Altered Urinary Elimination
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Questions and Answers

What is polyuria?

  • The production of large amounts of urine by the kidneys without an increase in fluid intake (correct)
  • The lack of urine production
  • The need to urinate often
  • The production of small amounts of urine by the kidneys

    • What is nocturia?

  • Voiding two or more times during the day
  • Painful or difficult voiding
  • Voiding two or more times at night (correct)
  • The need to urinate often

    • What is dysuria?

  • The need to urinate often
  • The lack of urine production
  • The production of large amounts of urine
  • Painful or difficult voiding (correct)

    • What is urinary incontinence?

    <p>The inability to control the flow of urine from the bladder</p> Signup and view all the answers

    What is stress urinary incontinence?

    <p>Involuntary, sudden loss of urine secondary to increased intraabdominal pressure</p> Signup and view all the answers

    What is anuria?

    <p>The lack of urine production</p> Signup and view all the answers

    What is oliguria?

    <p>Low urine output</p> Signup and view all the answers

    What is urinary retention?

    <p>A condition in which you are unable to empty all the urine from your bladder</p> Signup and view all the answers

    What is the normal daily fluid intake for a normal adult to promote normal urinary elimination?

    <p>1500mL</p> Signup and view all the answers

    What is the recommended daily fluid intake for a patient with a urinary tract infection (UTI) or urinary calculi?

    <p>2500mL</p> Signup and view all the answers

    What is the purpose of measuring urinary output?

    <p>To assess kidney function</p> Signup and view all the answers

    What is the purpose of the 24-hour urine collection test?

    <p>To determine creatinine clearance</p> Signup and view all the answers

    Why is it important to instruct a patient to keep urine separate from feces during urine collection?

    <p>To prevent contamination of the urine sample</p> Signup and view all the answers

    What is the normal urinary output for an adult?

    <p>60mL/h</p> Signup and view all the answers

    What is the purpose of wearing gloves when measuring urinary output?

    <p>To prevent infection</p> Signup and view all the answers

    What is the significance of a urinary output below 30mL/h?

    <p>It indicates low blood volume or kidney malfunction</p> Signup and view all the answers

    What is nocturnal enuresis in school-age children?

    <p>Involuntary urination at night</p> Signup and view all the answers

    Why do older adults experience nocturnal frequency?

    <p>Due to both enlarged prostate gland in men and weakened muscles supporting the bladder and urethral sphincter in women</p> Signup and view all the answers

    What can produce anxiety and muscle tension, leading to voiding difficulties?

    <p>All of the above</p> Signup and view all the answers

    Which of the following can increase urine production?

    <p>All of the above</p> Signup and view all the answers

    What is the purpose of a retention catheter or continuous bladder drainage (CBD)?

    <p>To manage urine retention due to poor bladder muscle tone</p> Signup and view all the answers

    Which of the following can interfere with urine production?

    <p>All of the above</p> Signup and view all the answers

    What is a surgical procedure that can affect urine production?

    <p>Cystoscopy</p> Signup and view all the answers

    Why is good muscle tone important for normal voiding habits?

    <p>To allow the bladder to fill adequately and empty completely</p> Signup and view all the answers

    What is the primary function of the kidneys in urinary elimination?

    <p>To filter waste and excess fluids from the blood</p> Signup and view all the answers

    What is the typical volume of urine in an adult bladder?

    <p>250-450 mL</p> Signup and view all the answers

    What stimulates the micturition reflex in the urinary bladder?

    <p>The stimulation of sensory nerve endings in the bladder wall</p> Signup and view all the answers

    What is the primary reason why women are more prone to urinary tract infections?

    <p>Greater proximity of the urethra to the anal and vaginal area</p> Signup and view all the answers

    At what age do children typically develop daytime control of their urinary habits?

    <p>2-5 years old</p> Signup and view all the answers

    What is a recommended method to prevent urinary tract infections?

    <p>Drinking eight 8-ounce glasses of water per day</p> Signup and view all the answers

    What is the primary factor that affects voiding in infants?

    <p>Developmental factors</p> Signup and view all the answers

    What is the typical specific gravity of urine in infants?

    <p>1.008</p> Signup and view all the answers

    Why is it recommended to wipe from front to back after urination or defecation?

    <p>To prevent introduction of gastrointestinal bacteria into the urethra</p> Signup and view all the answers

    What is the role of the pelvic nerve in the micturition reflex?

    <p>To transmit afferent impulses to the spinal cord</p> Signup and view all the answers

    What is a recommended way to manage urinary incontinence?

