NURS Fundamentals Exam 2 Prep - Elimination

What are the kidneys?

filter blood and convert waste products into urine

What are the ureters?

transport urine from kidneys to bladder

What is the bladder?

holds urine

What is the urethra?

conveys urine from the bladder to the exterior

What is urination (micturition)?

process of emptying bladder utilizing muscles and sphincters to control

What are diuretic medications?

increased the output of dilute urine

When should diuretics be administered?

morning

What is urine output?

key indicator of fluid volume status and perfusion

What is expected urinary output for an adult?

approx. 0.5 mL/kg/hr (30 ml/hr)

What are age-related considerations for the urinary tract and elimination?

noctuira, increased frequency, urine retension and stasis

What is urine retention and stasis?

due to loss of tone

What is the result of urine retention and stasis?

susceptible to UTIs

What is anuria?

24-hour urine output is less than 50 mL

What is dysuria?

painful or difficult urination

What is glycosuria?

presence of glucose in the urine

What is nocturia?

awakening at night to urinate

What is oliguria?

24-hour urine output is less than 400 mL; abnormally low urine output

What is polyuria?

excessive output of urine (diuresis)

What is proteinuria?

protein in the urine

What is pyuria?

pus in the urine

What is urgency?

strong desire to void

What is urinary incontinence?

involuntary loss of urine

What are diuretics?

prevent reabsorption of water and certain electrolytes in tubules

What are cholinergic medications?

stimulate contraction of destrusor muscle, producing urination

What are analgesics and tranquilizers?

suppress CNS, diminish effectiveness of neural reflex

What are nephrotoxic drugs?

ibuprofen, ASA, gentamycin

What should me monitored when on diuretics?

electrolyte levels

What is the result of a suppressed CNS?

involuntary urinary retention

What is urine color when on anticoagulants?

red urine (bloody)

What is urine color when on diuretics?

pale yellow urine

What is urine color when on pyridium?

orange to orange-red urine

What is Pyridium?

UTI associated pain

What is urine color when on amitriptyline?

green or blue-green urine

What is urine color when on levodopa?

brown or black urine

What is urine color when on nsenna glycoside?

yellowish-brown

What are types of urinary incontinence?

stress, urge, reflex, overflow, functional

What is stress urinary incontinence?

leakage with laughing, coughing, or sneezing

What is urge urinary incontinence?

strong urge to urinate with leaking occurs before getting to the toilet

What is reflex urinary incontinence?

urinary leakage because of nerve damage

What is overflow urinary incontinence?

incomplete bladder empyting that leads to overfilling and leakage

What is functional urinary incontinence?

physical/environmental barriers prevent timely toileting

What are interventions for urinary incontinence?

lifetsyle changes, limit caffeine/alcohol, pelvic floor exercises (kegels), bladder training, medications, devices, or surgery

What is urinary retention?

inability to completely empty the bladder

Who is most susceptible to urinary retention?

males; often related to enlarged prostate

What can result from urinary retention?

UTI, bladder damage, or kidney damage

What are conditions that alter urinary elimination?

dehydration, UTIs, kidney stones, kidney failure, prostate enlargement

What are signs of dehydration?

pee looks dark and concentrated

What is dehydration?

negative fluid balance; increased urine concentration (elevated BUN)

What are risk factors for UTIs?

sexually active people with female genitalia, people with indwelling urinary catheter in place, older adults (improper wiping)

What are kidney stones?

can lead to (dysuria) painful urination, hematuria (blood in urine), frequency/urgency

What is kideny failure?

as kidney function declines, urinary elmination decreases

What is the result of kidney failure?

increase in creatinine, electrolye imbalances (hyperkalemia)

What is prostate enlargement?

benign prostatic hyperplasia (BPH), leads to urinary retention

What are urinary diversions?

urinary catheterization, ureteral stent, urostomy, nephrostomy

What is a caution for urinary cath. use?

risk of infection

What are types of urinary catherizations?

intermittent urethral catheters, indwelling urethral catheter, suprapubic catheter

What are reasons for catheterizaiton?

relieve retention, obtaining a sterile specimen, empuyting bladder before, during, and after surgery, monitoring critcially ill patients, increasing comfort for terminally ill patients

What is catheter care?

separate from daily care, empty using clean technique, empty prior to transport, keep below level of bed, pressure ulcers

What is a ureteral stent?

bypass a blockage

What is a urostomy?

surgical creation of a stoma; ureters attached to small intestine to form stoma

What is a nephrostomy?

tube drains urine directly from kidneys; usually temporary during kidney stones or injury

What is a nursing urinary assessment?

palpate bladder, assess skin, assess urine

What is palpation of the bladder?

distended bladder can be felt between symphysis pubis and umbilicus

What is skin assessment?

assess color, texture, turgor (assess hydration status)

What is urine assessment?

assess color, odor, clairty, and sediment

What are urinary diagnostic tests?

post void residual, urine specimen collection, labs

What is a post void residual?

bladder scanning

What is urine specimen collection?

urinalysis, urine culture, 24-hour urine collection

What is a urinalysis?

the clean-catch midstream method is the most used approach

What is a urine culture?

sterile specimen container for urine collection, gloves, a waterproof pad, and sanitary wipes for the client

What is a 24-hour urine collection?

urine to be collect over a 24-hour period in a special container and refrigerated or kept on ice

What are methods to collect urine specimens?

clean catch, catherterization

What is a clean catch?

patient starts to uriante, stop, and then urinate in the specimen cup

What is catherterization?

a catheter to colelct urine; sterile technique

What labs are taken for urine collection?

elevated BUN and creatinine

What is a normal BUN?

6-20 mg/dL (100 mL)

What is a normal creatinine?

0.6 - 1.3 mg/dL

What are urinary nursing interventions?

urinal and bedpan use, bladder irrigation, bladder training, bladder scanning, atherization, medication, measuring urine output

What is bladder irrigation?

solution is flushed into the bladder via a urinary catheter

What is bladder training?

setting a schedule to use the bathroom

What is bladder scanning?

noninvasive nursing assessment used to estimate bladder urine volume

What are antidiuretics?

help decrease urine volume

What controls peristlasis?

nervous system

What is the stomach?

stores food, secretes digestive fluids, churns food to aid in digestion

What is the small intestine?

secretes enzymes that digest proteins and carbohydrates; digestion of food and absorption into the bloodstream

What is the large intestine?

primary organ of bowel elimination

What is the function of the large intestine?

asborption of water, formation of feces, expulsion of feces from the body

What can contribute to constipation?

decreased peristalsis

What is constipation?

infrequent bowel movements, often defined as three or less bowel movements in a week

What are characteristics of constipation?

stools are hard, lumpy, and difficult to pass

What are causes of constipation?

decreased mobility, dehydration

What meds cause constipation?

aluminum-containing antacids, anticholinergics and antispasmodics, diuretics, oral iron supplements, opiates

What are interventions for constipation?

a high-fiber diet, hydration, exercise, scheduled toileting/bowel training

What foods should be avoided for constipation?

cheese, lean meat, eggs, pasta

What is diarrhea?

refers to experiencing frequent loose, watery sttols throughout the day (typically three+ in 24 hour)

What meds cause diarrhea?

magnesium, antibiotics

What can result from frequent watery stools?

dehydration; monitor vital signs (BP/HR)

What foods should be avoided for diarrhea?

fruits and vegetbales, bran, chocolate, alcohol, coffee

What is bowel incontinence?

refers to accidental bowel leakage

What is the most common type of incontinence?

urge