URINARY AND BOWEL LATEST 2026 MAIN FINALS
EXAM QUESTIONS AND ANSWERS GRADED A+
✔✔Micturition (urination) - ✔✔Bladder is distended as it fills; stretch receptors trigger
the micturition reflex
Parasympathetic nerves stimulates the detrusor muscle to contract
External urethral sphincter is under voluntary control; neurons originate in brain stem
and cerebral cortex
Called "urination" and "voiding"
Urine collects in the bladder
Pressure stimulates special stretch receptors in the bladder wall
Stretch receptors transmit impulses to the spinal cord voiding reflex center
Internal sphincter relaxes stimulating the urge to void (unconscious)
If appropriate, the conscious portion of the brain relaxes the external urethral sphincter
muscle
Urine eliminated through the urethra
250 - 400 ml in bladder stimulate this process
.
Normally the external sphincter is contracted in a closed position so voiding can be
voluntarily delayed.
In children younger than 3 years, the micturition reflex leads to spontaneous urination.
✔✔All about pee - ✔✔1.2- 1.5 Liters per day output (____ cc/hour)
Light yellow to dark amber
Transparent
Faintly, aromatic (food and drugs alter odor and color)
pH 4.5 to 8
Urea/uric acid (waste products of protein and amino acid metabolism)
In adults, the average amount of urine per void is approximately 250 - 400 ml. All but 5 -
10 ml of urine is typically emptied from the bladder. Urine output can vary greatly
depending on intake and fluid loss. Patients with a catheter should drain a minimum of
30 ml of urine per hour. Urine output less than 30 mL/hr may indicate inadequate blood
flow to the kidneys.
The color of urine ranges from light yellow to a darker yellow to a dark brown-yellow
called amber. Hydration status affects urine color. High fluid intake may result in almost
,colorless urine. Dark amber or orange-brown urine would likely be caused by decreased
fluid intake. Medications can also alter urine color.
Urine is normally transparent. Freshly voided urine should appear clear and without
sediment (what is sediment??) Urine draining from an indwelling catheter should appear
clear and without sediment in the tubing but it may occasionally have mucus shreds.
Why do you want to monitor the urine from a catheter from the tubing NOT the bag?
Urine that has been sitting may appear cloudy or have sediment and should not be used
to describe current urine status.
The odor of freshly voided urine is typically described as aromatic. Generally, the more
dilute the urine the fainter the odor. The more concentrated the urine the stronger the
odor. Urine that has been sitting for a period of time may smell like ammonia. A strong
offensive odor is not normally present in urine that is free from infection.
Lighter colore with more fluids
Specific gravity varies depending on fluid intake and quantity of solutes; concentrated
urine has
✔✔Altered Urine Elimination - ✔✔Dysuria - pain with urination
Polyuria --- produce large amounts of urine (diuresis)
Oliguria --- produce low urine output, less than 500 ml/day or 30 ml/hour
Anuria --- little to no urine production
Some terms to be familiar with:
Dysuria: painful, difficult voiding caused by : stricture of urethra, UTI injury to bladder or
urethra
Polyuria called diuresis - can be from excessive intake or diabetes mellitus or chronic
nephritis
Oliguria may indicate impending renal failure
If person is anuric less than 100 ml/24 hours, they need dialysis . Can avoid dialysis if
10% of one kidney functions
✔✔Altered Urine Elimination patterns - ✔✔Most adults can postpone emptying bladder
until it has 250 - 400 cc urine
Frequency: voiding greater than 4 -6x/day increased fluid intake, UTI, stress,
Pregnancy; usually less than 250 cc/urine
Nocturia: voiding 2x or more at night
Urgency: strong desire to void, despite amount of urine in bladder caused by
psychological stress, UTI, weak perineal muscle control, incompetent spincter,
Enuresis: peeing in bed
Hematuria - gross = visible; occult = not visible to the naked eye.
Pyuria - pus
, Urinary Retention can't empty bladder... may get up to 2-3L urine; you can feel it if it's
bigger than 600-700 cc.
