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Oliguria
Output that is below 30mL/hr
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What is the average output for a normal adult?
30-60mL/hr
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In which part of the urinary system are solutes such as glucose reabsorbed?
Loop of Henle
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Additional water and sodium is reabsorbed here under the control of ADH and aldosterone.
Distal Convoluted Tubule
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Give two examples of what could cause a patient to have Oliguria.
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A patient with Oliguria is at risk for:
a)
b)
- a) renal failure
- b) poor tissue perfusion
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Daily weights are done when and why?
Daily weights are done if a patient is carrying excess fluid volume and are done to gauge their fluid balance/retention.
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What is the most important thing to remember when doing daily weights?
To do them at the same time everyday, on the same scale.
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Name the five components of the urinary system.
- 1-Adrenal gland
- 2-Kidneys
- 3-Ureters
- 4-bladder
- 5-Urethra
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What are the kidneys responsible for?
filtering metabolic wastes, toxins, excess ions and water from the bloodstream and excreting them as urine.
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In the process of urine formation, most water and electrolytes are absorbed here.
Proximal Convoluted Tubule
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What happens when a patient has impaired kidney function?
substances build up causing toxins that can poison cells.
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What is the medical term for urination?
Mictoration
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When you have patients straight from anesthesia, it's important they void within __ hours on their own.
8
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Urine collects in the bladder until pressure stimulates special sensory nerve endings in the bladder wall called ______ _______.
stretch receptors
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The stretch receptors transmit impulses to the spinal cord (to the voiding reflex) causing the _______ ________ to relax, which stimulates the urge to void.
internal sphincter
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The average amount of urine adults hold is between:
250-430mL
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The average amount children hold in their bladders is between:
50-200mL
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Define Enuresis
The involuntary passing of urine.
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Define nocturnal enuresis
"bed-wetting" - involuntary passing of urine during sleep.
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Infants usually void ___mL per day?
15-60mL/kg of wt/day
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What happens to the excretory function in older adults?
- a) The function of the kidneys diminish.
- b) The number of functioning nephrons
- decrease, impairing the kidney's
- filtering abilities.
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The decrease in kidney function in older adults puts them at risk for what? and why?
- a) toxicity from medications
- b) excretion rates are longer
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Complaints of urinary urgency and frequency are commonly due to ___________ in men and _________ in women.
- 1) enlarged prostate
- 2)weakened bladder and/or
- sphincter muscle
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What happens to the bladder capacity and it's ability to empty with age?
What does this explain?
What does this predispose the older adults to?
It diminishes, which increases residual retention.
This explains the need for older adults to void frequently during the night.
UTI's
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Putting off voiding when doing tasks can cause bladder infections from ______
_______.
Urinary stasis
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An estimated __% of nephrons are lost by age 80.
30
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Urinary incontinence in older adults may occur due to _______ problems or _________ impairments.
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A high salt diet _______ urine production.
decreases
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When you hold your urine too long, you open yourself up to?
infection
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What is the most commonly used diuretic?
Lasix
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Name 4 nephrotoxic drugs.
- 1-Gentamycin
- 2-Amphotericin B
- 3-Aspirin
- 4-Ibuprofen
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What is the term for voiding more than two times a night?
Nocturia
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Name the 7 factors that can affect voiding:
- 1-Developmental factors
- 2-Psychosocial
- 3-Fluid and food intake
- 4-Medications
- 5-Muscle tone
- 6-Pathologic conditions
- 7-Surgical procedures
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Define Lithotripsy
An ultrasound, shockwave treatment by which a kidney stone or calculus is broken down into small particles that can be passed by the body.
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Define Cystitis
Inflammation of the urinary bladder.
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Medical term form pain or burning during urination.
Dysuria
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A kidney infection that can cause pus in the urine.
pyelonephritis
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The two interchangeable medical terms meaning to produce abnormally large amounts of urine.
Polyuria, Diuresis
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The two interchangeable medical terms used to describe decreased urinary output.
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Define polydipsia
excessive thirst
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Medical term meaning excessive hunger.
Polyphagia
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What is the most common bacteria associated with UTI's?
E. coli
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Define hypertrophy
An enlargement of an organ or tissue.
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Normal urine consists of __% water and __% solutes.
96/4
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Normally the kidneys produce about ____mL of urine per day.
1500
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Low outputs may indicate low ______ volume or or _______ malfunction.
blood, kidney
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Normal urine pH is:
4.5-8
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A bladder scanner is an noninvasive assessment tool that can reduce the number of nosocomial ____ resulting from urinary catheterizations.
UTI's
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Residual urine is normally?
50-100mL
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BUN test
Blood Urea Nitrogen
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What is urea?
The end product of protien metabolism.
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How is urea measured in the urine?
with the BUN test.
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What are the 2 tests routinely used to evaluate renal function?
BUN and Creatinine Clearance.
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The creatinine clearance test uses 24hr urine and serum creatinine levels to determine the ___________ filtration rate.
glomerular
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The nurse is instructing the patient on giving a clean catch specimen. What does she instruct the patient do do?
- -Not to touch the top or cap when
- opening the collection cap.
- -wipe front to back with wipes
- provided
- -void a little into the toilet, then stop.
- -now void into the collection cup
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A sterile urine specimen comes from?
A catheder
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