indicate the presence of...
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bacteria, sperm, etc...
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Blood _____ be present in urine.
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should not
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_____ occurs when cells are depleted of glucose long enough.
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Ketone bodies
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Red urine may be from eating ____ and ____ or having ____ in it.
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blackberries and beets
blood |
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Yellow urine may indicate a diet high in _____.
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carotene
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Urine with a sweet or fruity smell is an indicator of...
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high blood sugar in diabetics (DKA)
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_____ measures the concentration of dissolved solids in the urine and gauges the ability of the kidneys to concentrate and excrete urine.
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Specific gravity
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A dehydrated client may have a ____ specific gravity.
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high
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An overly hydrated client may have a _____ specific gravity.
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low
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____ is a measure of the body's acid/base balance.
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pH
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____ pH comes from diets high in egg, meat, cheese, whole grains, and cranberries.
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Low
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____ pH comes from diets high in veggies, citrus fruits and milk.
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High
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Normal urine consists of ____ water and ____ solutes.
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96%
4% |
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Factors that affect urinary output include:
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fluid intake
body fluid losses through other routes such as perspiration, breathing, and diarrhea Cardiovascular and renal status of the individual |
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Abnormal urine colors include:
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dark amber, cloudy, dark orange, red or dark brown, mucous plugs, viscid and thick
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Abnormal urine output would be
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under 1200mL or a large amount over intake.
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Abnormal urine odors are ____.
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offensive
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There _____ (should/should not) be microorganisms present in the urine.
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should not
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The normal pH range for urine is _____.
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4.5-8
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Abnormal urine pHs are under ____ and over _____.
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4.5
8 |
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A specific gravity of _____ is normal.
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1.010-1.025
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A specific gravity over _____ is abnormal.
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1.025
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A specific gravity under _____ is abnormal.
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1.010
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Urinary output of less than ____mL/hr may indicate decreased blood flow to the kidneys and should be reported immediately.
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30
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Cloudy urine may be caused by...
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WBCs
bacteria pus contaminants such as prostatic fluid, sperm and vaginal drainage |
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Red blood cells in the urine that may be evident as pink, bright red or rusty brown urine is known as ______.
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hematuria
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Urine high in glucose has a _____ odor.
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sweet
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Freshly voided urine is normally somewhat ____.
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acidic
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Alkaline urine may indicate a state of _____, _____, or a diet high in ___ and ____.
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alkalosis, UTI, fruits and vegetables
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More acidic urine (low pH) is found in _____, with _____, or with a diet high in ____ or ____.
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starvation, diarrhea, protein foods or cranberries
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Concentrated urine has a ____ specific gravity.
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higher
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Diluted urine has a _____ specific gravity.
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lower
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Glucose in the urine indicates high blood glucose levels (greater than ___ mg/dL) and may be indicative of undiagnosed or uncontrolled ______.
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180
diabetes mellitus |
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Ketones are abnormal in the urine and may be present in patients who have _____, are in a state of ______, or have ingested excessive amounts of ____.
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uncontrolled diabetes mellitus
starvation aspirin |
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Blood is abnormal in the urine but may be present in patients who have ____, _____, or _____.
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UTI
kidney disease bleeding from urinary tract |
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Average urine output for 1-2 day old is ____.
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15-60 mL
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Average urine output for 3-10 day old is _____.
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100-300mL
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Average urine output for 10 days to 2 month old is _____.
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250-450mL
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Average urine output for 2 months to 1 year is _____.
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400-500mL
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Average urine output for 1-3 years is _____.
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500-600mL
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Average urine output for 3-5 years is _____.
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600-700mL
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Average urine output for 5-8 years is ______.
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700-1000mL
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Average urine output for 8-14 years is _____.
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1000-1400mL
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Average urine output for 14 years thru adulthood is ______.
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1500mL
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The average urine output for older adults is _____.
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less than 1500mL.
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Psychosocial factors affecting urinary elimination include: ____ have issues with public restrooms which leads to increased risk of UTI. Also ____ may lead to urgency and increased frequency.
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females
anxiety |
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Many pathologic conditions such as heart failure, shock, HTN, and end stage renal disease can affect blood flow to kidneys resulting in...
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interference with urine production.
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BPH stands for _____ and may be present in older adult males causing them to suffer from urinary retention and incontinence.
