Care of Urinary Elimination in Nursing
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Questions and Answers

What is the standard male catheter length generally used?

  • 25 cm
  • 30 cm
  • 41 cm
  • 45 cm (correct)

Which length of catheter is recommended for female patients who are bedbound or critically ill?

  • 41 cm
  • 45 cm (correct)
  • 30 cm
  • 25 cm

What is one key aspect of an aseptic closed urinary drainage system?

  • It is suitable for outdoor use only
  • It minimizes the risk of infections (correct)
  • It requires no special techniques for installation
  • It should be disconnected frequently

What should be done if there is unnecessary disconnection of a closed drainage system?

<p>It should be replaced using aseptic technique (A)</p> Signup and view all the answers

When selecting a urinary drainage system, which factor is NOT considered?

<p>Patient's dietary preferences (D)</p> Signup and view all the answers

What is the typical range of urine output for an adult in a 24-hour period?

<p>1200 to 1500 ml (C)</p> Signup and view all the answers

Which factor can significantly increase urine production?

<p>Diuretics (B)</p> Signup and view all the answers

Oliguria is defined as urine output that is:

<p>From 100 to 500 ml per 24 hours (B)</p> Signup and view all the answers

What does the specific gravity of urine indicate?

<p>The weight of urine compared to an equal volume of water (C)</p> Signup and view all the answers

Which of the following conditions is characterized by urine output exceeding 3000 ml per 24 hours?

<p>Polyuria (C)</p> Signup and view all the answers

Anuria is a grave condition that may indicate:

<p>Kidney failure (D)</p> Signup and view all the answers

Which condition results from the inability to control urination?

<p>Incontinence of urine (C)</p> Signup and view all the answers

Which factor does NOT influence the volume of urine excretion?

<p>Height of the individual (B)</p> Signup and view all the answers

What is a common symptom of bladder distention?

<p>Retention of urine (C)</p> Signup and view all the answers

Fluid balance monitoring is crucial for evaluating which aspect of patient health?

<p>Fluid and electrolyte imbalance (C)</p> Signup and view all the answers

Which nursing care practice is essential for incontinent patients?

<p>Use of disposable absorbent products (B)</p> Signup and view all the answers

What characterizes acute urinary retention?

<p>Happens suddenly and lasts for a short period (B)</p> Signup and view all the answers

What should a nurse do to assist a patient with urinary retention?

<p>Position the patient in a squatting position (A)</p> Signup and view all the answers

Which of the following can lead to urinary retention?

<p>Urethral obstruction (D)</p> Signup and view all the answers

What signifies chronic urinary retention?

<p>A long-lasting medical condition (C)</p> Signup and view all the answers

What pH level indicates that a fluid is acidic?

<p>Below 7 (A)</p> Signup and view all the answers

Which factor is NOT associated with urinary incontinence?

<p>Increased fluid retention (B)</p> Signup and view all the answers

What is the primary role of acidic urine?

<p>To control bacterial growth (C)</p> Signup and view all the answers

Which substance's presence in urine is most indicative of diabetes mellitus?

<p>Ketones (C)</p> Signup and view all the answers

Which of the following symptoms is associated with obstructive urinary calculi?

<p>Dysuria (C)</p> Signup and view all the answers

Nocturia is characterized by excessive urination at night in which age group?

<p>Adults younger than 65 years old (C)</p> Signup and view all the answers

Which symptom indicates the loss of urine during sleep after age 4 or 5?

<p>Nocturnal enuresis (C)</p> Signup and view all the answers

What could be a common cause of nocturia?

<p>Prostate enlargement in men (D)</p> Signup and view all the answers

Pollakisuria is frequently associated with which condition?

<p>Urinary tract infection (A)</p> Signup and view all the answers

What is the primary purpose of urinary catheterisation?

<p>To facilitate urine drainage when medically necessary (C)</p> Signup and view all the answers

Which of the following is a contraindication for urethral catheterisation?

<p>Acute prostatitis (D)</p> Signup and view all the answers

How often should permanent urinary catheters be evaluated for necessity?

<p>Every day (B)</p> Signup and view all the answers

Which of the following is NOT an indication for permanent catheterisation?

