urinary elimination

What are the waste products that the urinary system removes?

• urea (produced when protein rich foods are digested)

• creatinine (by product of muscle metabolism)

What are the functions of the kidneys?

• filter liquid waste from the blood

• balance electrolytes in the blood

• regulate blood volume and pressure

• produce erythropoietin for red blood cell formation

• synthesize vitamin D to help control calcium levels

• maintain acid-base balance of the ECF

What is anuria?

failure of the kidneys to produce or excrete urine

What is dialysis?

a technique in which fluids and molecules pass through an artificial semipermeable membrane and are filtered by means of osmosisW

What is hemodialysis?

the patient’s blood flows continually from the body through vascular catheters to the dialysis machine

What is peritoneal dialysis?

performed by instilling dialysis solution into the patient’s abdominal cavity through an external catheter

What is oliguria?

reduced urine volume

• less than 1mL/kg/hr in an infnat

• less than 0.5mL/kg/hr in children

• less than 500mL/day in adult

What could cause oliguria?

prerenal, intrarenal or postrenal failure

What are signs and symptoms of oliguria?

• breathless

• pale

• clammy

• cool skin

• low BP

• edema

• anemia

• changes in heart rhythm

• hepatomegaly

What is polyguria?

an excessive volume of urine formed and excreted each day

• 2500mL or more per day for adults

What can polyuria be caused by?

• consuming large amount of fluids

• consuming caffeine or alcohol

• ingestion of too much salt or glucose

• use of diuretic medications

• diabetes

• imaging tests that involve contrast media or dye, or other disease processes

What is nocturia?

excessive urination at night

What is dysuria?

painful urination

• caused by UTIs, cystitis, STDs, yeast infections, kidney or bladder stones, prostatic enlargement, malignancy etc.

What is hematuria?

abnormal presence of RBCs in urine

• could be caused by

  • inflammation of mucosa and invasion of bacteria

  • malignancy

  • renal stones

  • trauma

  • infection

  • medications

  • tumors of the kidney

  • renal cysts

  • infarction

  • arteriovenous malformations (AVMs)

What is stress incontinence?

loss of urine control during activities that increase intrabdominal pressure (ex: coughing, sneezing, laughing, or exercise)

What is urge incontinence?

sudden or strong urge to void followed by rapid bladder contraaction

What is mixed incontinence?

combination of stress and urge incontinence

What is functional incontinence?

lack of urine control in the absence of any abnormalities in the urinary tract

• occurs when some physical limitation is functioning such as difficulty with clothing fasteners or impaired mobility, hinders reaching toilet before voiding

What is overflow incontinence?

seen in patients who are unable to empty the bladder completely, resulting in a constant dribbling or urine or increased frequency of urination

What is temporary incontinence?

can occur in association with factors such as severe constipation, infections in urinary tract, or medication usage

What is enuresis?

involuntary passing of urine

• may be structural or pathologic, although it may be related to nonurinary problems such as constipation, stress, and illness

What is the most common type of urinary diversion?

orthotopic bladder substitute (ileal neobladder)

• most closely resembles the original bladder in both location and function

What food causes urine to turn pink or red?

• beets

• blackberries

• rhubarb

What food causes urine to turn orange?

• carrots

What food causes urine to turn brown?

• fava beans

• aloe

What food causes urine to turn green?

• asparagus

What medications cause urine to turn brown?

• antimalarial drugs

• laxatives

• metronidazole

What medications turn the urine orange?

• rifampin

• warfarin

• phenazopyridine

What medications turn the urine blue or green?

• cimetidine

• indomethacin

• promethazine

What condition turns the urine blue green?

hypercalcemia

What condition turns the urine brown?

liver failure

What is blood urea nitrogen and creatinine?

used to evaluate renal function

What do increased BUN levels mean?

• disease that is compromising function of kidney

• dehydration

• diabetes

• high BP

• blockage of urinary tract

• high-protein diet

• severe burns

• GI bleeding

What are normal BUN levels?

10 to 20 mg/dL

What causes low BUN levels?

• low protein diet

What medications affect BUN level results?

• certain antibiotics

• corticosteroids

• diuretics

What is normal specific gravity of urine?

1.005 to 1.030

• higher level of specific gravity, the more solid material is contained in the urine

What is the average pH of urine?

6

What does the presence of ketones in the urine mean (ketonuria)?

fat has broken down for energy

• large amounts may indicate:

  • a diet low in sugars and carbs

  • prolonged fasting or starvation

  • vomiting

What is computed tomography used to diagnose?

• kidney stones

• bladder stones

• blockage in urinary tract

***NPO 8 to 12 hours before, may be prescribed a laxative or enema, scan takes 30-60 min, patient must lie still

Why are cystoscopys performed?

to determine cause of:

• hematuria

• dysuria

• incontinence

• frequency

• urgency

• retention

***NPO 8 to 12 hours before, takes up to 45 min, pink tinged urine is common after

What does routine catheter care include?

• urethral meatus cleansed once or twice daily