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benign prosthetic hypertrophy
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Clients with cognitive impairments such as _____ may lose the ability to sense a full bladder or they may be unable to recall the procedure for actually voiding.
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alzheimers
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Incontinence ____ (is/is not) normal in older adults.
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is not
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Some surgical and diagnostic procedures can be done to see what the urinary system looks like and _____ may be noted afterwards.
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some bleeding
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Muscle tone can affect urinary elimination. Therefore, if a person has an ____ for an extended period of time it can cause the detrusor muscle in the bladder to become weakened.
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indwelling catheter
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A person should have ____ glasses of water per day because this helps maintain optimal renal function.
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8-10
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____ and ____ can cause diuresis.
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Caffeine and alcoholic beverages
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_____ is increased formation and excretion of urine.
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Diuresis
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____ add to usual fluid intake and can increase the production of urine.
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Fruits
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Alcohol inhibits the release of ____ which causes increased water loss in urine.
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ADH
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Some medications cause ____ and _____.
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urinary retention
changes in urine color |
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____ are medications that prevent the reabsorption of water and certain electrolytes resulting in increased urinary output.
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Diuretics
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_____ is an excess amount of urine due to increased fluid intake, or diabetes mellitus, diabetes insipidus, and chronic nephritis
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Polyuria
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Polyuria is urine output of more than ____mL urine/24hr.
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2000
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Polyuria can lead to excessive _____, intense _____, _____ and ______.
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fluid loss, thirst, dehydration and weight loss
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_____ is a diminished or scanty amount of urine due to dehydration of low fluid intake and can result in permanent kidney damage.
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Oliguria
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____ often indicates impaired blood flow to kidneys or impending renal failure.
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Oliguria
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Oliguria is when urine output is less than _____mL/hr or less than _____mL/24hr.
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30
400 |
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____ is the absence of urine. It can occur with a client in renal failure or severe dehydration.
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Anuria
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Less than 100mL of urine/24hr is known as ______.
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anuria
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_____ is a urinary problem of voiding at intervals of less then q2h and can be caused by increased fluid intake, UTI, stress or pregnancy.
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Frequency
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____ is night time voiding (more than 3 times per night).
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Nocturia
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_____ is a sudden strong desire to go/void. It is common in people with poor external sphincter control or unstable bladder contractions.
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Urgency
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____ is difficult or painful voiding caused by UTI or damage to the urethra and other structures.
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Dysuria
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The leakage of urine despite voluntary control of urine is called ______.
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dribbling
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The delay and difficulty of initiating voiding is called _____.
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hesitancy
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Involuntary urination in children beyond the age when voluntary control is normally acquired is called _____.
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enuresis
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A _____ is any dysfunction of the urinary bladder caused by problems with the CNS or nerves supplying the bladder.
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neurogenic bladder
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There are 2 types of neurogenic bladders:
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flacid and spastic
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A _____ neurogenic bladder has involuntary emptying.
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spastic
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A _____ neurogenic bladder occurs when the perception of bladder fullness is lost or there is ineffective detrusor muscle contraction.
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flacid
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_____ is the INVOLUNTARY leakage of urine or loss of bladder control.
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Urinary incontinence
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Urinary incontinence is a ____ not a disease.
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health symptom
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Urinary incontinence can lead to increased incidence of _____, ____, or _____.
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social isolation
withdrawal depression |
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_____ urinary incontinence comes pretty suddenly and is brief, lasting 6 months or less. The causes are reversible.
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Transient (Acute)
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_____ urinary incontinence is chronic but with appropriate treatment 80% clients can improve symptoms or be cured.
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Established
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Urinary incontinence occurs more commonly in ____ and can be due to a shorter urethra or trauma to pelvic floor.
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women
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5 types of urinary incontinence are:
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-stress
-urge -mixed -overflow -functional |
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_____ incontinence is the involuntary loss of urine r/t increased intraabdominal pressure d/t coughing, sneezing, laughing, or other physical activity; usually the volume lost is very small.
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Stress
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____ incontinence is the involuntary loss of urine associated with abrupt and strong desire to void; usually associated with instability or involuntary contractions of the detrusor muscle.
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Urge
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_____ incontinence is the involuntary loss of urine r/t symptoms of stress and urge incontinence.
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Mixed
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____ incontinence is the involuntary loss of urine associated with overextension and overflow of the bladder; the signal for emptying the bladder is nonfunctional resulting in dribbling.
