Elimination: Urinary Assessment; Urinary Antiseptics – Flashcards

As the volume increases, the bladder walls stretch, sending sensory impulses to the micturition center in the sacral spinal cord. Impulses from the micturition center respond to or ignore this urge, thus making urination under voluntary control. If the person chooses not to void, the external urinary sphincter remains contracted, inhibiting the micturition reflex. However, when a person is ready to void, the external sphincter relaxes, the micturition reflex stimulates the detrusor muscle to contract, and efficient emptying of the bladder occurs.

Some pathophysiological factors are acute and reversible (UTI), whereas others are chronic and irreversible (slow, progressive development of renal dysfunction). Also, medications including anesthesia interfere with both the production and characteristics of urine, as well as affecting the act of urination, and the ability to completely empty or control voiding.

Urinary retention is an accumulation of urine resulting from an inability of the bladder to empty properly. Urinary tract infection results from catheterization procedure. Urinary diversion is the diversion of urine to external source. Urinary incontinence is the involuntary leakage of urine that is sufficient to be a problem.

Normal urine ranges from a pale, straw color to amber, depending on its concentration (It is usually more concentrated in the morning, or with fluid volume deficits). Bleeding from the kidneys or ureters causes dark red urine; bleeding from the bladder or urethra causes bright red urine. Various meds. and food also change urine in color. Normal urine appears transparent at voiding. Urine that stands in a container becomes cloudy. Freshly voided urine in a patient with renal disease appears cloudy or foamy because of high protein concentrations. Urine may also appear thick and cloudy as a result of bacteria and WBC's. The more concentrated the urine, the stronger the odor. Stagnant urine has an ammonia odor, which is common in patients who are repeatedly incontinent. Diabetes Mellitus, or starvation can cause urine to have a sweet, or fruity odor from the acetone or acetoacetic acid. Some meds and foods such as amoxicillin and asparagus can affect the odor as well. A foul odor is often associated with a possible infection.

Social isolation Disturbed body image Urinary incontinence (functional, stress, urge, overflow) Pain (acute, chronic) Risk for infection Toileting self-care deficit Impaired skin integrity Impaired urinary elimination Constipation Urinary retention.

Help patients learn to relax and stimulate the reflex to void by helping them assume the normal position for voiding. The sound of running water helps many patients void through the power of suggestion. Stroking the inner aspect of the thigh stimulates sensory nerves and promotes the micturition reflex. A nurse can also pour warm water over the patient's perineum and create the sensation to urinate.

Good perineal hygiene that includes cleaning the urethral meatus after each voiding or bowel movement is essential, drinking enough fluids high in acid ash such as apple or cranberry juice.

pH tests: The pH of the urine indicates acid-base balance. An acid pH helps protect against bacterial growth. Protein test: Normally protein is not present in urine. It is common in renal disease because damage to glomeruli or tubules allows it to enter urine. Glucose test: Patients with diabetes mellitus often have glucose in urine as a result of inability of tubules to reabsorb high glucose concentrations. Ingestion of high concentrations of glucose causes some glucose to appear in urine of healthy persons. Ketones test: Patients whose diabetes mellitus is poorly controlled experience breakdown of fatty acids. End products of fat metabolisms are ketones. Some patients with dehydration, starvation, or excessive aspirin usage also have ketonuria. Blood test: A positive test for occult blood occurs when intact erythrocytes, hemoglobin, or myoglobin is present. Blood in a routine urine specimen in a woman may be a result of contamination with menstrual fluid. Specific gravity test: This measures the concentration of particles in urine. High specific gravity reflects concentrated urine, and low specific gravity reflects diluted urine. Dehydration, reduced renal blood flow, and increased ADH secretion elevate specific gravity. Overhydration, early renal disease, and inadequate ADH secretion reduce specific gravity.