✔✔Urinary Incontinence - ✔✔Incontinence - involuntary loss of urine from bladder.
Functional: normal bladder and spincter control but person cannot reach toilet because
of environmental, physical, or cognitive barriers
.
Reflex: involuntary loss of urine at predictable intervals (e.g. when a certain amount of
urine is in the bladder) seen in dysfunction in CNS from Parkinson's, CVA, SCI, MS
Stress: involuntary loss of less than 50 mL of urine associated with activity that
increases abdominal pressure; more common in women but occurs in men who have
had prostatectomy and radiation; coughing, sneezing, laughing, lifting jumping running
(cause = weak pelvic floor muscles, childbirth, obesity...)
Urge: involuntary loss of urine occurring after feeling an urgent need to void. Sometimes
overlaps with overactive bladder syndrome - muscles overactive and cause sudden
urge to void. Urge UI is most common type of UI in older adults. Can't quite tell the
bladder is full then when you sense it it is sudden. Seen in pt w uti's, those on diuretics,
smokers, with etoh use.
Total: - continuous, unpredictable loss - if type of incontinence doesn't fit the other
categories
Look at table 32.2
✔✔Factors Affecting Voiding - ✔✔Age:
Older adult = may experience urgency (a need to empty bladder more frequently); often
have nocturia (need to pee at night)
Alcohol increases urine as it slows production of ADH while caffeine drinks increase
urine production
Foods and meds can change color of urine (Pyridium)
Body fluid - if person loses fluid eg. Vomiting, diarrhea, excessive diaphoresis re: fever
or sweating, burns, blood loss pee less
Body position - eg men usually pee best when standing; hard to pee when lying flat in
bed.
Cognition - may not realize need to pee
Psychological - simply thinking about voiding can influence the process; hearing about it
(or running water). Pouring warm water over the inner thigh...just as giving a person a
cold bedpan can delay. If stressed - may need to pee more or less.
Nurses may not void all day because too busy Circumstances may not be conducive to
void - time, privacy
EXAM QUESTIONS AND ANSWERS GRADED A+
✔✔Micturition (urination) - ✔✔Bladder is distended as it fills; stretch receptors trigger
the micturition reflex
Parasympathetic nerves stimulates the detrusor muscle to contract
External urethral sphincter is under voluntary control; neurons originate in brain stem
and cerebral cortex
Called "urination" and "voiding"
Urine collects in the bladder
Pressure stimulates special stretch receptors in the bladder wall
Stretch receptors transmit impulses to the spinal cord voiding reflex center
Internal sphincter relaxes stimulating the urge to void (unconscious)
If appropriate, the conscious portion of the brain relaxes the external urethral sphincter
muscle
Urine eliminated through the urethra
250 - 400 ml in bladder stimulate this process
.
Normally the external sphincter is contracted in a closed position so voiding can be
voluntarily delayed.
In children younger than 3 years, the micturition reflex leads to spontaneous urination.
✔✔All about pee - ✔✔1.2- 1.5 Liters per day output (____ cc/hour)
Light yellow to dark amber
Transparent
Faintly, aromatic (food and drugs alter odor and color)
pH 4.5 to 8
Urea/uric acid (waste products of protein and amino acid metabolism)
In adults, the average amount of urine per void is approximately 250 - 400 ml. All but 5 -
10 ml of urine is typically emptied from the bladder. Urine output can vary greatly
depending on intake and fluid loss. Patients with a catheter should drain a minimum of
30 ml of urine per hour. Urine output less than 30 mL/hr may indicate inadequate blood
flow to the kidneys.
The color of urine ranges from light yellow to a darker yellow to a dark brown-yellow
called amber. Hydration status affects urine color. High fluid intake may result in almost
,colorless urine. Dark amber or orange-brown urine would likely be caused by decreased
fluid intake. Medications can also alter urine color.
Urine is normally transparent. Freshly voided urine should appear clear and without
sediment (what is sediment??) Urine draining from an indwelling catheter should appear
clear and without sediment in the tubing but it may occasionally have mucus shreds.