<p>Bacteriological examination (C)</p> Signup and view all the answers

What is a potential risk associated with bladder catheterisation?

<p>Urinary tract infection (A)</p> Signup and view all the answers

What material options are available for sterile urinary catheters?

<p>Plastic, latex, or silicone (B)</p> Signup and view all the answers

Which method is described as suitable for improving palliative/hospice comfort care?

<p>Permanent catheterisation (C)</p> Signup and view all the answers

Which is the correct statement about catheter material coatings?

<p>Some catheters have coatings such as silicone or hydrogel (C)</p> Signup and view all the answers

What is the primary use of a three-way catheter?

<p>Following urological surgery or for bladder bleeding (C)</p> Signup and view all the answers

Which range of catheter sizes is most commonly used in clinical practice?

<p>Ch 10 to 28 (A)</p> Signup and view all the answers

What size of catheter is typically required for children?

<p>Ch 8 to 10 (D)</p> Signup and view all the answers

Which balloon size is most commonly used for adults?

<p>5 ml to 10 ml (D)</p> Signup and view all the answers

What is the primary concern when using larger catheter sizes than 18 Ch?

<p>Discomfort and increased risk of blockage (B)</p> Signup and view all the answers

Why is aqueous glycerine preferred over sterile water for inflating silicone catheters?

<p>It reduces the risk of balloon dislocation (D)</p> Signup and view all the answers

What diameter size is indicated by a catheter marked as 18 Ch?

<p>6 mm (B)</p> Signup and view all the answers

What issue may occur if a silicone catheter is inflated with water?

<p>Water loss leading to catheter falling out (B)</p> Signup and view all the answers

Which factor is associated with an increased heart rate?

<p>Hypovolemia (B)</p> Signup and view all the answers

Which condition is likely to cause an irregular pulse rhythm?

<p>Overactive thyroid gland (A)</p> Signup and view all the answers

What effect does age have on heart rate?

<p>Heart rate is higher in males than females after puberty (A)</p> Signup and view all the answers

Which of the following medications may lower the heart rate?

<p>Cardiotonics (C)</p> Signup and view all the answers

Which of the following is NOT a cause of increased heart rate?

<p>Opioids (D)</p> Signup and view all the answers

Flashcards

Normal Urine Output (Adults)

The typical amount of urine produced by an adult in a 24-hour period, ranging from 1200 to 1500 ml.

Diuresis

The process of producing and eliminating urine from the body.

Polyuria

The amount of urine produced is greater than 3000 ml per 24 hours.

Anuria

The amount of urine produced is less than 100 ml per 24 hours.

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Oliguria

The amount of urine produced is between 100 and 500 ml per 24 hours.

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Fluid Balance Monitoring

The process of measuring urine excretion.

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Specific Gravity

The weight or density of a substance compared to water.

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Acidity of Urine

The pH level of urine, which is typically slightly alkaline.

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Urinary Elimination

The process of eliminating waste products from the body through urine.

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Acidic Urine

A pH below 7. Urine is usually slightly acidic with a pH ranging from 4.5 to 6.5.

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Proteinuria

A condition where protein is present in the urine. It can indicate various issues like kidney stones, urinary tract infections or trauma.

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Glycosuria

A condition where glucose (sugar) is present in the urine. It can indicate diabetes mellitus or other conditions like shock.

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Dysuria

A painful or burning sensation when urinating. Often associated with a urethra infection.

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Pollakisuria

A frequent urge to urinate, often with only a small amount of urine produced. It can be associated with bladder infections, enlarged prostate or other conditions.

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Nocturia

Excessive urination at night. Common causes can include pregnancy, infections, diuretics or prostate enlargement.

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Nocturnal Enuresis

Loss of urine during sleep, usually after the age of 4-5. Can be a symptom of bladder control issues or other medical conditions.

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Urinary Incontinence

Involuntary loss of urine that occurs when someone doesn't have control over their urination.

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Bladder Distention

An abnormal swelling or enlargement of the bladder due to urine retention.

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Urinary Retention

Inability to empty the bladder fully, or having a residual volume of urine greater than 150-200 ml in the bladder.

