NSG 100 Exam V4
• polyuria: -excessive production of urine
-can cause excessive fluid loss->intense thirst, dehydration, weight loss
• diuresis: increased formation and secretion of urine
• polydipsia: extreme thirst, associated with polyuiria
• anuria: absence of urine production
• oliguria: scant urine productionmay signal impending renal failure
• nocturia: voiding at night
• urgency: feeling the need to urinate immediately
• dysuria: painful or difficult urination
• urinary hesitancy: difficulty in starting a urinary stream
• neurogenic bladder: -does not perceive bladder fullness
-unable to control urinary sphincters
• urinary incontinence: the involuntary leakage of urineup to 50% of women, 5% of men <
age 65
60% of men > age 60 (related to treatment for enlarged prostate)
• urinary retention: inability to empty the bladdermore in men than women r/t prostate
enlargement uncommon in women
• Urge UI (urinary incontinence): etiology: irritation of stretch bladder receptors
presentation: urinary urgency, frequenct, nocturia, bladder contractires, small void
(parapalegic)
Tx (treatment): anticholinergics, diet, tx of underlying causes
• Stress UI: etiology: increased intra-abdominal pressure
presentation: dribbling with coughing, laughing, sneezing (post menopause, obesity,childbirth)
tx: kegel, alpha adrenergic antagonists
• Overflow UI: etiology: urinary retention
presentation: discomfort, restlessness, diaphoresis, constant flow or lack of aware-ness of
filling
tx: catheterization d/t chronic retention of urine
• functional UI: etiology: environmental presentation: inability to get to the bathroom
timelytx: toileting programs, adaptive equipment
• Total UI: etiology: neuropathy, trauma
,presentation: constant flow of urine, lack of awareness, continuous, unpredictable
loss of urine
tx: management of skin, dignity
• Transient UI: appears suddenly and lasts 6 months or less
• mixed UI: urine loss with features of two or more types of incontinence (ie, stressand urge)
• Assess: data about voiding patterns, habits, past history of problems
• voiding patterns to assess: daily intakenumber of voiding episodes
volume
recent changes
• syptoms of alterations: nocturia, frequency, urgency, dribbling, retention, hes-itancy,
polyuira, oliguria, dysuria
• oliguria: scanty production of urine
• skin and mucosal membrance assessment: assess hydration color, texture, skin turgor,
skin integrity in perineal area for incontinent pt
• kidney assessment: check for costovertebral tenderness/ flank pain
• bladder assessment: distended bladder rises above symphysis pubisdull tone (percussion)
due to fluid in bladder
• urethral meatus: observe for discharge, inflammation, and lesionsdorsal recumbent
position, retract labia in female
• bladder scanner: a noninvasive device that creates an ultrasound image of thebladder for
measuring the volume of urine in the bladder; use it to assess bladder volume whenever
inadequate bladder emptying is suspected (such as after the removal of a catheter, evaluation
of incontinence, or after urologic surgery)
• assessment of urine: -Intake and output (hourly output of < 30 mL for morethan 2 hours
cause for concern)
-Characteristics of urine
Color: Pale-straw to amber color
Clarity/turbidity: Transparent unless pathology is present
Odor: Ammonia in nature(dehydration-strong scent; fruity in DM d/t spilled glucose)
-Urine testing (pH 4.6 to 8) (specific gravity (1.015-1.025)
• urinalysis (UA): urine screening test that includes physical observation, chem-ical tests,
and microscopic evaluation
, don't use first urine of the morning
• specific gravity (SG): weight or degree of concentration of a substance com-pared to
equal volume of water
• culture: requires clean or sterile sample (clean urinary meatus)24-48 hours to reveal
findings of bacterial growth
• noninvasive urinary tests: KUB-kidney, ureter, bladder x-rayCT-provides additional info
IV pyleogram
• invasive urinary procedure: cytoscopy- looks into bladder
• urine test contraindications: assess for sensitivity to dyesome procedures require orders
some require consent form
• nursing diagnosis-
urinary functioning as problem: Incontinence, pattern alteration, and urinary re-tention.
