215 urinary

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elevatedsound7
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215 urinary
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2013-04-08 14:45:20
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215 urinary
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215 urinary
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  1. Renal Collic =
    pain that is happens when a stone gets caught in a ureter
  2. kidneys regulate
    fluids, electrolytes and acid base balances
  3. kidneys produce
    hormones that control RBC formation, BP, vit. D activation
  4. main filtration unit of the kidney
    nephron
  5. filtration stops in kidney when SBP
    > 70 systolic 
  6. ADH =
    enhances water absorption
  7. Aldosterone =
    promotes Na+ reabsorption = water absorption
  8. renin =
    regulates BP
  9. erythropoetin =
    hormone that stimulates RBC production
  10. vitamin D important for
    reabsorption of calcium in GI tract
  11. Detrusor muscle =
    iddle layers of smooth muscle in bladder
  12. adults can hold how much before urge to void
    200-300 mL
  13. bladder can hold up to
    1000-2000 mL
  14. children fell urge to void when
    100 - 200 mL
  15. urethra in men compared to women
    mens is longer than womens
  16. 1st void of the day is....
    `most concentrated
  17. is urination voluntary or involuntary
    voluntary
  18. retention =
    when urine is not excreted properly, but is produced normally
  19. diseases that effect urination =
    • Diabetes mellitus
    • Alzheimers
    • BPH = bengn prostatic hypertrophy
  20. nocturia =
    urination at night
  21. polyuria =
    excessive fluid loss from urination
  22. Anuria =
    no urine produced
  23. Oliguria =
    decreased amount of urine production
  24. Diuresis =
    excessive urine production
  25. acceptable urne amount of normal person per hour =
    30mL per hour
  26. Disuria
    painful/difficult urination
  27. In aging adult decreased ability to concentrate urine causes
    nocturia
  28. in aging adult... decreased muscle tone causes
    decreased capacity to hold urine
  29. in aging adult... decreased contractility causes
    urine stasis - - urine sitting in bladder which increases risk for UTi
  30. food drinks high in sodium =
    retention of fluid
  31. Potassium =
    the most dangerous electrolyte in reference to cardiac contractility
  32. Thiazide Diuretics =
    • Diuril
    • act on the distal tuble
  33. Loop diuretics are and act on
    • lasix
    • act on ascending loop
  34. Osmotic Diuretics =
    • Mannitol
    • increases concentration of fluid in tubules
  35. Postassium sparin diuretic =
    • aldactone
    • does not allow K+ to be excreted
  36. common med that is nephro toxic
    tylenol
  37. hematuria =
    blood in urine
  38. coumadin can cause what in reference to kidneys
    hematuria
  39. diuretics can cause urine color to be
    pale yellow
  40. pyridium causes urine color to be
    orange red
  41. stress does what to urine output
    decreases it
  42. analgesics and anesthesia can cause urine output to
    decrease
  43. elavil or B complex vitamins casue urine color to be
    blue green
  44. Levodopa casues urine color to be
    brown black
  45. coumadin causes urine color to be
    orange
  46. urinary retention =
    bladder not responding to micturation reflex
  47. urinary retention casues urine output to
    stop or small urine output multiple times a day
  48. baldder scanner used
    to determine urinary retention
  49. why are women more susceptible to UTI's
    shorter urethra and improper cleaning
  50. cystitis =
    inflammation of the bladder
  51. urethritis =
     inflammation of the urethra
  52. proper cleaning of a women's perineal area is so important...
