Urinary System Assessment, Infections, Incontinence & Catheter Care

Vocabulary flashcards summarizing essential terms, concepts and devices related to kidney labs, UTIs, types of incontinence, catheter care, and urinary diversions from the lecture.

Blood Urea Nitrogen (BUN)

Waste product of protein metabolism; rises with renal impairment, high-protein diet or dehydration; normal ~7-20 mg/dL.

Creatinine

Waste from normal muscle metabolism; most specific routine lab for kidney function; elevated with renal failure or severe dehydration.

BUN/Creatinine Ratio

Comparison of the two labs; both high suggests kidney impairment, isolated high BUN usually points to dehydration.

Urine Specific Gravity

Measure of urine concentration; normal 1.003-1.030 (book 1.005-1.030); high = concentrated/dehydrated, low = dilute.

Nephrotoxic Medications

Drugs (e.g., aminoglycosides, NSAIDs) that can damage kidneys; may need to be held if BUN/Cr rising.

Dehydration

Deficit of body water; elevates BUN, creatinine, urine specific gravity and predisposes to UTIs.

High-Protein Diet

Can raise BUN without renal damage because more protein is metabolized to urea.

Urinary Tract Infection (UTI)

Microbial infection anywhere from urethra to kidneys; classic symptoms frequency, urgency, dysuria, cloudy foul urine.

Cystitis

Inflammation/infection of the bladder; often interchangeable term for lower UTI.

Pyelonephritis

Upper UTI; infection reaches kidneys, causing flank pain, fever, hematuria, possible sepsis.

Leukocytes (in urine)

White blood cells detected on dipstick; indicate infection or inflammation such as UTI.

Dysuria

Painful or difficult urination; common UTI symptom.

Hematuria

Blood in urine; may appear with severe cystitis, pyelonephritis or catheter trauma.

Acute Confusion (Delirium)

Common first sign of UTI in older adults owing to atypical presentation.

Catheter-Associated UTI (CAUTI)

Nosocomial infection linked to indwelling catheter; risk rises each day catheter remains.

Indwelling Catheter (Foley)

Double-lumen tube left in bladder; balloon keeps it in place; provides continuous drainage.

Straight Catheter (Intermittent)

Single-lumen, no balloon; inserted once to drain bladder or obtain sterile specimen, then removed.

Suprapubic Catheter

Catheter placed surgically through abdominal wall into bladder; lower infection rate than urethral Foley for long-term use.

PureWick Female External Catheter

Soft external device connected to low continuous suction to collect urine without entering urethra.

Condom Catheter

External male urinary collection device resembling a condom attached to drainage tubing.

StatLock

Securement device that anchors catheter tubing to thigh, reducing traction and urethral trauma.

Dependent Loop (Tubing)

Sagging loop below drainage bag level; impedes flow and promotes backflow/bacterial growth—must be avoided.

Five Goals of Indwelling Catheter Care

Keep system CLOSED, FLOWING, and CLEAN; maintain skin integrity; encourage normal urine production; remove ASAP.

Bladder Irrigation

Flushing bladder via catheter (intermittent or continuous) to prevent clots or instill medication.

Post-Void Residual

Volume left in bladder after urination; assessed by bladder scan or straight cath to diagnose retention.

Bladder Scan

Portable ultrasound estimating bladder volume non-invasively.

Stress Incontinence

Leakage with increased intra-abdominal pressure (cough, sneeze, jump); due to weak pelvic floor.

Urge Incontinence

Sudden strong need to void followed by involuntary loss; associated with detrusor overactivity/overactive bladder.

Mixed Incontinence

Combination of stress and urge features; common in older women.

Reflex Incontinence

Unconscious release when bladder reaches certain volume, often from neurologic injury (spinal cord).

Functional Incontinence

Loss of urine because physical or cognitive barriers prevent reaching or using toilet in time.

Transient Incontinence

Temporary leakage caused by reversible factors (UTI, diuretics, acute illness).

Overflow Incontinence

Constant dribble or weak stream from over-distended bladder, usually due to obstruction or impaired detrusor.

Benign Prostatic Hyperplasia (BPH)

Enlarged prostate that obstructs urine flow, causing retention and possible overflow incontinence.

Pelvic Floor Muscles

Musculature supporting bladder, uterus and rectum; weakness leads to stress incontinence.

Kegel Exercises

Repeated voluntary contraction of pelvic floor to strengthen muscles and reduce stress incontinence.

Scheduled Voiding

Behavioral technique of toileting on a fixed timetable (e.g., every 2 h) to reduce accidents.

Pelvic Floor Physical Therapy

Specialized rehab to improve pelvic muscle strength and bladder control.

Pessary

Vaginal device supporting pelvic organs to decrease pressure on bladder and reduce incontinence.

Penile Clamp

External clamp applied to penis to control male stress or post-prostatectomy leakage.

Artificial Urinary Sphincter

Implanted cuff and pump system that mechanically closes urethra; patient squeezes pump to void.

Sacral Nerve Stimulator

Implanted device delivering mild electrical pulses to sacral nerves to calm overactive bladder.

Skin Barrier Cream

Protective ointment applied to perineal skin to prevent breakdown from urine exposure.

Clean-Catch Urine Specimen

Midstream collection technique that minimizes contamination for culture testing.

Reagent Dipstick

Multi-test strip detecting leukocytes, nitrates, glucose, protein, pH, specific gravity, etc.

Specific Gravity Normal Range

Typical adult range 1.003-1.030; textbook often cites 1.005-1.030.

Hydration Status

Fluid balance indicator assessed via labs, skin turgor, intake/output, and urine concentration.

Ileal Conduit (Conventional Urostomy)

Urinary diversion using isolated ileum segment that brings continuous urine flow to abdominal stoma.

Indiana Pouch

Continent urinary diversion forming internal reservoir from bowel; emptied intermittently by self-catheterization.

Stoma

Surgically created external opening (e.g., of ileal conduit); should be beefy red and moist.

Peristomal Skin

Skin surrounding a stoma; prone to maceration and yeast infection, requires vigilant care.

Mucus in Ileal Conduit Urine

Normal finding because conduit is made from intestinal tissue that secretes mucus.

CAUTI Prevention Motto

"Keep it CLOSED, keep it FLOWING, keep it CLEAN"—core principles for Foley management.