Exam 4 MEGA Set

KSU Nursing Interventions Exam 4

Structures of the Urinary System

Kidneys, Ureters, Bladder, Urethra.

Functional Unit of the Kidney

Nephron.

Structures of the Urinary System

Kidneys, Ureters, Bladder, Urethra.

Functional Unit of the Kidney

Nephron.

Primary Functions of the Urinary System

Filtration of blood, Elimination of waste via micturition, Regulation of fluid and electrolyte balance.

Bladder Capacity

Approximately 800 mL.

Muscle Responsible for Bladder Contraction

Detrusor muscle.

Sphincters Controlling Urine Release

Internal urethral sphincter and external urethral sphincter.

Trigger for Micturition Reflex

Bladder fills to ~200 mL.

System Controlling Bladder Emptying

Autonomic nervous system.

Why Females are More Prone to UTIs

Shorter urethra allows easier bacterial access.

Why Males Expel Bacteria More Easily

Longer urethra.

Key Urinary Assessment Questions

Changes in urination, pain, history of UTIs or stones, incontinence, pain during or after intercourse.

Cloudy Urine Suggests

Infection or presence of sediment.

Strong Urine Odor Suggests

Urinary Tract Infection (UTI).

Normal Urinary Output Per Hour

30 mL/hr.

Minimum 24-Hour Urine Output

720 mL.

Decreased Output Despite Normal Intake

Obstruction, kidney dysfunction, fluid loss.

Polyuria Definition

Excessive urine output.

Oliguria Definition

Decreased urine output.

Anuria Definition

Absence of urine production (<50 mL/24 hrs).

Urgency Definition

Sudden, compelling urge to void.

Frequency Definition

Frequent urination without increased total output.

Nocturia Definition

Waking at night to urinate.

Hematuria Definition

Blood in urine.

Microscopic vs Gross Hematuria

Microscopic: seen under microscope. Gross: visible to naked eye.

Pyuria Definition

Presence of pus in urine.

Urinary Retention Definition

Inability to fully empty the bladder.

Enuresis Definition

Bedwetting.

How Sodium Affects Urine Output

High sodium causes water retention, reducing urine output.

Effect of Purines on Urinary Health

these foods increase risk for kidney stones.

Mobility and Urination

Limited mobility can prevent access to toilet.

Neurologic Injury and Urination

May cause retention or incontinence due to sensation or control loss.

Why Pregnant Women Urinate More

Hormones, blood volume, and fetal bladder pressure.

Diuretics Effect on Urination

Increase urine output.

Cholinergic Medications and the Bladder

Stimulate detrusor muscle, promote urination.

CNS Depressants Effect on Urination

Reduce bladder responsiveness to signals.

Stress Incontinence Definition

Leakage during increased abdominal pressure.

Urge Incontinence Definition

Sudden urge followed by involuntary urine loss.

Functional Incontinence

Loss of urine due to physical or environmental barriers.

Total Incontinence

Continuous, unpredictable urine loss.

Purpose of Kegel Exercises

Strengthen pelvic floor muscles to manage incontinence.

Kegel Exercise Routine

Contract 5-10 sec, release, repeat 10 times daily.

Purpose of Urinalysis

Assesses pH, protein, glucose, ketones, blood, bacteria, specific gravity.

Normal Specific Gravity Range

1.010-1.025.

High Specific Gravity Indicates

Concentrated urine (possible dehydration).

Low Specific Gravity Suggests

Diluted urine (overhydration or renal impairment).

Purpose of 24-Hour Urine Collection

Evaluate kidney excretion of waste and protein.

Kidney Function Blood Tests

BUN and Creatinine.

Purpose of Bladder Scan

Assess bladder volume and retention.

Purpose of Intravenous Pyelogram (IVP)

Detect structural abnormalities using dye.

Purpose of Cystoscopy

Direct visualization of bladder interior.

When to Use Clean Catch Sample

For urinalysis and cultures.

Sterile Urine Sample Use

For culture and sensitivity tests.

Where to Collect Urine from a Catheter

From the sampling port, not the bag.

Difference: Intermittent vs Indwelling Catheter

Intermittent: temporary. Indwelling: long-term with balloon.

Suprapubic Catheter

Surgically inserted through abdominal wall into bladder.

Coudé Catheter Use

Easier insertion in patients with enlarged prostate.

How Often to Empty Catheter Bag

Every 8 hours or when full.

Why Keep Drainage Bag Below Bladder

Prevent backflow and infection.

French Scale Measures

Catheter size (larger number = larger diameter).

Typical Adult Catheter Size

14-18 French.

Sterile Field Boundary

1-inch margin is considered non-sterile.

Unattended Sterile Field

Considered contaminated.

Where to Touch Sterile Packages

Only the outside and 1-inch margin.

Which Hand Becomes Non-Sterile First

The hand that touches the patient.

Female Catheter Insertion: Swabs

3 swabs: one per labia minora, one urethra.

Male Catheter Insertion: Cleaning

Outward circular motion, new swab each time.

How Far to Advance Catheter After Urine

2 more inches.

3 Ways to Prevent CAUTI

Limit catheter use, sterile insertion, daily peri care.

Should Antiseptics Be Used for Daily Catheter Care?

No, use regular cleaning products unless ordered.

Preventing Catheter Tubing Obstruction

Avoid kinks and maintain gravity drainage.

Incontinence and Skin Integrity

Moisture can cause skin breakdown and infection risk.

Best Skin Protection from Incontinence

Keep dry, breathable pads, barrier creams.

Why Toileting is a Fall Risk

Urgency + impaired mobility = unsafe toileting.

Targeted Toileting Times

On waking, post-meals, before bed.

Fundamentals Textbook

Resource for additional IV content support.

Scrub-the-Hub Technique

Cleans IV hub to prevent contamination.

Patency Checks

Verify IV catheter functionality regularly.

Blood Return

Confirm blood flow to ensure IV patency.

Medication-Specific Requirements

Check specific protocols for IV administration.

Infusion Pump Use

Training includes operating devices for IV fluids.

Peripheral IV Therapy

Focus on equipment, not insertion techniques.

Continuous Infusions

Administer fluids consistently over time.

Intermittent Infusions

Includes secondary or piggyback IV setups.

Direct IV Administration

Also known as IV push for immediate effects.

IV Catheter Design

Flexible tube remains after needle removal.

Gauge Sizes

Smaller numbers indicate larger IV catheter diameters.

Color Codes for Gauges

Light blue for 22 gauge, orange for 14 gauge.

Extension Tubing

Connects catheter to IV equipment, 3-4 inches long.

Needleless System

Prevents needle access, enhancing safety.

Priming Tubing

Filling tubing with fluid to remove air.

Clamp Types

Control flow in IV tubing: pinch, slide, roller.

No-Touch Technique

Avoid touching sanitized parts to maintain sterility.

Needleless Connectors

Protect unused IV connectors from contamination.

IV Catheter Assessment

Includes checking placement and visibility during exams.

Transparent Film Dressings

Allow visualization of IV insertion sites.

Transparent film dressings

Allow visualization of IV insertion site.

IV site assessment

Check for redness, swelling, pain, or leakage.

Coban Wrap

Prevents dislodgement during patient movement.

Assessment frequency

Minimum every four hours for continuous infusions.

IV patency

Confirmed once per shift and before use.