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Overflow
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_____ incontinence is the involuntary unpredictable passage of urine in a client with intact urinary and nervous systems. It may be d/t a cognitive issue, different environment, injury, etc...
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Functional
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Clients with ____ incontinence might be treated with preparations that increase bladder capacity. The primary drug for this is Ditropan.
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urge
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An intervention for stress incontinence is _____.
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kegel exercises
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Interventions for urge incontinence are:
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medications and bladder continence training
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An intervention for overflow continence is ______.
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catheterization
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____ are an intervention for urinary incontinence that help strengthen the pelvic floor muscles therefore helping to reduce episodes of incontinence.
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Kegel exercises
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When using ____ as an intervention for urinary incontinence, the client must be alert and physically able to follow a program.
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bladder continence training
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Bladder continence training is used primarily with clients who have _____ or are in _____.
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urge incontinence or are in nursing homes.
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The goal of bladder continence training is to
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gradually lengthen periods between urination by increasing the bladder capacity.
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_____ focuses on having a client void at regular intervals; matches the natural schedule that patient already follows.
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Habit training or scheduled toileting
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______ are primarily used to inhibit detrusor muscle contraction and increase bladder capacity.
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Medications
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_____ requires a physician's order. It is the insertion of a tube into the bladder for the purpose of draining the bladder.
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Catheterization
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Limiting ____, ____, ____ and ____ consumption helps with stress and urge incontinence.
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caffeine, alcohol intake, citrus juices and artificial sweeteners
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The marked accumulation of urine in the bladder as a result of the inability of the bladder to empty completely is known as ______.
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urinary retention
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Urinary retention can be caused by...
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-Benign prostatic hypertrophy (BPH)
-Acute inflammation -Bladder calculi -Medications -Neurogenic (flacid) bladder |
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BPH is seen particularly in _____ and it occurs when the patient experiences retention because of the enlargement that prevents urine from getting all the way outside the body.
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older males
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Interventions to relieve or prevent urinary retention include:
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-promoting urination
-catheterization |
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3 ways to promote urination are:
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-Enhancing the stimulus to void
-Use of medications -Removal of obstruction (stones) |
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2 types of catheters are:
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indwelling and intermittent
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An ____ catheter is inserted and a balloon is inflated to keep the catheter in place.
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indwelling
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An _____ catheter is placed, the bladder is drained and the catheter is immediately removed.
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intermittent
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The most common nosocomial infection is ____. It is due to catheterization and surgical manipulations.
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UTI
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____ are most susceptible to UTI's because of the close proximity of the anus to the urinary meatus and their short urethra tube.
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Women
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Symptoms of a urinary tract infection include:
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-dysuria (painful voiding)
-fever, chills, N/V, malaise -hematuria -flank pain, tenderness -cloudy urine |
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A symptom of UTI in older people may be _____.
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confusion
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Interventions for treatment or prevention of UTI's are:
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-assess for risk factors and
Teach clients to: -consume at least 1200-1500mL/day -void when urge is felt -wipe front to back -take ALL prescribed meds -add cranberry juice and ascorbic acid to daily routine -avoid tight clothing |
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Cranberry juice works as an intervention for UTI's because it _____ urinary pH which enhances the _____ of urine.
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decreases
antibacterial activity |
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The purpose of catheterization is to
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prevent urinary retention and remove urine from the bladder.
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Factors that put clients at risk for developing UTIs are
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-sexually active women
-infrequent voiding -catheterized -diabetes -high glucose in urine |
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Important factors to note during the nursing assessment of urinary function include:
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-nursing history
-physical assessment of urinary system -hydration status -examination of urine -data from diagnostic tests and procedures |
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When obtaining nursing history it is important to note:
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-normal voiding patterns
-appearance of urine -recent changes (increase in frequency/output, change in color) -past or current problems of patient and family members -intake |
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During physical assessment of the urinary system inspect the following:
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-urethral meatus for swelling, discharge, inflammation
-skin color, texture, turgor, signs of irritation -edema (may indicate renal or cardiovascular issues) |
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Assess for urinary tension by palpating over the _____.
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symphysis pubis
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Surgical rerouting of urine from the kidneys to a site other than the bladder is called _____.
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urinary diversion
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Usually clients with urinary diversions have no control over the passage of urine and therefore require the use of an _______ that acts as a reservoir for urine.
