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8/4/2019 URINARY Catheterization PRINT
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Urinary Elimination
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Characteristics of Normal and
Abnormal Urine
Amount in 24hours
Normal
1, 200 1,500 ml( 30 ml/hr)
Abnormal
Under 1,200 ml Alarge amount over
intake
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Nursing Considerations
Urinary output normally is approx. equal to
fluid intake.
Output of less than 30 ml/hr may indicate
decrease blood flow to the kidneys and
should be immediately reported
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Characteristics of Normal and
Abnormal Urine
Color, clarity Normal
Straw, Amber(Clear )
AbnormalDark Amber CloudyDark Orange
Red/Dark Brown
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Nursing Considerations Concentrated urine is darker in
color ,/Dark yellow urine is oftenindicative of dehydration
Dilute urine may appear almost clearor very pale yellow.
RBC in urine (hematuria) may beevident as pink, bright red or rustybrown urine -sign of a bladder
infection or carcinoma
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Nursing Considerations
Dark orange to brown urine can be asymptom of jaundice
Green tinged urine after six days ofsedation with propofol at a
moderately high dose
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Nursing Considerations Note: Some drugs may alter urine
colorRifampicin bright orange red
Laxative red
Chloroquine rusty yellow
Phenazopyridine orange brown
Yellowing/light orange may be caused
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Characteristics of Normal and
Abnormal Urine
Odor
Normal
Faint Aromatic
Abnormal
Offensive
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Nursing Considerations Some food (eg
asparagus) causea musty odor
Infected urine canhave a fetid odor.
Urine high inglucose has asweet odor
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Characteristics of Normal and
Abnormal Urine
Sterility
Normal
No Microorganism
Abnormal
Microorganism
Present
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Nursing Considerations
Urine specimenmay contaminate
by bacteria fromperineum duringcollection.
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Characteristics of Normal and
Abnormal Urine
pH
Normal
4.5 8
Abnormal
Over 8 Under 4.5
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Nursing Considerations Freshly voided
urine is normallysomewhat acidic.
Alkaline urine mayindicate a state ofalkalosis, UTI or
diet high in fruitsand vegetables.
More acidic urine
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Characteristics of Normal and
Abnormal Urine
Specific Gravity Normal
1.010 1.025
Abnormal
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Nursing Considerations
Concentrated urine has a higherspecific gravity.
Diluted urine has a lower specificgravity
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Characteristics of Normal and
Abnormal Urine
Glucose
Glucose in theurine indicateshigh bloodglucose level
(>180 mg/dl) and
Normal
Absent
Abnormal
Present
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Characteristics of Normal and
Abnormal Urine
Protein
Protein in the
Normal
Absent
Abnormal
Present
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Characteristics of Normal and
Abnormal Urine
Ketones
Ketones, the endproduct of thebreakdown offatty acids, are
not normally
Normal
Absent
Abnormal
Present
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Characteristics of Normal and
Abnormal Urine
Pus
Pus in urine mayindicative of UTI
Normal
Absent
Abnormal
Present
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Characteristics of Normal and
Abnormal Urine
Blood
Blood may bepresent in theurine of theclients who have
Normal
Absent
Abnormal
Present
lteration on rinary
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lteration on rinaryElimination
Problem : Polyuria ( diuresis)
Definition : Production of excessive
amount of urine (> 100ml/hr or >2500ml/day)
Selected Associated Factors
- Fluids containing caffeine or alcohol
- - Prescribed diuretics
lteration on rinary
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lteration on rinaryElimination
Problem : Oliguria
Definition : Production of decreased
amount of urine (
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lteration on rinaryElimination
Problem :Anuria
Definition : Absence of production of
urine by the kidneys such as 0-10ml/hr
Selected Associated Factors
- Decrease fluid intake , dehydration
- Hypotension, shock or kidney dse.
lteration on rinary
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lteration on rinaryElimination
Problem :Urinary Frequency
Definition : Voiding in frequent
interval
Selected Associated Factors
- Pregnacy- Increase fluid intake
- UTI
lteration on rinary
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lteration on rinaryElimination
Problem : Nocturia
Definition : Increased urination at
night
Selected Associated Factors
- Pregnacy- Increase fluid intake
- UTI
lteration on rinary
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lteration on rinaryElimination
Problem : Dysuria
Definition : Voiding that is eitherpainful or difficult
Selected Associated Factors
- UTI, Infection and Trauma
lteration on rinary
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lteration on rinaryElimination
Problem : Enuresis
Definition : Bed wetting, repeated
involuntary voiding beyond 4-5 yearsof age
Selected Associated Factors
- Famil Histor Home stresses
lteration on rinary
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lteration on rinaryElimination
Problem : Urinary Incontinence
Definition : A continuous andunpredictable loss of urine
Selected Associated Factors- Bladder inflammation
- UTI
- Kidney diseases
lteration on rinary
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lteration on rinaryElimination
Problem : Urinary Retention
Definition : The accumulation of urinein the bladder with associated inabilityof the bladder to empty itself.
Note: 250-450 ml. of urine in thebladder triggers micturition reflex
Selected Associated Factors- Recent anesthesia
- Recent surgery
N i I t ti f Cli t
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Nursing Interventions for Clients
with Urinary Incontinence
Bladder Retraining Program.Determine the clients voiding pattern
or establish a regular voiding time.
Lengthen the intervals of voiding once
the clients voiding can be controlled.
Regulate fluid intake
N i I t ti f Cli t
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Nursing Interventions for Clients
with Urinary Incontinence
Avoid stimulants at bedtime
Schedule diuretics in the morning.
Adequate fluid intake in the morning.
Kegels Exercise ( alternating tension
and relaxation of the pubococcygeal
muscles
N i I t ti t I d
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Nursing Interventions to Induce
Voiding/Urination
Provide privacy
Provide fluids to drink
Assist the patient in the anatomical
position of voiding
Serve clean, warm and dry bedpan
female or urinal male
N i I t ti t I d
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Nursing Interventions to Induce
Voiding/Urination
Allow the client to listen to the soundof running water
Dangle fingers in warm water
Pour warm water over the perineum
Promote relaxation
N i I t ti t I d
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Nursing Interventions to Induce
Voiding/Urination
Perform Credes Maneuver as ordered
Administer cholinergics as ordered
Last resort: URINARY
CATHETERIZATION
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