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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