    because clean front to back prevents bacteria from bowel entering the urethras
  53. 90% of UTI's casued by
    E. Coli
  54. causes of UTI
    • improper cleaning
    • catherters
    • urinary retention
    • diabetes
    • surgical manipulation
  55. why does diabetes increases risk of UTI
    excess sugar in urine
  56. lower UTI S&S =
    • frequency and urgency
    • dysuria and nocturia
    • hesistency
    • incontinence
    • suprapubic tenderness
    • fever, chills
    • person feels full even after voiding
    • nausea, vomiting, malasie
  57. In Elderly UTI can cause
    • confusion
    • increases falls
    • sudden onset incontinence
    • loss of appetite
    • tahycardia
    • tachypnea
    • hypotension
  58. Diagnosis of UTI =
    • urinalysis
    • culture and sensitivity
    • cystoscopy = endoscope of bladder (recurrent infections)
  59. tretement of UTI
    • increase fluid2-3L q day to flush out system
    • cranberry juice 300mL q day X 3-4 weeks
  60. nursing implications of UTI
    • empty baldder completely
    • postions males standing females sitting
    • monitir S&S
    • teach proper cleaning
  61. teaching for UTI
    • 2-3 L/day
    • adequate sleep and rest
    • empty bladder asap when need to urinate
  62. continence in kids usually around
    2-5 yo
  63. types of incontinence =
    • stress
    • urge
    • overflow
    • functional
  64. stress incontinence =
    • pt cannot tighten urethra enough
    • caused by weakening of bladder neck
    • increase abdominal pressure
    • happens in women with multi vaginal briths
    • DO NOT empty bladder enough
  65. Urge incontinence =
    • strong desire to urinate; can't supress signal fromthe bladder muscel to the brain
    • strong urge to void
    • large amounts of urine
  66. overflow incontinenece =
    • loss of urine associated with an over distended bladder
    • casues = side effect of meds, enlarged prstate, urinary retention
  67. functional incontinenece =
    • loss of urine casued by something other than disease ( loss of cognitive function, meds, restraints)
    • NOT A RENAL ISSUE
  68. medications to treat incontinence =
    • Anticholinergics
    • antispasmodics (Ditropan)
  69. PVR =
    • post voided residuals
    • (after pt voids check residual amount by baldder scan or straight cath)
  70. Ileal conduit =
    ureter joined with portion of small intestine and stoma created
  71. Kock ileal reservoir =
    pt straight caths stoma
  72. Serum creatinine norm
    o.5 - 1.2 mg/dl
  73. BUN =
    • Blood urea nitrogen
    • 10-20mg/dl
  74. Serum creatinine =
    • measures end product of muscle and protein metabolism
    • 50% of renal function can be lost before see  an increase in creatinine level
  75. BUN measures
    • renal excretion or urea nitrgne
    • increases may indicate liver or kidney disease, dehydration, decreased renal perfusion, infection
    • decreased = malnutrtion, fluid volume excess, sever liver danage
  76. Secific gravity norm =
    • 1.005 - 1.035
    • increase = dehyration
    • decrease = fluid retention
  77. turbidity =
    cloudy ?
  78. best indicator of overall kidney function =
    • creatinine clearance test
    • 24 hour urine sample
  79. normal pH of urine =
    • 4.6 - 8
    • average 6
  80. are glucose, ketones, protein in urne common
    • no not good
    • glucose and ketones in diabetics
    • protein with pregnant women with preeclampsia
  81. nurisng outcome for urination issues
    • intake will equal output
    • maintian fluid and electrolyte balance
    • empty baldder every 2 hours
  82. stimulation of micturation ways =
    warm water on hands or perineal area
  83. meds used for overactive baldder
    Vesicare and Ditropan
  84. Urecholine is used to treat
    urinary retention
  85. Flomax used to treat
    • BPH
    • relaxes smooth muscle of the baldder
  86. indwelling urethral cath =
    foley catheter
  87. intermittant urethral catheters =
    straight cath
  88. suprapubic catheter =
    for long term management pf urinary dysfunction
  89. how to prevent UTI's in catheterized patients
    • hang bag on frame of bed
    • assess for kins in tubing
    • keep bag lower than level of bladder
    • assess urinary drainage
    • strict asepsis tech/ protocol
    • cath/peri care (atleast once a shift) q 8hours
    • fluids up to 3000 mL/day
    • pelvic floor muscle exercises
    • minimize coffee and tea
    • weight loss

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