Urinary Elimination Overview
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Questions and Answers

What is the primary function of the urinary system?

  • Digestion of food
  • Maintaining blood pressure
  • Respiration
  • Formation and elimination of urine (correct)
  • The gastrointestinal organs have no role in urine formation.

    True (A)

    Name one psychological factor that may alter the elimination process.

    Anxiety

    The urinary system includes the kidneys, ureters, bladder, and ______.

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

    Match the following terms with their corresponding features:

    <p>Normal urine = Pale yellow color Dehydrated urine = Dark yellow color Infection = Cloudy appearance Diabetes = Sweet smell</p> Signup and view all the answers

    What is a common complication associated with urinary catheterization?

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

    Which of the following should be assessed before a diagnostic examination?

    <p>Allergies to iodine or contrast dye (B)</p> Signup and view all the answers

    An indwelling catheter is also known as a straight catheter.

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

    How often should long-term catheters be changed?

    <p>Every 4-6 weeks</p> Signup and view all the answers

    Foul odor from a bedside commode is a normal occurrence.

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

    What is an important nursing responsibility during the laboratory process?

    <p>Label all specimens.</p> Signup and view all the answers

    The ________ catheter system is specifically designed for female patients.

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

    Match the type of catheter with its description:

    <p>Indwelling catheter = Catheter inserted and remains in place for an extended period External female catheter = External system for female patients using suction Suprapubic catheter = Inserted through an incision in the lower abdomen Condom catheter = External option for male patients to manage urinary incontinence</p> Signup and view all the answers

    Nurses should encourage fluid intake especially if using __________ dye.

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

    Match the safety guidelines to their corresponding actions:

    <p>Identify patients at risk for latex allergies = Take precautions during patient care Assess for allergies to povidone-iodine = Provide alternatives such as chlorhexidine Follow principles of surgical and medical asepsis = Maintain a sterile environment Evaluate changes in the patient’s voiding pattern = Determine effectiveness of nursing interventions</p> Signup and view all the answers

    What is the primary function of the kidneys?

    <p>Stimulation of red blood cell production (B), Control of blood pressure (C)</p> Signup and view all the answers

    The female urethra is longer than the male urethra.

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

    What is a common consequence of an obstruction in the ureters?

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

    The functional units of the kidneys are called __________.

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

    Match the urinary organs with their functions:

    <p>Kidneys = Filter blood and produce urine Ureters = Carry urine to the bladder Bladder = Reservoir for urine Urethra = Conducts urine out of the body</p> Signup and view all the answers

    What percentage of glomerular filtrate is usually excreted as waste?

    <p>1% (A)</p> Signup and view all the answers

    Urine in the ureters is typically sterile.

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

    What enzyme is released by the kidneys when there is decreased blood supply?

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

    Which of the following complications can arise from urinary catheterization?

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

    What is a common diagnostic test used to visualize the urinary tract using contrast dye?

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

    Continent urinary diversions allow patients to have control over their urine flow.

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

    What is one method to prevent catheter-associated urinary tract infections (CAUTI)?

    <p>Timely removal of urinary catheters</p> Signup and view all the answers

    Cloudy urine is a normal characteristic and does not indicate infection.

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

    What is the normal pH range for urine?

    <p>4.6 to 8</p> Signup and view all the answers

    A permanent urinary diversion through the abdominal wall is known as a(n) ______.

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

    Which technique is crucial during the placement of a urinary catheter?

    <p>Sterile technique (A)</p> Signup and view all the answers

    Normal urine color ranges from pale straw color to ______.

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

    Match the following urine characteristics with their potential implications:

    <p>Pale straw color = Normal Cloudy urine = Potential infection Red or pink-tinged urine = Possible blood presence Strong ammonia odor = Normal</p> Signup and view all the answers

    Match the following urinary diversion types with their characteristics:

    <p>Continent urinary reservoir = Requires self-catheterization Orthotopic neobladder = Replaces bladder anatomically Ileal conduit = Permanent urinary diversion Nephrostomy tubes = Drains obstructed renal pelvis</p> Signup and view all the answers

    Bladder spasms are a sign of a successful urinary catheterization.

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

    Which of the following would indicate a concerning finding in a urinalysis?

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

    Self-image and self-esteem can be affected by incontinence.

