WK2: urinary elimination

micturition

urination; occurs when a complex neural response allows the bladder to contract, the urethral sphincter to relax, and urine to leave the body through the urethra

hematuria

blood in urine, sign of glomerular injury

renin

part of RAAS; released from juxtaglomerular cells when BP decreases, converting angiotensin into angiotensin I

pyelonephritis

kidney infection

bacteremia

when bacteria spreads to bloodstream

bacteriuria

bacteria in the urine

dysuria

burning sensation during urination

cystitis

inflammation of the bladder, causing frequent and urgent sensation of the need to void and may cause incontinence

catheter-associated UTI (CAUTI)

results in increased length of hospital stay, morbidity, and morality for patients

urinary incontinence (UI)

any complaint of involuntary loss of urine, often occuring with other lower urinary tract symptoms

nocturia

the need to get up at night on a regular basis to urinate and the number of times urine is passed during the main sleep period

urinary retention

the marked accumulation of urine in the bladder due to the bladder’s inability to empty

urinary diversion

a urinary stoma to divert the flow of urine from the kidneys directly to the abdominal surface

transient UI

urine loss resulting from causes outside of or affecting the urinary system that resolves when the underlying causes are treated

urge UI

involuntary loss of urine associated with urgency, frequency, or nocturia; can be part of overactive bladder syndrome

stress UI

involuntary loss of urine on effort or physical exertion, including sporting activities, or on sneezing or coughing

mixed UI

urine loss that has both stress and urge incontinence

overflow UI

involuntary loss of urine when the bladder does not completely empty with a high residual urine volume or a palpable nonpainful bladder remaining after voiding

functional UI

urine loss due to inability to reach the toilet

neurogenic bladder dysfunction

lower urinary tract dysfunction caused by an underlying disease or disorder of the nervous system. symptoms: urge, incontinence, frequency, and retention

nephrostomy tubes

insertion of a tube directly into the renal pelvis to provide urinary drainage

postvoid residual (PVR)

the volume remaining in the bladder after a void

urgency

report of a sudden, compelling desire to pass urine which is difficult to defer; may be due to overactive bladder syndrome

hesitancy

report of delay in initiating voiding (when individual is ready to pass urine); may be due to hypotonic bladder, anxiety, urethral stricture, or obstruction associated with prostate enlargement

polyuria

report that urine excretion volume over 24 hrs is noticeably larger than previous excretion; due to excess fluid intake, diabetes, diuretic use, etc

oliguria

diminished urinary output relative to intake; due to dehydration, renal failure, increased ADH secretion

dribbling

leakage of urine despit voluntary control of urination; due to stress incontinence, overflow from urinary retention, postvoid pooling of urine in urethra

pH

usually 4.6-8.0; urine that stands for several hours becomes alkaline

protein

usually none, but very little may be found in urine; seen more in renal disease because damage to glomeruli or tubules allows for entry

glucose

usually none found in normal urine; presence may indicate diabetes or ingestion of high concentrations (for healthy people)

ketones

none found in normal urine; present for diabetes mellitus patients or patients with dehydration, starvation, or excessive aspirin usage

blood

none found in normal urine (unless on cycle for females); presence may indicate damage, trauma, or surgery of the lower urinary tract, glomeruli, or tubules

specific gravity

measures the concentration of particles in urine; high = concentrated, low = diluted; normal range from 1.010-1.025

white blood cells

very little to none found in normal urine; greater numbers may indicate UTI

bacteria

none found in normal urine; presence indicates UTI, patient may or may not have symptoms

casts

cylindrical bodies whose shapes take on the likeliness of objects within the renal tubule; presence in urine is always an abnormal finding and indicates renal alterations

abdominal roentgenogram

noninvasive; determines size, shape, symmetry, and location of the kidneys; diagnose urinary calculi; preliminary X-ray imaging before IVP

CT scan

noninvasive; used to obtain detailed images of structures within a selected plane of the body; computer recinstructs cross-sectional image

intravenous pyelogram (IVP)

noninvasive; used to view collecting ducts, renal pelvis, and outline the ureters, bladder, and urethra using dye, which is excreted through urine

retrograde pyelogram

noninvasive; used to provide detailed anatomical views of the ureter, ureteropelvic junction, renal pelvis, and calyces

retrograde urethrogram

noninvasive; used to obtain oblique X-ray films of the male urethra by instilling a small volume of iodine-bound contrast material into the urethra from a retrograde direction

renal (kidney) scan

noninvasive; used to determine renal blood flow, anatomical structure of kidneys, and excretory function using a radioisotope

renal ultrasonography

noninvasive; used to identify gross renal structures and structural abnormalities in the kidney using high frequency, inaudible sound waves

bladder ultrasonography

noninvasive; used to identify structural abnormalities of bladder or lower urinary tract; also used to estimate volume of urine in bladder

endoscopy

invasive; uses endoscope for direct visualization, specimen collection, or treatment of the interior of the kidney, ureter, bladder, and urethra

arteriogram

invasive; used primarily to visualize the renal arteries of their branches to detect narrowing or occulsion

uroflowmetry

measures the rate of urine expelled and is noninvasive

catheterization

involves introducing a narrow tube through the urethra and into the bladder to allow a continuous flow of urine into a drainage receptacle

incontinence-associated dermatitis (IAD)

type of irritant dermatitis and moisture associated skin damage caused by prolonged exposure to urine or stool on the skin