Elimination - Urination
No description yet. This curated deck is ready for daily study.
Card preview (24)
Why are women more from to UTI compared to men?
Female urethra is shorter, 1.5-2’’, making it more prone to UTI, where as male urethra 5.5-6 ¼’’
Generally describe the physiology/act of urination
1. Bladder volume increases 2. Stretch receptors triggered 3. Transmits impulse to spinal cord 4. Internal sphincter relaxes, urge to void • If appropriate place and time, external urethral sphincter muscle relaxes and urination takes place • If time, place inappropriate, then reflex subsides until stimulated again
T/F: Intake must not equal output
False, intake = output
Know the quantity of mL that you should be intaking and outputting. In regards to intake, how make mL comes from: • Drinks • Water in food • Metabolism byproduct In regards to ouput, how make mL comes from: • Urine • Lungs • Skin • Sweat • Feces
Intake - 2500 mL • Drinks = 1500 • Water in food = 750 • Metabolism by product = 250 Output - 2500 mL • Urine = 1500 • Lungs = 400 • Skin = 400 • Sweat = 100 • Feces = 100
How many cups of water is needed? How many mL?
8-10 cups (8 ounces) per day = 2000-3000 mL
Tenting is a sign of _________
dehydration
What type of patient problems will need I&O (Hint: 3) Know disease examples of each
Disease states causing fluid RETENTION • Renal failure • Cardiac failure • Liver failure Disease states causing fluid LOSS • Diarrhea • Vomitting • Hemorrhaging Post-Operative Patients • x
What are the components to be included when measuring a patient’s fluid intake and output? List all applicable items (Hint: 3 intake, 3 output)
Intake: • Oral fluids (including water, jello, popsicles, ice cream) • IV fluids • Irrigations Output: • Urine • Emesis (vomit) • Drainage (from surgical sites, wounds, etc.)
What does GFR stand for? What does it indicate?
• GFR: glomerular filtration rate • indicates how well kidneys functioning
What is a healthy GFR number? If someone has kidney disease, would their GFR number be higher or lower?
• Healthy GFR - 120 • Kidney disease = ↓GFR
What are 2 major conditions that contribute to decrease kidney function?
• Diabetes • HTN
What stage does hemodialysis get started? How long does dialysis take?
• Stage 3b • Dialysis can take up 4-5 hours • Be done 3x/week
T/F: Peritoneal dialysis has to be done at a kidney care center
False, peritoneal dialysis can be done by the patient at home
What is the normal amount of urinary output? (in mL/hr)
60-120mL/hour
Oliguria What are the causes of oliguria? (Hint: 3 causes)
decrease urine output; 24-hour urine output of less than 30mL/hr OR 400 mL/24 hours • Lack of fluid intake • Vomitting/Diarrhea (abnormal losses) • Impaired blood flow to the kidneys
Anuria
absence of urine; 24-hour urine ouput is less than 50mL
Compare Acute Renal Failure (ARF) and Chronic Renal Failure (CRF) in terms of predisposing factors
Acute (ARF) • Nephrotic drugs • Severe dehydration Chronic (CRF) • Diabetes • HTN
What is the normal range for specific gravity? If the number is higher/lower than the normal range, what will the urine look like/what does it indicate about a persons fluid status?
• Specific gravity: 1.015-1.025 • ↑specific gravity = concentrated urine • ↓specific gravity = dilute urine
Factors Affecting Urination - Developmental Considerations What are common urinary changes and challenges that occur in elderly patients? (Select all that apply.) • Increased urine concentration, resulting in higher specific gravity. • Diminished urine concentration, resulting in lower specific gravity. • Decreased bladder tone. • Decreased bladder contractility. • Muscle weakness interfering with reaching the toilet in time. • Decreased use of medications that affect urinary function. • Increased medication use with side effects that may impact urinary function.
Correct Answers 2. Diminished urine concentration, resulting in lower specific gravity 3. Decreased bladder tone 4. Decreased bladder contractility 5. Muscle weakness interfering with reaching the toilet in time 7. Increased medication use with side effects that may impact urinary function Incorrect Answers: 1. Increased urine concentration, resulting in higher specific gravity. 6. Decreased use of medications that affect urinary function.
Factors Affecting Urination - Food and Fluid What type of effect does alcohol have on urine production? How does sodium affect urine production?
Alcohol • Diuretic effect -> increase urine production Sodium Content • Increase H2O reabsorption -> decrease urine production (more water retained by the body)
Factors Affecting Urination - Activity Describe the effects immobility has on the urinary system
Immobility • Funtional incontinence: urine loss caused by the inability to reach the toilet because of environmental barriers, physical limitations, loss of memory, or disorientation • Poor muscle tone
Factors Affecting Urination - Psychological What are 2 psychological factors that can affect urination?
• Embarassment • Stress
Factors Affecting Urination - Medicaiton How can medication affect urine? (Hint: color)
Can cause color changes in urine (brown)
Factors Affecting Urination - Medical Status How do pathologic conditons and post op effects of anesthesia affect urine output?
Pathologic Conditions • Most cuase fluid retention and decreased urine output Post Op Effects of Anesthesia • Usually cause fluid retention