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

    What must patients with a continent urinary reservoir be willing to do daily?

    <p>Catheterize 4-6 times a day</p> Signup and view all the answers

    What is the purpose of measuring intake and output in a clinical setting?

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

    Flashcards

    Urinary System Functions

    The urinary system is responsible for the formation and elimination of urine, regulating fluid balance and excretion of waste.

    Diagnostic Tests

    Common tests for assessing urinary function include urinalysis, urine culture, and imaging studies.

    Factors Impacting Urination

    Factors affecting urinary elimination include hydration level, medication, and psychological state.

    Normal vs Abnormal Urine

    Normal urine features include pale yellow color and clear appearance, while abnormal urine may indicate disease or infection.

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    Nursing Interventions

    Nurses can promote normal urinary elimination through patient education, encouraging fluid intake, and monitoring bladder function.

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    Indwelling catheter

    A catheter that remains inside the bladder, often with a balloon to hold it in place.

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    Catheter maintenance

    Regular changes of catheters every 4-6 weeks in long-term use to minimize risk of infection.

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    Closed drainage system

    A catheter system that prevents contamination and maintains a sterile pathway for urine drainage.

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    Continuous bladder irrigation

    A procedure using normal saline to flush the bladder, especially after surgery to remove clots.

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    Potential infection from catheters

    The most common complication associated with catheter use; requires careful monitoring.

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    CAUTI

    Catheter-Associated Urinary Tract Infection, an infection from catheter use.

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    Biofilm

    A slimy layer formed by bacteria on surfaces, including catheters.

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    Complications of Catheterization

    Issues like bladder spasms, pain, and kidney damage from long-term catheter use.

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    Joint Commission NPSG

    Guidelines for preventing infections related to catheter use.

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    Urinary Diversion

    Surgical procedure to redirect urine flow, either temporary or permanent.

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    Continent Urinary Diversion

    A urinary diversion that allows patient control over urination, e.g., neobladder.

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    Incontinent Urinary Diversion

    A permanent diversion without control over urine flow, e.g., ureterostomy.

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    Nephrostomy Tubes

    Small tubes for draining urine from the renal pelvis due to obstruction.

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    Infection Control Principles

    Methods used to prevent infection spread, especially UTIs.

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    Nocturnal Enuresis

    Nighttime incontinence, common in children and some adults.

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    Psychosocial Implications of Incontinence

    How incontinence affects self-image and cultural views.

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    Intake and Output Measurement

    Tracking fluid intake and urine output for assessment.

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    Urinalysis Normal Values

    Reference ranges for urine tests indicating health status.

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    Imaging Tests for Urinary Tract

    Diagnostic procedures like x-rays and ultrasounds for urinary issues.

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    Characteristics of Normal Urine

    Normal urine should be pale straw to amber and transparent.

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    Abnormal Urine Indicators

    Signs like color changes, cloudiness, or strong odor indicating possible issues.

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    Foul odor in commode

    A foul odor is considered abnormal and may indicate an issue.

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    Specimen labeling

    All specimens must be labeled and preserved according to lab protocols.

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    Patient consent for procedures

    Signed consent is required before diagnostic examinations according to agency policy.

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    Monitoring after procedures

    Assess intake and output (I&O), voiding, urine, and encourage fluids post-procedure.

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    Evaluating patient outcomes

    Determine if patient interventions are effective based on expected outcomes and changes in symptoms.

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    Urinary Tract Organs

    The organs that include the kidneys, ureters, bladder, and urethra.

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    Nephrons

    The functional units of the kidneys responsible for filtration.

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    Glomerulus

    A cluster of capillaries in the nephron that filters blood.

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    Erythropoietin

    A hormone produced by the kidneys that stimulates red blood cell production.

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    Renin-Angiotensin System

    A hormone system regulating blood pressure through fluid balance.

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    Ureters

    Tubes that carry urine from the kidneys to the bladder.

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    Bladder

    A distensible organ that stores urine before elimination.

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    Urethra

    The tube that carries urine from the bladder to the outside of the body.

