Exam (elaborations)
Fundamentals Exam 2 Chapter 44 Urinary Elimination ATI
Fundamentals Exam 2 Chapter 44 Urinary Elimination ATI
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Fundamentals Exam 2 Chapter 44Urinary Elimination ATI
Urinary System: - -filtration, reabsorption, excretion
-Pathway of Urine: - -Kidneys to the nephrons (perform most of
filtration/elimination. Then Urine goes from kidneys to ureters to the bladder.
Then once bladder fills up, the brain tells the bladder to relax the internal
and external sphincter to relax and urine is released through the urethra.
-How much urine can the bladder hold? - -150-200mL
-daily urine production - -1500-2000 mL/day
-Urinary Diversions - -Surgical creation of a stoma that is temporary or
permanent for drainage of urine.
Can be continent (controlled) or incontinent (w/out control)
Continent have reservoir in abdomen.
-ureterostomy - -incontinent urinary diversion for which the surgeon
attaches one or both ureters via a stoma to the surface of the abdominal wall
-nephrostomy - -incontinent urinary diversion for which the surgeon
attaches a tube from the renal pelvis via a stoma to the surface of the
abdominal wall
-factors affecting urinary elimination - -poor abdominal and pelvic muscle
tone; acute and chronic disorders; spinal cord injury; surgery; immobility;
medications; diet
-children - -achieve full bladder control by 4 to 5 years
-prostate - -enlarges after 40 years of age; urinary frequency; hesitancy;
retention; incontinence; UTIs
-childbirth and gravity - -weakens the pelvic floor putting clients at risk for
prolapse of the bladder leading to stress incontinence that can be managed
with Kegel exercises
-older adults - -fewer nephrons; loss of muscle tone of bladder leading to
frequency; inefficient emptying of bladder leaving residual urine increasing
risk of UTIs; increase in nocturia
, -pregnancy - -growing fetus compromises bladder space and compressed
the bladder; 30-50% increase in circulatory volume increasing renal workload
and output; hormone relaxin causes relaxation of sphincter
-diet - -increase in Na leads to decreased urination; caffeine and alcohol
intake lead to increased urination
-immobility - -incontinence is not a result of aging but of neurological or
mobility impairments
-pyschosocial factors - -emotional stress and anxiety; having to use public
toilets; lack of privacy during hospital stays; not having enough time during
breaks
-pain - -suppression of urge; obstruction in ureter leading to renal colic;
arthritis or painful joints causing immobility and leading to delayed urination
-surgery - -alterations in glomerular filtration rate from anesthesia and
opioid analgesics resulting in decreased urine output; lower abdominal
procedures creating obstructive edema and inflammation
-medications - -diuretics preventing reabsorption of water; antihistamines
and anticholinergics causing retention; chemotherapy damaging kidneys
-orange/red urine - -phenazopyridine
-green/blue urine - -amitriptyline
-dark urine - -levodopa
-sonography - -noninvasive portable ultrasound scanner for measure
bladder volume and residual volume after urination
-xrays - -to determine size shape and position of kidneys ureters and
bladder
-IV pyelogram - -injection of contrast media (iodine) for viewing of ducts,
renal pelvis, ureters, bladder, and urethra; No dye if allergy to shellfish
-renal scan - -view of renal blood flow and anatomy of the kidneys without
contrast
-renal ultrasound - -view of gross renal structures and structural
abnormalities using sound waves
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