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NUR 168; CHAPTER 37 URINARY ELIMINATION
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NUR 168; CHAPTER 37 URINARYELIMINATION
Urinary System:
- Kidneys and ureters
- Bladder
- Urethra
Kidneys and Ureters:
•Maintain composition and volume of body fluids
•Filter and excrete blood constituents not needed; retain those that are needed
•Excrete waste product (urine)
-The nephrons maintain and regulate fluid balance through the mechanisms of
selective reabsorption and secretion of water, electrolytes, and other substances. .
-Urine from the nephrons empties into the kidneys.
Bladder:
•Smooth muscle sac innervated by ANS
•Serves as a temporary reservoir for urine
•Composed of three layers of muscle tissue called detrusor muscle
-The inner longitudinal layer, the middle circular layer, and the outer longitudinal
layer
•Sphincter guards opening between the urinary bladder and urethra
•Urethra conveys urine from bladder to the exterior of the body
,Urethra:
•Conveys urine from the bladder to the exterior
•Male urethra functions in excretory and reproductive systems
•No portion of the female urethra is external to the body
Act Of Urination (Micturition, Voiding):
•Process of emptying the bladder
-Detrusor muscle contracts, the internal sphincter relaxes, urine enters the posterior
urethra
-Muscles of the perineum and external sphincter relax
-Muscle of the abdominal wall contracts slightly
-Diaphragm lowers, micturition occurs
Which term describes a condition in which 24-hour urine output is less than 50
mL?
A. Dysuria
B. Glycosuria
C. Pyuria
D. Anuria
Answer: D. Anuria
Rationale: Anuria is synonymous with kidney shutdown or renal failure. Dysuria is
painful or difficult urination. Glycosuria is the presence of sugar in the urine.
Pyuria is pus in the urine.
Anura:
24-hour urine output is less than 50 mL
Dysura:
Painful or difficult urination
,Oliguria:
24-hour urine output is less than 400 mL
Pyuria:
Pus in the urine
Urinary Incontinence:
Involuntary loss of urine
Factors Effecting Micturition:
•Developmental considerations
•Food and fluid intake
•Psychological variables
•Activity and muscle tone
•Pathologic conditions
•Medications
Developmental Considerations Of Micturition:
•Children
-Toilet training 2 to 3 years old, enuresis
•Effects of aging
-Nocturia
-Increased frequency
-Urine retention and stasis
-Voluntary control affected by physical problems
Diuretics cause increased urine production, resulting in the need for increased
urination and possibly urge incontinence.
, A. True
B. False
Answer: A. True
Rationale: Diuretics cause increased urine production, resulting in the need for
increased urination and possibly urge incontinence.
Diseases Associated With Renal Problems:
•Congenital urinary tract abnormalities
•Polycystic kidney disease
•Urinary tract infection
•Urinary calculi
•Hypertension
•Diabetes mellitus
•Gout
•Connective tissue disorders
Effects of Medications on Urine Production and Elimination: Diuretics:
•prevent reabsorption of water and certain electrolytes in tubules
Effects of Medications on Urine Production and Elimination: Cholinergic
medications:
•stimulate contraction of detrusor muscle, producing urination
Effects of Medications on Urine Production and Elimination: Analgesics and
tranquilizers:
suppress CNS, diminish effectiveness of neural reflex
Medications Affecting Color of Urine: Diuretics:
Pale yellow urine
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