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Acute Urinary Retention

Urinary retention that appears suddenly and lasts for a short period of time. Patients cannot urinate at all.

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Chronic Urinary Retention

Urinary retention that lasts for a long period of time.

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Micturition Reflex

A reflex that stimulates the urge to urinate, helps relax the urethral sphincter, and promotes voiding.

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Urinary Control

The ability to control the bladder and its contents.

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Incontinence Care

A care plan designed to help with maintaining hygiene and prevent skin irritation associated with incontinence.

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Intermittent Catheterization

A catheter inserted into the bladder for short-term purposes like taking urine samples or emptying the bladder before surgery. It's removed after use.

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Indwelling Catheterization

A catheter left permanently inside the bladder for long-term urine drainage. It requires ongoing care and monitoring.

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Acute Prostatitis

An infection of the prostate gland, which is a contraindication for urethral catheterization.

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Urinary Catheter Materials

Urinary catheters can be made of different materials, each with its own advantages and disadvantages.

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Catheter Coatings

Urinary catheters are often coated with additional materials to enhance their properties, such as reducing friction or preventing infection.

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Permanent Catheter Assessment

The need for a permanent urinary catheter should be assessed daily, and removal is necessary when it's no longer required.

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Urinary Tract Infection (UTI) Prevention

A reason to use a urinary catheter is to prevent urinary tract infections, especially in patients with certain medical conditions.

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Urinary Catheterization Risks

Urinary catheterization is not a straightforward procedure and can lead to complications, so it should be performed only when medically necessary.

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Three-way catheter

A type of catheter primarily used after urological surgery or when bleeding occurs from the bladder or prostate tumor. It allows for continuous or intermittent bladder irrigation to remove blood clots or debris.

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Tiemann catheter

A type of permanent catheter typically used for males with enlarged prostate. It has a curved tip designed for easier insertion.

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Nelaton catheter

A type of permanent catheter typically used for general catheterization of males, females, and infants. It has a straight tip.

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Charriére scale

A scale used to measure the external diameter of permanent catheters. 1 mm is equivalent to 3 Ch.

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Balloon size

The balloon inside a permanent catheter that is inflated to hold the catheter in place within the bladder. Sizes range from 3 ml for pediatric use to 30 ml for postoperative needs.

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Catheter size

The size of the permanent catheter is important for proper drainage and comfort. Larger sizes are needed when the urine is thick, bloody, or contains large amounts of sediment. However, sizes larger than 18 Ch can cause discomfort and increase the risk of blockage and infection.

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Aqueous glycerine for silicone balloon inflation

Aqueous glycerine is used for inflating silicone catheters because sterile water can diffuse through the balloon wall and cause it to shrink over time, potentially leading to catheter dislocation. Aqueous glycerine solution helps to maintain balloon volume.

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Balloon size indication

The size of the permanent catheter is indicated on the catheter connection and typically includes both minimum and maximum ml or cc (cm3) of the balloon volume.

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Standard Urinary Catheter Lengths

The standard length for a male urinary catheter is 45 cm, while a shorter 25 cm length is often preferred for women due to comfort and discreetness. However, the male standard length can be used for women in certain situations like immobility, obesity, illness, or post-surgery.

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Aseptic Closed Drainage System

A closed urinary drainage system is preferred to minimize the risk of urinary tract infections. This system directly connects the sterile catheter to a sterile bag, maintaining sterility and limiting unnecessary disconnections.

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Selecting the Right Drainage Bag

The choice of urinary drainage bag depends on the patient's situation, including length of use (short-term or long-term), mobility, cognitive function, and daily routine. The goal is to select a system that is easy to manage and avoids discomfort or embarrassment for the patient.

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Types of Urinary Drainage Systems

Different types of drainage systems exist, each designed for particular needs. These include pre-connected systems, anti-reflux bags, bags with sampling ports, leg bags, and bedside bags.

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Aseptic Technique with Catheters

Aseptic technique is crucial when handling urinary catheters and drainage systems. This involves sterile equipment and procedures to prevent contamination and infection.

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What causes increased heart rate?

