Elimination
Terms
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- What shape are the kidneys.
- bean
- Where are the kidney's located?
- 12 Thoracic and 3rd Lumbar vertebrae
- Which kidney is higher?
- left
- Where is the bladder located in the male? female?
-
Male: against rectum
Female: behind uterus - An average bladder can hold ___ mL of urine.
- 600
- What structure is attached to the kidneys?
- ureters
- What is the function of the ureters?
- carry waste to the bladder
- Where do you find sterile urine?
- Ureters
- Approx. How long is the ureter in the male? female?
-
Male: 20 cm
Female: 4-6 1/2 cm - Structure that carries urine out of the body
- Urethra
- What are the 3 sections of the male urethra?
- Prostatic, Membranous, Penile
- Approx. how much urine does the average person produce a day?
- 1-2 L
- What is urine made up of?
- 95% water, 5% solute
- Name some of the solutes found in urine.
- Urea, uric acid, creatine, ammonia
- What is the function of the nephrons?
- remove waste from kidney
- What percent of cardiac output runs through the kidney's?
- 25%
- What is the glomerus?
- cluster of capillaries
- How many L. of blood flow through the nephrons daily?
- 180 L
- What does the glmerus filter?
- glucose
- What is proteinuria?
- Protein in the urine
- How does alcohol increase Urinary Output?
- Stops the anti-dierutic hormone?
- What substance found in drinks ups UOP?
- caffeine
- What is urinary retention?
- accumulation of urine in the bladder because the bladder cannot empty
- S/S of urinary retention
- feeling of pressure, discomfort, tenderness over symphasis pubis restlessness
- what are some factors that effect urinary elimination?
- growth and development, disease, mobility
- How many mL of urine make for a distended bladder?
- > 1000mL
- What causes urinary retention?
- enlarged prostate, urethral stricture, SCI, emotional, anxiety, meds.
- Interventions for distended bladder
- up fluid intake, increase activity,catheterization
- What percent of all nosocomial infects are UTI's?
- 36-40%
- What is bacteriuria?
- bacteria in urine
- What are some causes of UTI's?
- up fluid intake, antibiotics, teaching
- What are the types of incontinence?
- total, functional, stress, urge, reflex
- What is total incontinence?
- no control of elimination, constant and unpredictable
- Is functional incontinence voluntary or involuntary?
- involuntary
- What is stress incontinence caused by?
- increased abdominal pressure
- What are the symptoms of stress incontinence?
- dribbling of urine, urgency
- Name some situations where stress incontinence can occur.
- While coughing, laughing, vomitting, pregnancy
- What causes Urge incontinence?
- decrease in bladder capacity
- What are some symptoms of Urge incontince?
- urgency and frequency
- What causes reflex incontinence?
- spinal injury or disease
- Does a person with relex incontinence have an urge to void?
- NO
- What happens with reflex incontinence?
- the bladder spasms at regular intervals
- Which type of incontinence is easiest to control?
- Urge
- What are the two types of urinary diversions?
- continent and incontinent
- What procedure is done with an incontinent diversion?
- ureterostomy
- What is a ureterostomy?
- surgical procedure creating a stoma on outer wall for continuous urine drainage
- What do they do for a continent urinary diversion?
- make a continent pouch inside the abd.
- What is a continent pouch?
- pouch inside abd where urine is stored until pt. cateterizes and removes
- What is a continent pouch made from?
- bowel
- What are some problems with both the continent and incontinent diversions?
- Skin breakdown and fluid and electrolyte imbalance
- What is the main bacteria that causes UTI's?
- E-Coli
- Where can UTI's occur?
- anywhere on the urinary tract
- What is urgency?
- immediate need to void
- What can cause urgency?
- full bladder and/or UTI
- What is Dysuria?
- painful urination
- What causes dysuria?
- bladder inflammation and trauma
- What is frequency?
- voiding in short intervals
- What can cause frequence?
- increased fluid intake, pressure on bladder, pregnancy
- What is hesitancy?
- difficulty starting urination
- What can cause hesitancy?
- enlargement of prostate and anxiety
- What is polyuria?
- voiding large amounts
- What can cause polyuria?
- excess fluid intake, D.M.
- What is oliguria?
- decreased urine output
- What causes oliguria?
- dehydration, renal failure
- What is nocturia?
- increase in urine output during the night
- What causes nocturia?
- excess fluids (esp around bedtime)and caffeine
- What is hematuria?
- blood in the urine
- What causes hematuria?
- neoplasms of the kidney, glomerular disease
- What do you monitor when assessing Urinary Ouput?
- Intake and Output of the patient
- What does intake include?
- IV, oral - including soups, coffee, jello, broth, and ice
- What does output include?
- NG tubes, chest tube, JP (and other) drains, foley catheters, elimination
- What does the color of urine look like?
- pale straw to amber in color
- What can change the color of urine?
- concentration and hematuria
- What is the clarity of urine?
- after voiding - tranparent
- When can urine be cloudy?
- after it sits awhile, when there is bacteria present, and during renal failure
- What odor does urine have?
- ammonia
- What is a urinalysis?
- client urinates in cup and it is sent to the lab
- Which urine test is not sterile?
- urinalysis
- What is a midstream urine test?
- "clean catch" start to void before catching urine in "midstream"
- What is a C and S test?
- culture and sensitivity
- Where must a C & S test come from?
- catheter
- How does a 24 hr urine test work?
- start time, waste 1st sample, keep the rest for 24 hr period, keeping the last sample
- What is a KUB?
- kidneys, ureters and bladder x-ray showing gross anatomy
- What is an IVP?
- Intravenous pyelogram
- What does an IVP allow the physician to do?
- view entire urinary system and assess renal function
- Does an IVP use dye injection
- yes
- What are some reactions a patient may have from the dye in an IVP?
- factial flushing, dizziness
- What specific allergy should you look for before doing an IVP?
- iodine
- What is a renal scan?
- indirect visualization of urinary tract
- What is injected in a renal scan?
- radio isotopes
- What information does a renal scan give you?
- info about blood flow and anatomical structures
- When is a renal scan indicated?
- in clients unable to have IVP
- What is a computerized axial tomography used for?
- to obtain detailed image with in a certain plain
- What can you visualize with a CT?
- tumors, obstructions, retroperitoneal masses, and lymph node enlargement
- What is a renal ultrasound?
- painless, non-invasive diagnostic tool to assess urinary disorders
- What does a renal ultrasound identify?
- gross renal anatomy and structure, abnormalities of kidney and lower UT
- What is an angiogram/arteriogram?
- invasive radiographic procedure using a contrast material to outline the vascular supply to the kidneys
- What is catheterization?
- introducing a tube through urethra into bladder to drain urine
- What are the types of catheterizations?
- intermittent and indwelling
- What is an intermittent catheter?
- straight cath to drian urine - not permanent
- What is an indwelling catheter?
- a long term cather used for bladder emptying