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    Study Notes

    Urinary Elimination Overview

    • Urinary elimination is a fundamental human function
    • This function can be affected by illness or procedures
    • Urination involves the bladder, urinary sphincter, and the central nervous system (CNS)
    • Most people experience a strong urge to urinate when the bladder holds 400-600 milliliters of urine
    • Nurses' role includes assessing urinary tract functions and supporting bladder emptying

    Urinary Tract Organs

    • Kidneys: Nephrons (functional units) contain glomeruli, act as filters; large proteins do not normally filter; 99% of filtrate reabsorbed
    • Ureters: Carry sterile urine to the bladder; obstruction can cause backflow
    • Bladder: Distensible muscular reservoir; low pressure during filling to prevent backflow infections; expands as it fills
    • Urethra: Urine travels through the urethra from the bladder; female urethra (3-4 cm) shorter than male (18-20 cm), which increases risk for UTIs

    Kidneys - Detailed Role

    • Essential for erythropoietin production, which stimulates red blood cell production and maturation
    • Role in blood pressure control through renin-angiotensin system; decreased blood supply triggers renin release, converting angiotensinogen to angiotensin II, which stimulates aldosterone release, causing water retention and increased blood pressure.

    Urinary Tract Infections (UTIs)

    • Infections primarily caused by E. coli
    • Classified by location: upper-kidney or lower-bladder/urethra
    • Elderly individuals may have atypical presentations with nonspecific symptoms (e.g., delirium, confusion, fatigue, loss of appetite).

    Urinary Incontinence

    • Involuntary loss of urine
    • Types include: transient, functional, overflow, stress, urge/urgency, and reflex incontinence

    Urinary Catheterization

    • When should a catheter be used?
    • Minimizing infection risk is critical
    • Following CDC infection control guidelines is essential
    • Types of catheters include: indwelling Foley, external female catheter, intermittent catheters, and suprapubic catheters

    Potential Complications of Urinary Catheterization

    • Infection: The most common problem; bacteria can enter the bladder, urethra, urinary tract, or kidneys
    • Biofilm: A protective coating that can form around the catheter
    • Other complications include: leaks, bladder spasms, pain, bladder stones, injury to urethra or kidneys (with long-term use).

    Nursing measures to prevent CAUTIs

    • Following infection control principles
    • Preventing inappropriate short-term catheter use
    • Nurse-driven timely removal of catheters
    • Using appropriate sterile techniques
    • Meticulous catheter care during indwelling catheter use

    Urinary Diversions

    • Temporary or permanent
    • Continent (urine is stored in a pouch; catheter insertion into the stoma for emptying) vs. incontinent (e.g., ureterostomy or nephrostomy) diversions
    • Different types include continent urinary reservoirs, orthotopic neobladders, and ileal pouches

    Assessment

    • Intake and output measurements (including what to include)
    • Kidney percussion to detect flank pain
    • Bladder palpation for distention, tenderness, and pain
    • Utilizing bladder scanners if retention suspected
    • Assessment of external genitalia and urethral meatus (inspect for drainage, inflammation, swelling, or lesions).
    • Perineal skin assessment (for erythema, moisture, erosion, itching, or burning pain)
    • Knowledge of common diagnostic urine tests/values and their normal range (e.g., urinalysis, pH, specific gravity, glucose, ketones)

    Laboratory, Diagnostic and Imaging Tests

    • Urine tests (e.g., urinalysis, culture and sensitivity)
    • Diagnostic tests, including but not limited to, radiography, CT scans, and ultrasounds

    Nursing Responsibilities in Urinary System

    • Provide education on aspects like specimen handling, infection control, and diagnostic procedures.
    • Obtain informed consent from patients and adhering to agency policies for diagnostics (e.g., allergies to iodine and contrast dye). Ensure patients follow the appropriate diet; assessing fluid intake especially if radiopaque dye is used.
    • Document and reassess fluid balance

    Evaluation and Safety Guidelines

    • Assess patient's self-image, social interactions, sexuality, and emotional status to determine their view of the situation
    • Evaluate patient outcomes to measure intervention effectiveness and changes in voiding patterns/presence of symptoms
    • Assess patient/caregiver compliance with the plan
    • Following surgical and medical asepsis principles; identifying patients at risk for latex allergies or allergies to povidone-iodine, with alternative use of chlorhexidine

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    Description

    Explore the basic functions and organs involved in urinary elimination. This quiz covers the anatomy of the urinary tract, the role of the kidneys, and the importance of proper urination. Test your knowledge on how these systems interact and their clinical significance.

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