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Urinary Elimination OSU OKC Exam With Complete Solutions!!
Urinary Elimination- ANSWER-the final event in the removal and elimination of excess water and by-products of body metabolism.
Factors That Commonly Affect Urinary Elimination- ANSWER-Growth and Development- Children cannot voluntarily control voiding until 18 to 24 months old. In older adults the ability to hold urine between the initial desire to void and an urgent need to void decreases.
Sociocultural Factors-Cultural and gender norms vary. North Americans require toilet facilities to be private, whereas the cultural norm in some cultures includes shared toilet facilities.
Psychological Factors- Anxiety inhibits bladder emptying because of incomplete relaxation of the pelvic floor muscles and urinary sphincter.
Personal Habits- The need for privacy and adequate time to void can impact the ability to empty the bladder adequately.
Pathological Conditions-Diabetes mellitus, multiple sclerosis, and stroke can alter bladder contractility and the sensation of bladder filling. Patients have either an overactive bladder or poor bladder emptying.
Arthritis, Parkinson's disease, dementia, and chronic pain syndromes interfere with access to a toilet in a timely manner.
Prostatic enlargement
Surgical Procedures-Local trauma from lower abdominal and pelvic surgery sometimes obstructs the flow of urine, necessitating the temporary use of an indwelling urinary catheter.
Medications-Diuretics increase urinary output by preventing resorption of water and
certain electrolytes.
Some drugs alter the color of urine
Diagnostic Studies-Cystoscopy may cause localized trauma of the urethra, leading to transient (1 to 2 days) dysuria and hematuria.
Anytime the sterile urinary tract is catheterized, there is risk for infection.
Characteristics of Normal Urine - ANSWER>>Color-Normal urine ranges in color from a pale straw color to amber, depending on its concentration. Urine is usually more concentrated in the morning or with fluid volume deficits.
Clarity-Normal urine appears transparent at the time of voiding. Urine that stands several minutes in a container becomes cloudy.
Odor-Urine has a characteristic ammonia odor. The more concentrated the urine, the stronger the odor. As urine remains standing, such as in a collection device, more ammonia breakdown occurs and the odor becomes stronger. Some foods, such as asparagus and garlic, can change the odor.
Characteristics of Abnormal Urine - ANSWER>>Color-Dark amber urine is the result of high concentrations of bilirubin (urobilinogen) in patients with liver disease.
Blood in the urine is never a normal finding. Bleeding from the kidneys or ureters usually produces dark red urine; bleeding from the bladder or urethra usually produces bright red urine. Hematuria and blood clots are a common cause of urinary catheter blockage.
Clarity-In renal disease, freshly voided urine is cloudy due to protein concentration. Urine can also be thick and cloudy due to the presence of bacteria and WBC's.
Odor-A foul odor can indicate infection of the UTI
Common Diagnostic Tests of the Urinary System - ANSWER>>> Abdominal
- Do not restrict fluids if you have incontinence. Concentrated urine can irritate the bladder and worsen bladder symptoms.
- Maintain good voiding habits, - Women: sit back on the toilet seat, do not "hover over the toilet, " and have feet flat on floor. **- Void at consistent intervals usually every 3 to 4 hours, based on fluid intake.
- Do not strain while voiding or during movement of the bowels.
- Allow time for complete emptying of the bladder.**
- Establish a standard bowel routine. A rectum full of stool can irritate the bladder and cause urgency and frequency.
- Prevent urinary tract infection. - Women: clean the perineum from front to back after each voiding and each bowel movement; wear cotton undergarments **- Drink at least enough water to produce pale yellow urine.
- Shower or bathe at least daily**
- Smoking cessation decreases the risk of bladder cancer, as well as other risks such as a chronic cough that can contribute to stress urinary incontinence.
- New onset of changes in bladder habits, flank pain, frequency, urgency, dysuria, or hematuria should be reported to the healthcare provider.
Nursing Interventions to Reduce Risk for Urinary Tract Infections. - ANSWER>>• Women: Cleanse the perineum from front to back after each voiding and bowel movement; wear cotton undergarments
**- Drink adequate water to produce pale yellow urine.
Nitrofuraotoin - ANSWER>>Aka Macrobid-do not use with neurontin or nitroglycerin.
-Used as an antibiotic/UTI prophylaxis.
Trimethoprim-Sulfamethozaxole - ANSWER>>aka Bactrim-do not use for sulfa allergy
-Used as antibiotic
Ciprofloxacin - ANSWER>>aka Cipro-used as antibiotic
Phenazopyridine Hydrochloride - ANSWER>>aka: Azo-Gesic, Azo-Standard, Uristat
-Used as a urinary tract analgesic
When is a sterile collection needed? - ANSWER>>When a urinary culture is ordered.
Pyridium - ANSWER>>Common medication that affects urine color