    <p>Continence (bladder) retraining</p> Signup and view all the answers

    What is the purpose of providing a call signal in the bathroom?

    <p>To summon help in case of a fall</p> Signup and view all the answers

    What is the primary function of the detrusor muscle in the urinary bladder?

    <p>To contract and relax during the micturition reflex</p> Signup and view all the answers

    Why is it recommended to practice frequent voiding?

    <p>To prevent organism from ascending into the bladder</p> Signup and view all the answers

    What is the recommended type of underclothing to wear to prevent urinary tract infections?

    <p>Cotton</p> Signup and view all the answers

    What is the recommended frequency of voiding to prevent urinary tract infections?

    <p>Every 2 to 4 hours</p> Signup and view all the answers

    Study Notes

    Altered Urinary Elimination

    • Polyuria (diuresis): production of large amounts of urine without increased fluid intake, can lead to intense thirst (polydipsia), often seen in patients with diabetes, diabetes insipidus, and chronic nephritis.
    • Oliguria: low urine output.
    • Anuria: lack of urine production.

    Altered Urinary Elimination

    • Urinary frequency: need to urinate often.
    • Nocturia: voiding two or more times at night.
    • Urgency to urinate: feeling that one must urinate immediately.
    • Dysuria: painful or difficult voiding.
    • Enuresis/bed-wetting: involuntary passing of urine in children after bladder control is achieved.
    • Urinary incontinence: temporary or permanent inability of the external sphincter muscles to control the flow of urine from the bladder.

    Types of Urinary Incontinence

    • Stress urinary incontinence: involuntary loss of urine secondary to increased intraabdominal pressure, often triggered by physical activities like laughing, sneezing, straining, coughing, or exercising.
    • Urge urinary incontinence: sudden, intense urge to urinate followed by an involuntary loss of urine.
    • Mixed urinary incontinence: symptoms of both stress and urge urinary incontinence.
    • Overflow urinary incontinence: involuntary leakage of urine from an overdistended bladder due to impaired detrusor contractility and/or bladder outlet obstruction.

    Urinary Retention

    • Condition in which one is unable to empty all the urine from the bladder.

    Average Daily Urine Output by Age

    • Not specified.

    Nursing Management

    Assessing

    • Nursing history: assess voiding pattern, frequency, appearance of urine, and any recent changes or past/current problems with urination.
    • Physical assessment: percussion of kidneys to detect areas of tenderness, palpation and percussion of bladder, inspection of urethral meatus for swelling, discharge, or inflammation, and assessment of skin color, texture, and tissue turgor for edema.
    • Assessing urine: measure urine output, which is normally 60mL/h or about 1500mL/day in adults, and factors affected by fluid intake, perspiration, breathing, diarrhea, cardiovascular, and renal status.
    • Urine output below 30 mL/h may indicate low blood volume or kidney malfunction.

    Diagnostic Tests

    • Blood tests: Blood Urea Nitrogen (BUN) and creatinine.
    • 24-hour urine collection: measures creatinine clearance.
    • Collecting urine specimens: measures specific gravity.

    Nursing Intervention

    Maintaining Normal Urinary Elimination
    • Promoting fluid intake: increase fluid intake to increase urine production, stimulate the micturition reflex, and maintain normal daily intake of 1500mL for normal adults.
    • Maintaining normal voiding habits.
    Preventing Urinary Tract Infections
    • Fluid intake: drink eight 8-ounce glasses of water per day to flush bacteria out of the urinary system.
    • Hygiene: practice frequent voiding (every 2 to 4 hours) to flush bacteria out of the urethra and prevent organisms from ascending into the bladder.
    Managing Urinary Incontinence
    • Continence (bladder) retraining.
    • Pelvic floor muscle exercise (Kegels).
    • School-age children: enuresis, bed-wetting, and nocturnal enuresis.

    Factors Affecting Voiding

    • Development factors: infants, preschoolers, and older adults.
    • Psychosocial factors: privacy, normal position, sufficient time, and running water.
    • Fluid and food intake: caffeine, sodium, and certain foods can affect urine production.
    • Medication: diuretics, chlorothiazide, or furosemide (Lasix).
    • Muscle tone: good muscle tone maintains stretch and contractility of the detrusor muscle and pelvic muscle tone.
    • Pathologic conditions: renal failure, heart failure, urinary calculus, and hypertrophy of the prostate gland.
    • Surgical and diagnostic procedures: cystoscopy, spinal anesthetics.

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    Description

    This quiz covers altered urinary elimination patterns, including polyuria, oliguria, anuria, urinary frequency, nocturia, urgency, and dysuria. It's essential for understanding kidney function and related disorders.

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