• nursing diagnosis-
urinary functioning as the etiology: anxiety, caregiver role strain, risk for infection
• implementation: health promotion (pt ed, promoting normal micturtion) stimulating
micturtion reflex (help pt sense urge to urinate, relax during void-ing---squat or sit, sound of
water)
adequate fluid intake, promote bladder emptying (wait until urine flow stops)
• acute care implementation: allow time and provide privacy
meds (parasympathetic stimulation of the detrusor muscle aids emptying, choliner-gic drugs
increase bladder contration and improve emptying)
catheterization
• kidneys: -remove waste from blood to form urine
-maintain composition and volume of body fluids
-once every 30 minutes body's total blood volume passes through kidneys for wasteremoval
• ureters: transport urine from the kidneys to the bladder
• bladder: holds urine until urge to urinate develops
• urethra: tube leading from the urinary bladder to the outside of the body
• bladder: -cannot be palpated when empty
-can extend to umbilicus when distended
-when empty. lies i pelvic cavity behind symphisus pubis
• polyuria: -excessive production of urine
-can cause excessive fluid loss->intense thirst, dehydration, weight loss
• diuresis: increased formation and secretion of urine
• polydipsia: extreme thirst, associated with polyuiria
• anuria: absence of urine production
• oliguria: scant urine productionmay signal impending renal failure
• nocturia: voiding at night
• urgency: feeling the need to urinate immediately
• dysuria: painful or difficult urination
• urinary hesitancy: difficulty in starting a urinary stream
• neurogenic bladder: -does not perceive bladder fullness
-unable to control urinary sphincters
• urinary incontinence: the involuntary leakage of urineup to 50% of women, 5% of men <
age 65
60% of men > age 60 (related to treatment for enlarged prostate)
• urinary retention: inability to empty the bladdermore in men than women r/t prostate
enlargement uncommon in women
• Urge UI (urinary incontinence): etiology: irritation of stretch bladder receptors
presentation: urinary urgency, frequenct, nocturia, bladder contractires, small void
(parapalegic)
Tx (treatment): anticholinergics, diet, tx of underlying causes
• Stress UI: etiology: increased intra-abdominal pressure
presentation: dribbling with coughing, laughing, sneezing (post menopause, obesity,childbirth)
tx: kegel, alpha adrenergic antagonists
• Overflow UI: etiology: urinary retention
presentation: discomfort, restlessness, diaphoresis, constant flow or lack of aware-ness of
filling
tx: catheterization d/t chronic retention of urine
• functional UI: etiology: environmental presentation: inability to get to the bathroom
timelytx: toileting programs, adaptive equipment
• Total UI: etiology: neuropathy, trauma
,presentation: constant flow of urine, lack of awareness, continuous, unpredictable
loss of urine
tx: management of skin, dignity
• Transient UI: appears suddenly and lasts 6 months or less
• mixed UI: urine loss with features of two or more types of incontinence (ie, stressand urge)
• Assess: data about voiding patterns, habits, past history of problems
• voiding patterns to assess: daily intakenumber of voiding episodes
volume
recent changes
• syptoms of alterations: nocturia, frequency, urgency, dribbling, retention, hes-itancy,
polyuira, oliguria, dysuria
• oliguria: scanty production of urine
• skin and mucosal membrance assessment: assess hydration color, texture, skin turgor,
skin integrity in perineal area for incontinent pt
• kidney assessment: check for costovertebral tenderness/ flank pain
• bladder assessment: distended bladder rises above symphysis pubisdull tone (percussion)
due to fluid in bladder
• urethral meatus: observe for discharge, inflammation, and lesionsdorsal recumbent
position, retract labia in female
• bladder scanner: a noninvasive device that creates an ultrasound image of thebladder for
measuring the volume of urine in the bladder; use it to assess bladder volume whenever
inadequate bladder emptying is suspected (such as after the removal of a catheter, evaluation
of incontinence, or after urologic surgery)
• assessment of urine: -Intake and output (hourly output of < 30 mL for morethan 2 hours
cause for concern)
-Characteristics of urine
Color: Pale-straw to amber color
Clarity/turbidity: Transparent unless pathology is present
Odor: Ammonia in nature(dehydration-strong scent; fruity in DM d/t spilled glucose)
-Urine testing (pH 4.6 to 8) (specific gravity (1.015-1.025)
• urinalysis (UA): urine screening test that includes physical observation, chem-ical tests,
and microscopic evaluation
, don't use first urine of the morning
• specific gravity (SG): weight or degree of concentration of a substance com-pared to
equal volume of water
• culture: requires clean or sterile sample (clean urinary meatus)24-48 hours to reveal
findings of bacterial growth
• noninvasive urinary tests: KUB-kidney, ureter, bladder x-rayCT-provides additional info
IV pyleogram
• invasive urinary procedure: cytoscopy- looks into bladder
• urine test contraindications: assess for sensitivity to dyesome procedures require orders
some require consent form
• nursing diagnosis-
urinary functioning as problem: Incontinence, pattern alteration, and urinary re-tention.
• nursing diagnosis-
urinary functioning as the etiology: anxiety, caregiver role strain, risk for infection
• implementation: health promotion (pt ed, promoting normal micturtion) stimulating
micturtion reflex (help pt sense urge to urinate, relax during void-ing---squat or sit, sound of
water)
adequate fluid intake, promote bladder emptying (wait until urine flow stops)
• acute care implementation: allow time and provide privacy
meds (parasympathetic stimulation of the detrusor muscle aids emptying, choliner-gic drugs
increase bladder contration and improve emptying)
catheterization
• kidneys: -remove waste from blood to form urine
-maintain composition and volume of body fluids
-once every 30 minutes body's total blood volume passes through kidneys for wasteremoval
• ureters: transport urine from the kidneys to the bladder
• bladder: holds urine until urge to urinate develops
• urethra: tube leading from the urinary bladder to the outside of the body
• bladder: -cannot be palpated when empty
-can extend to umbilicus when distended
-when empty. lies i pelvic cavity behind symphisus pubis