Factors that can increase heart rate include emotions, fever, physical activity, hypovolemia (low blood volume), dehydration, bleeding, and the release of adrenaline or epinephrine (hormones that stimulate the heart).

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What factors affect heart rate?

Factors that can decrease heart rate include age (heart rate slows with age), being male (males tend to have lower heart rates than females after puberty), opioids (medications that slow down the heart), cardiotonics (medications that strengthen the heart), and antihypertensives (medications that lower blood pressure).

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What does an irregular pulse rhythm often indicate?

An irregular heart rhythm can be a sign of heart disease or an overactive thyroid gland.

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What hormones increase heart rate?

Adrenaline and epinephrine are hormones that increase heart rate.

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What medication increases heart rate?

Atropine is a medication that increases heart rate.

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Study Notes

Care of Urinary Elimination

  • Urination requires integrated functioning of the bladder, urethra, brain, spinal cord, and peripheral nerves.

  • Nurses need to understand the integrated function of urination and identify patient characteristics and common urinary problems.

  • It is important to respect patient needs and privacy.

  • Many factors affect urinary volume and quality, including:

    • Pathophysiological conditions (acute/reversible, chronic/irreversible)
    • Psychological factors
    • Fluid balance
    • Surgical and diagnostic procedures
    • Medications (including anesthesia)
    • Age
    • Diet
    • Fluids intake

  • These factors impact urine production, characteristics, and urination control.

  • Understanding these factors helps nurses and physicians assess patients, be non-judgmental, and plan individualized care.

Assessment of Urine

  • Urine color, clarity, odor, volume, specific gravity, acidity, and abnormal components are important health indicators.
  • Normal urine is a light yellow/amber, color varies with hydration.
  • Overhydration results in nearly colorless urine; dehydration leads to dark amber/orange-brown.
  • Medications, abnormal components, and foods can change urine color.
  • Tables showing these variations are mentioned

Clarity of Urine

  • Freshly voided urine is usually clear/transparent.
  • Cloudiness can indicate abnormal substances (bacteria, blood, proteins, mucous).

Odor of Urine

  • Fresh urine has a characteristic odor.
  • Dilute urine has fewer odors.
  • Concentrated urine, or urine exposed to air for a while, can have a strong, ammonia-like odor.
  • Certain foods/medications can alter urine odor.

Urine Volume

  • Typical urine volume for adults is 250-400 ml/void.
  • Daily urine excretion (diuresis) is 1200-1500 ml in adults.
  • Many factors influence volume (age, diet, fluids, disease).
  • Increased volume (polyuria) can indicate diabetes, diuretics or excessive fluid intake.
  • Decreased volume (oliguria) indicates dehydration, heart failure, kidney problems, severe burns.

Urine Specific Gravity

  • Specific gravity measures the concentration of dissolved substances in urine.
  • Normal urine specific gravity is 1015-1025.
  • Lower values indicate dilute urine, higher values indicate concentrated urine.

Urine pH

  • Urine is usually slightly acidic (pH 4.5-8.5).
  • Abnormal pH can indicate certain conditions.
  • Abnormal components can include glucose, ketones, bilirubin, blood cells, bacteria, and various other components.
  • Tables summarizing these conditions are mentioned.

Urinary Elimination Problems

  • Signs and symptoms of altered urinary elimination, such as painful urination, frequent urination, nocturia (excess urination at night), difficulty urinating, incontinence.
  • Specific circumstances like urinary tract infections, obstructions, prostate issues, neurological problems, and trauma are discussed and related issues.

Urinary Catheterization

  • Types (intermittent, indwelling) and when used
  • Procedures associated with catheterization (appropriate care and sterilization procedures).
  • Reasons for insertion and evaluation
  • Complications of catheterization such as infections.
  • Factors to consider when choosing catheter sizes and materials., including ease of use, suitability (male/female/infant), length, and material type (silicone, latex, etc.).
  • Common catheter types (Foley, Tiemann) and their applications.
  • Appropriate use with children and other vulnerable populations.

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Description

This quiz focuses on the essential aspects of urinary elimination relevant to nursing practice. It examines the integrated functioning of urination and the factors that affect urinary volume and quality. Understanding these concepts is crucial for effective patient assessment and individualized care.

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