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external ostomy appliance
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A _____ diverts urine from the kidneys to a stoma.
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nephroctomy
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An ______ removes a segment of the ilium and reattaches the remaining two ends. The removed portion is used to form a pouch and diverted outside the body as a stoma.
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ileal conduit
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The most common urinary diversion is the _____.
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ileal conduit
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When assessing the urine the nurse should:
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-measure urinary output
-measure residual volume -review diagnostic test results |
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PVR stands for _____.
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post void residual
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PVR can be measured by having a person empty their bladder then...
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insert catheter to remove any remaining amount of urine.
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A _____ is a hand-held portable device used to measure bladder urine volume noninvasively.
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bladder scan
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A _____ is the physical, chemical and microscopic exam of urine.
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urinalysis (UA)
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_____ is the end product of protein metabolism.
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BUN (blood urea nitrogen)
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Creatine is the product of creatine phosphate. High creatine means ______.
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renal issues
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____ and ____ are usually ordered together and are referred to as renal function study. They help look at how well the kidneys are functioning.
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BUN and Creatinine
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Interventions for treatment or prevention of UTI's are:
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-assess for risk factors and
Teach clients to: -consume at least 1200-1500mL/day -void when urge is felt -wipe front to back -take ALL prescribed meds -add cranberry juice and ascorbic acid to daily routine -avoid tight clothing |
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Cranberry juice works as an intervention for UTI's because it _____ urinary pH which enhances the _____ of urine.
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decreases
antibacterial activity |
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The purpose of catheterization is to
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prevent urinary retention and remove urine from the bladder.
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Factors that put clients at risk for developing UTIs are
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-sexually active women
-infrequent voiding -catheterized -diabetes -high glucose in urine |
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Important factors to note during the nursing assessment of urinary function include:
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-nursing history
-physical assessment of urinary system -hydration status -examination of urine -data from diagnostic tests and procedures |
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When obtaining nursing history it is important to note:
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-normal voiding patterns
-appearance of urine -recent changes (increase in frequency/output, change in color) -past or current problems of patient and family members -intake |
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During physical assessment of the urinary system inspect the following:
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-urethral meatus for swelling, discharge, inflammation
-skin color, texture, turgor, signs of irritation -edema (may indicate renal or cardiovascular issues) |
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Assess for urinary tension by palpating over the _____.
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symphysis pubis
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Surgical rerouting of urine from the kidneys to a site other than the bladder is called _____.
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urinary diversion
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Usually clients with urinary diversions have no control over the passage of urine and therefore require the use of an _______ that acts as a reservoir for urine.
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external ostomy appliance
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A _____ diverts urine from the kidneys to a stoma.
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nephroctomy
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An ______ removes a segment of the ilium and reattaches the remaining two ends. The removed portion is used to form a pouch and diverted outside the body as a stoma.
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ileal conduit
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The most common urinary diversion is the _____.
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ileal conduit
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When assessing the urine the nurse should:
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-measure urinary output
-measure residual volume -review diagnostic test results |
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PVR stands for _____.
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post void residual
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PVR can be measured by having a person empty their bladder then...
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insert catheter to remove any remaining amount of urine.
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A _____ is a hand-held portable device used to measure bladder urine volume noninvasively.
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bladder scan
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A _____ is the physical, chemical and microscopic exam of urine.
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urinalysis (UA)
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_____ is the end product of protein metabolism.
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BUN (blood urea nitrogen)
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Creatinine is the product of creatinine phosphate. High creatinine means ______.
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renal issues
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The NANDA definition of Impaired Urinary Elimination is
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disturbance in urine elimination.
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Defining characteristics of impaired urinary elimination include:
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-voiding> q2h
-voiding<once q6h -nocturia -dysuria -hesitancy -feelings of incomplete bladder emptying -incontinence |
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General interventions for urinary intervention are:
-promoting ____ intake -maintaining normal _____ -assisting with _____ -preventing ____ -managing urinary ______ -______ training |
fluid
voiding patterns toileting UTIs incontinence continence bladder |
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Additional general interventions for urinary intervention are:
-_____ exercises -maintain skin ____ -applying _____ devices -performing _____ and _____ -provide care for clients with ____ and _____ |
pelvic muscle exercises
maintain skin integrity apply external urinary drainage devices perform urinary catheterizations and bladder irrigations provide care for clients with indwelling urinary catheters and urinary diversions |
