Urinary Elimination definition
Controls Volume, composition of blood.
Rids body of excess fluid, electrolytes
Depends on effective functioning of upper and lower UT
Normal urinary elimination function
Urinary process maintains the concentration of ions needed for-Neuronal and muscle function, bone strength, and cellular regeneration.
Maintains homeostatic regulation of blood pressure for adequate circulation of oxygen and nutrients.
Upper Urinary Tract
Kidneys, Ureters
Lower Urinary Tract
Urinary bladder, Urethra, pelvic floor
Kidneys func
Removes waste from the blood to form urine
Ureters func
Transport urine from the kidneys to the bladder
Bladder func
Reservoir for urine until the urge to urinate develops
Urethra Func
Urine travels from the bladder and exits through the urethral meatus
Act of Urination 3 parts
Brain structures influence bladder function
1. Stretching of bladder wall signals the micturation center in the sacral spinal cord
2. Impulses from the micturation center in the brain response to or ignore this urge, thus making urination under voluntary
Factors influencing Urination
Disease conditions, medications, medical procedures, socioeconomic factors, personal habits, fluid balance, surgical conditions, diagnostic tests, psychological factors
Polyuria
Diuresis: Production of abnormally large amounts of urine, +2,000 ml
Polydipsia
Extreme thirst: associated with polyuria
Anuria
Absence of urine production (Less than 100 ml day)
Oliguria
May signal impending renal failure (100-400 Ml 24 hours)
Retention
An accumulation of urine due to the inability of the bladder to empty
Urinary Incontinence
Involuntary leakage of urine
UTI
The presence of microorganisms in UT causing pain, burning, fever, chilld, nausea, vomiting, frequent urge sensation
Symptoms of Urinary alterations
Urgency, frequency, retention, dysuria, Nocturia, Urinary hesitancy, neurogenic bladder
Nursing assessment factors
Patterns of urination, symptoms of urinary alterations, factors affecting urination, intake/output, color, clarity, odor
physical assessment- skin and mucosal membranes
Assess hydration
Physical assessment- kidneys
Flank pain may occur with inflammation or infection
Physical assessment- urethral meatus
Observe for discharge, inflammation and leisons
Physical assessment- Bladder
Distended bladder rises above the symphysis pubis.
Blood samples labs
BUN, creatinine, Creatinine clearance, GFR, Uric Acid, Na+, Mg+, Po4-, K+, Ca+
Urine samples Lab
Urinalysis: PH, protein, glucose, blood, specific gravity, RBCs, WBCs, crystals. Urine Culture, Urine cytology, Urinalysis
Radiologic labs
KUB, IVP, Arteriogram, renal scan, ultrasound, CT scan, MRI
Urinary Diversion
Diversion of urine to external source
Urinary incontinence
symptom not a disease- most common manifestation of impaired bladder control. NOT A NORMAL CONSEQUENCE OF AGING
Urinary incontinence- patho
Results from higher than normal bladder pressures or reduced urethral resistance.
Urinary incontinence factors
Relaxation of pelvic muscles
Disruption of cerebral and NS control
Disturbances of bladder and its musculature
Acquired irreversible factors of Urinary Incontinence
CNS, spinal cord trauma
Stroke
MS
Parkinson disease