Why do you want to monitor the urine from a catheter from the tubing NOT the bag?
Urine that has been sitting may appear cloudy or have sediment and should not be used
to describe current urine status.
The odor of freshly voided urine is typically described as aromatic. Generally, the more
dilute the urine the fainter the odor. The more concentrated the urine the stronger the
odor. Urine that has been sitting for a period of time may smell like ammonia. A strong
offensive odor is not normally present in urine that is free from infection.
Lighter colore with more fluids
Specific gravity varies depending on fluid intake and quantity of solutes; concentrated
urine has
✔✔Altered Urine Elimination - ✔✔Dysuria - pain with urination
Polyuria --- produce large amounts of urine (diuresis)
Oliguria --- produce low urine output, less than 500 ml/day or 30 ml/hour
Anuria --- little to no urine production
Some terms to be familiar with:
Dysuria: painful, difficult voiding caused by : stricture of urethra, UTI injury to bladder or
urethra
Polyuria called diuresis - can be from excessive intake or diabetes mellitus or chronic
nephritis
Oliguria may indicate impending renal failure
If person is anuric less than 100 ml/24 hours, they need dialysis . Can avoid dialysis if
10% of one kidney functions
✔✔Altered Urine Elimination patterns - ✔✔Most adults can postpone emptying bladder
until it has 250 - 400 cc urine
Frequency: voiding greater than 4 -6x/day increased fluid intake, UTI, stress,
Pregnancy; usually less than 250 cc/urine
Nocturia: voiding 2x or more at night
Urgency: strong desire to void, despite amount of urine in bladder caused by
psychological stress, UTI, weak perineal muscle control, incompetent spincter,
Enuresis: peeing in bed
Hematuria - gross = visible; occult = not visible to the naked eye.
Pyuria - pus
, Urinary Retention can't empty bladder... may get up to 2-3L urine; you can feel it if it's
bigger than 600-700 cc.
✔✔Urinary Incontinence - ✔✔Incontinence - involuntary loss of urine from bladder.
Functional: normal bladder and spincter control but person cannot reach toilet because
of environmental, physical, or cognitive barriers
.
Reflex: involuntary loss of urine at predictable intervals (e.g. when a certain amount of
urine is in the bladder) seen in dysfunction in CNS from Parkinson's, CVA, SCI, MS
Stress: involuntary loss of less than 50 mL of urine associated with activity that
increases abdominal pressure; more common in women but occurs in men who have
had prostatectomy and radiation; coughing, sneezing, laughing, lifting jumping running
(cause = weak pelvic floor muscles, childbirth, obesity...)
Urge: involuntary loss of urine occurring after feeling an urgent need to void. Sometimes
overlaps with overactive bladder syndrome - muscles overactive and cause sudden
urge to void. Urge UI is most common type of UI in older adults. Can't quite tell the
bladder is full then when you sense it it is sudden. Seen in pt w uti's, those on diuretics,
smokers, with etoh use.
Total: - continuous, unpredictable loss - if type of incontinence doesn't fit the other
categories
Look at table 32.2
✔✔Factors Affecting Voiding - ✔✔Age:
Older adult = may experience urgency (a need to empty bladder more frequently); often
have nocturia (need to pee at night)
Alcohol increases urine as it slows production of ADH while caffeine drinks increase
urine production
Foods and meds can change color of urine (Pyridium)
Body fluid - if person loses fluid eg. Vomiting, diarrhea, excessive diaphoresis re: fever
or sweating, burns, blood loss pee less
Body position - eg men usually pee best when standing; hard to pee when lying flat in
bed.
Cognition - may not realize need to pee
Psychological - simply thinking about voiding can influence the process; hearing about it
(or running water). Pouring warm water over the inner thigh...just as giving a person a
cold bedpan can delay. If stressed - may need to pee more or less.
Nurses may not void all day because too busy Circumstances may not be conducive to
void - time, privacy
