Practice Test Ati Chapter 44: Urinary Elimination

PRACTICE TEST ATI CHAPTER 44: URINARY ELIMINATION ______ is a precise system of filtration, reabsorption, and excretion. These processes help maintain fluid and electrolyte balance while filtering and excreting watersoluble wastes. - CORRECT ANSWER-Urinary elimination what are primary organs involved in urinary elimination - CORRECT ANSWER-kidneys, with the nephrons performing most of the functions of filtration and elimination. Most adults produce between _____ and _____ mL of urine per day. - CORRECT ANSWER-1500 and 2000 urine passage? - CORRECT ANSWER-ureters into the bladder, the storage reservoir for urine. Once an adequate amount of urine collects in the bladder then ends a signal to the brain to indicate the need to urinate. The person then relaxes the internal and external sphincters located at the bottom of the bladder and the urethra. Urine passes from the bladder through the urethra where it exits the body. Urinary diversions are _____, a stoma for the drainage of urine - CORRECT ANSWERtemporary or permanent Ureterostomy - CORRECT ANSWER-an incontinent urinary diversion for which the surgeon attaches one of both ureters via a stoma to the surface attaches one or both ureters via a stoma to the surface of the abomnal wall. Nephrostomy - CORRECT ANSWER-an incontinent urinary diversion for which the surgeon attaches a tube from the renal pelvis via a stoma to the surface of the abdominal wall kock pouch (continent ideal bladder conduit) - CORRECT ANSWER-a continent urinary diversion in which the surgeon forms a reservoir from the ileum. the pouch is emptied by a clean straight catheterization every 2-3 hours initially, and every 5term-4-6 hours once the pouch expands to capacity. neobladder - CORRECT ANSWER-a new bladder created by the surgeon using the ileum that attaches to the ureters and urethra it allows the client to maintain continence; the client learns to void by straining the abdominal muscles Urinary diversions may be created for clients for what reasons? - CORRECT ANSWERcancer or injury to the bladder. Factors Affecting Normal Urinary Elimination: - CORRECT ANSWER-Age / Pregnancy / Diet Poor abdominal and pelvic muscle tone Acute and chronic disease conditions Spinal cord injury Immobility / Psychosocial factors / Pain factors affecting urinary elimination? - CORRECT ANSWER-poor abdominal and pelvic muscle tone acute and chronic disorders spinal cord injury age (enlarged prostate, few nephrons) Menopause (decrease perineal tone due to reduced estrogen) pregnancy diet immobility psychosocial factors pain surgical procedures medications factors affecting urinary elimination? Age - CORRECT ANSWER--Full bladder control by 4 to 5 years of age -Enlargement of the prostate after 40 years of age leading to urinary frequency, hesitancy, retention, incontinence, and urinary tract infections (UTIs). -Childbirth and gravity weaken the pelvic floor, putting clients at risk for prolapse of the bladder, leading to stress incontinence, which clients can manage with pelvic floor (Kegel) exercises. Older adult clients -Fewer nephrons -Loss of muscle tone of the bladder - frequency occurs -Inefficient emptying of the bladder - residual urine increasing the risk of UTIs - Increase in nocturia factors affecting urinary elimination? Pregnancy - CORRECT ANSWER-- A growing fetus compromises bladder space and compresses the bladder. -There is a 30% to 50% increase in circulatory volume, which increases renal workload and output. -The hormone relaxin causes relaxation of the sphincter. factors affecting urinary elimination? Diet - CORRECT ANSWER-- An increase in sodium leads to decreased urination. - Caffeine and alcohol intake lead to increased urination. ● Poor abdominal and pelvic muscle tone ● Acute and chronic disorders ● Spinal cord injury ● Immobility -Incontinence is not associated with aging. It is a result of neurological or mobility impairments. factors affecting urinary elimination? Psychosocial factors - CORRECT ANSWER-- Emotional stress and anxiety - Having to use public toilets, lack of privacy when hospitalized - Not having enough time to urinate (predetermined bathroom breaks in elementary schools) factors affecting urinary elimination? Pain - CORRECT ANSWER-- Suppression of the urge to urinate when there is pain in the urinary tract -Obstruction in the ureter leading to renal colic - Arthritis or painful joints causing immobility, which leads to delayed urination factors affecting urinary elimination? Surgical procedures - CORRECT ANSWER-- Alterations in glomerular filtration rate from anesthesia/opioid analgesics, resulting in decreased urine output - Lower abdominal surgery creating obstructing edema and inflammation factors affecting urinary elimination? Medications - CORRECT ANSWER-- Diuretics preventing reabsorption of water - Antihistamines and anticholinergics causing urinary retention-Medications changing urine color -Phenazopyridine (Pyridium) - orange - Amitriptyline - green/blue - Levodopa (Dopar) - brown/black - Chemotherapy creating a toxic environment for the kidneys DIAGNOSTIC TESTS Bedside sonography with a bladder scanner - CORRECT ANSWER-noninvasive portable ultrasound scanner for measuring bladder volume and residual volume after vasive portable ultrasound scanner for measuring bladder volume and residual volume after urination. DIAGNOSTIC TESTS Kindeys, ureters, ballader - CORRECT ANSWER-x-ray to determine size, shape, and position of these structures