Sulfisoxazole is the prototype sulfonamide, but it is distributed in a combination for with erythromycin. Sulfisoxazole and other sulfonamides acts as antimetabolites of para-aminobenzoic acid (PABA), which microorganisms require to produce folic acid. By these means, sulfonamides halt multiplication of new bacteria but do not kill mature, fully formed bacteria. Uses for sulisoxazole include treatment of UTI's- acute, recurrent, and chronic. The drug may also be a part of adjunctive therapy for trachoma, chloroquine-resistant malaria, acute otisi media, and meningoccal meningitis caused by H. influenzae. Adverse GI effects include nausea, vomiting, diarrhea, jaundice, hepatitis, pancreatitis, and stomatits (most common). A small percentage of patients develop cholestatic jaundice. Hematological effects include actue hemolytic anemia in patients with a deficiency of glucose-6-phosphate dhydrogenase (G6PD), aplastic anemia, agranulocytosis, thrombocytopenia, and leukopenia. Dermatological effects include puritis, urticaria, Stevens-Johnson syndrome, and exfoliative dermatitis. Urinary effects include Crystalluria (crystals in the urine, causing renal irritation), hematuria, anuria, and reduction in sperm count. Contraindications include hypersensitivity to sulfisoxazole or any other of the sulfonamides, salicylates, or chemically related medications used to treat group A beta-hemolytic streptococcal infections. Porphyria, G6PD deficiency, hepatic disease, and renal disease are also contraindications. When administering sulfonamides, it is important to monitor the pH of the urine. Alkalinization may be necessary; this involves giving sodium bicarbonate. However, alkalinization is not required with sulfisoxazole because this drug is highly soluble, or sulfonamides used to treat intestinal infections or burn wounds because there is little systemic absorption.

The lack of urination or urine production of less than 100 ml per day.

Bacteria in the urine.

Reveals important information about how well your kidneys and liver are working. A BUN test measures the amount of urea nitrogen that's in your blood.

The introduction of a catheter (a hollow flexible tube) into a body cavity or organ to inject or remove a fluid.

The volume of plasma cleared of creatinine after parenteral administration of a specified amount of the substance.

Sensitivity analysis determines the effectiveness of antibiotics against microorganisms (germs) such as bacteria that have been isolated from cultures. Sensitivity analysis may be done along with: Blood culture. Clean catch urine culture or catheterized specimen urine culture.

A substance or drug that tends to increase the discharge of urine.

Pain or burning during urination as urine flows over inflamed tissues. It is a common symptom of a lower UTI. (Ex. HCTZ, Furosemide, Triamteren, Methazolamide)

The presence of excess sugar in the urine, as in diabetes.

The irritation to bladder and urethral mucosa that results in blood-tinged urine.

A behavioral modification treatment technique for urinary incontinence that involves placing a patient on a toileting schedule. The time interval between urination is gradually increased in order to train the patient to remain continent.

The uncontrolled or involuntary discharge of urine, especially during sleep.

To urinate.

Abnormally excessive urination during the night

Excretion of an abnormally small volume of urine, often as the result of a kidney disorder.

Excessive passage of urine, as in diabetes.

The presence of pus in the urine, usually a sign of urinary tract infection.

It is used to find the cause of or monitor urinary tract infections, bleeding in the urinary system, or kidney or liver disease. It can also be used for diabetes, some diseases of the blood and bladder stones.

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Voiding.

The involuntary leakage of urine that is sufficient to be a problem.

An accumulation of urine resulting from an inability of the bladder to empty properly.

Another word for emptying the bladder or urinating.

Inflammation of the bladder, associated symptoms include hematuria and urgency/frequency.

Signs are flank pain, fever, and chills.

UTI's.

Renal stone formation.

Renal alterations.

Renal disease. (Not visible under a microscope)

Infection or renal failure

Various medications.

An alteration in urinary elimination.

A UTI.

Renal disease or some damage or medications.

Renal calculi.

Inflammatory, proliferative, and remodeling.

The inflammatory response, epithelial proliferation and migration, and the re-establishment of the epidermal layers.

6 to 7; 4.

Slough; eschar.

An infection. (Needs to be resolved for a wound to heal)

Tertiary intention.

Secondary intention.

Secondary.

Primary.

Hematoma.