FINAL TEST FOR EXAM 2 CHAPTER 44 URINARY ELIMINATION ATI

FINAL TEST FOR EXAM 2 CHAPTER 44 URINARY ELIMINATION ATI Urinary System: - CORRECT ANSWER-filtration, reabsorption, excretion Pathway of Urine: - CORRECT ANSWER-Kidneys to the nephrons (perform most of filtration/elimination. Then Urine goes from kidneys to ureters to the bladder. Then once bladder fills up, the brain tells the bladder to relax the internal and external sphincter to relax and urine is released through the urethra. How much urine can the bladder hold? - CORRECT ANSWER-150-200mL daily urine production - CORRECT ANSWER- mL/day Urinary Diversions - CORRECT ANSWER-Surgical creation of a stoma that is temporary or permanent for drainage of urine. Can be continent (controlled) or incontinent (w/out control) Continent have reservoir in abdomen. ureterostomy - CORRECT ANSWER-incontinent urinary diversion for which the surgeon attaches one or both ureters via a stoma to the surface of the abdominal wall nephrostomy - CORRECT ANSWER-incontinent urinary diversion for which the surgeon attaches a tube from the renal pelvis via a stoma to the surface of the abdominal wall factors affecting urinary elimination - CORRECT ANSWER-poor abdominal and pelvic muscle tone; acute and chronic disorders; spinal cord injury; surgery; immobility; medications; diet children - CORRECT ANSWER-achieve full bladder control by 4 to 5 years prostate - CORRECT ANSWER-enlarges after 40 years of age; urinary frequency; hesitancy; retention; incontinence; UTIs childbirth and gravity - CORRECT ANSWER-weakens the pelvic floor putting clients at risk for prolapse of the bladder leading to stress incontinence that can be managed with Kegel exercises older adults - CORRECT ANSWER-fewer nephrons; loss of muscle tone of bladder leading to frequency; inefficient emptying of bladder leaving residual urine increasing risk of UTIs; increase in nocturia pregnancy - CORRECT ANSWER-growing fetus compromises bladder space and compressed the bladder; 30-50% increase in circulatory volume increasing renal workload and output; hormone relaxin causes relaxation of sphincter diet - CORRECT ANSWER-increase in Na leads to decreased urination; caffeine and alcohol intake lead to increased urination immobility - CORRECT ANSWER-incontinence is not a result of aging but of neurological or mobility impairments pyschosocial factors - CORRECT ANSWER-emotional stress and anxiety; having to use public toilets; lack of privacy during hospital stays; not having enough time during breaks pain - CORRECT ANSWER-suppression of urge; obstruction in ureter leading to renal colic; arthritis or painful joints causing immobility and leading to delayed urination surgery - CORRECT ANSWER-alterations in glomerular filtration rate from anesthesia and opioid analgesics resulting in decreased urine output; lower abdominal procedures creating obstructive edema and inflammation medications - CORRECT ANSWER-diuretics preventing reabsorption of water; antihistamines and anticholinergics causing retention; chemotherapy damaging kidneys orange/red urine - CORRECT ANSWER-phenazopyridine green/blue urine - CORRECT ANSWER-amitriptyline dark urine - CORRECT ANSWER-levodopa sonography - CORRECT ANSWER-noninvasive portable ultrasound scanner for measure bladder volume and residual volume after urination xrays - CORRECT ANSWER-to determine size shape and position of kidneys ureters and bladder IV pyelogram - CORRECT ANSWER-injection of contrast media (iodine) for viewing of ducts, renal pelvis, ureters, bladder, and urethra; No dye if allergy to shellfish renal scan - CORRECT ANSWER-view of renal blood flow and anatomy of the kidneys without contrast renal ultrasound - CORRECT ANSWER-view of gross renal structures and structural abnormalities using sound waves cystoscopy - CORRECT ANSWER-use of lighted instrument to visualize treat and obtain specimens from the bladder and urethra urodynamic testing - CORRECT ANSWER-test for bladder muscle function by filling the bladder with CO2 or 0.9% NaCl and comparing pressure readings with reported sensations Promoting healthy urination elimination equipment - CORRECT ANSWER-urinal for men; toilet, bedpan, commode, fracture pan for supine; have clients sit when possible; privacy and adequate time I&O equipment - CORRECT ANSWER-hard plastic urometer on indwelling catheter drainage bag; graduated cylinders, urinal or toilet receptacle; poor into graduated cylinder What output calls for concern? - CORRECT ANSWER-less than 30 mL/hr for more than 2 hrs bladder retraining for urge incontinence - CORRECT ANSWER-use timed voiding; kegel exercises; assist in relaxation techniques; offer undergarments; teach not to ignore urge; positive reinforcement while remaining continent; eliminate or decrease caffeine; diuretics in morning urinalysis - CORRECT ANSWER-random nonsterile specimen; explain procedure; label container clean catch specimen - CORRECT ANSWER-teach technique; after thorough cleansing of urethral meatus, clients catch urine midstream; for culture and sensitivity catheter specimen - CORRECT ANSWER-for culture and sensitivity; obtain sterile specimen from straight or indwelling using surgical asepsis (sterile) time urine specimen - CORRECT ANSWER-collect for 24 hr or other duration; discard first voiding; collect all other urine; refrigerate, label, transport catheter children - CORRECT ANSWER-8-10 fr catheter women - CORRECT ANSWER-14-16 fr catheter men - CORRECT ANSWER-16-18 fr