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Fundamentals of Nursing NUR 101

2. Chapter 14. Urinary Elimination. 3. Urinary Elimination . Kidneys and Ureters.Maintain composition and volume of body fluids. Filter and excrete blood constituents not needed and retain those that are needed.Excrete waste product (urine)Nephrons remove the end products of metabolism and regulate fluid balance. Urine from the nephrons empties into the kidneys..

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Fundamentals of Nursing NUR 101

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    1. 1 Fundamentals of Nursing (NUR 101) Prepared by Nabeel Al-Mawajdeh RN.Mcs. King Saud University- Aflaj College

    2. 2

    3. 3 Urinary Elimination Kidneys and Ureters. Maintain composition and volume of body fluids. Filter and excrete blood constituents not needed and retain those that are needed. Excrete waste product (urine) Nephrons remove the end products of metabolism and regulate fluid balance. Urine from the nephrons empties into the kidneys.

    4. 4 Act of Micturition Process of emptying the bladder. - Detrusor muscle contracts, internal sphincter relaxes, urine enter posterior urethra. - Muscles of perineum and external sphincter relax. - Muscle of abdominal wall contracts slightly. - Diaphragm lowers, Micturition occurs.

    5. 5 Factors Affecting Micturition Developmental considerations. Food and fluid intake. Psychological variables. Activity and muscle tone. Pathologic conditions. Medication.

    6. 6 Diseases Associated With Renal Problems Congenital urinary tract abnormalities. Polycystic kidney disease. Urinary tract infection. Urinary calculi. Hypertension. Diabetes mellitus. Gout. Connective tissue disorders.

    7. 7 Effects of Medications on Urine Production and Elimination Diuretics-prevent reabsorption of water and certain electrolytes in tubules Cholingeric medications stimulate contraction of detrusor muscle, producing urination. Analgesics and tranquilizers suppress CNS diminish effectiveness of neural reflex.

    8. 8 Medications Affect in Color of Urine Anticoagulants red color. Diuretics lighten urine to pale yellow. Pyridium orange to orange-red urine. Elavil green or blue-green. Levodopa brown or black.

    9. 9 Using the Nursing Process Assessing data about voiding patterns, habits, past history of problems. Physical examination of urinary system, skin hydration, urine. Correlation of these findings with results of procedures and diagnostic tests.

    10. 10 Assessing a Problem With Voiding Explore its duration, severity, and precipitating factors. Note patient's perception of the problem. Check adequacy of patient's self-care behaviors.

    11. 11 Physical Assessment of Urinary Functioning Kidneys check for costovertebral tenderness. Urinary bladder palpate and percuss the bladder or use bedside scanner. Urethral meatus inspect for signs of infection, discharge, or odor. Skin assess for color, texture, turgor, and excretion of wastes. Urine assess for color, odor, clarity, and sediment.

    12. 12 Measuring Urine Output Ask patient to void into bedpan, urinal, or specimen container in bed or bathroom. Pour urine into appropriate measuring device. Place calibrated container on flat surface and read at eye level. Note amount of urine voided and record on appropriate form. Discard urine in toilet unless specimen is needed.

    13. 13 Diagnoses Urinary functioning as the problem. Incontinence, pattern alteration, urinary retention. Urinary functioning as the etiology. Anxiety, caregiver role strain, risk for infection.

    14. 14 Planned Patient Goals Urine output about equal to fluid intake. Maintain fluid and electrolyte balance. Empty bladder completely at regular intervals. Report ease of voiding. Maintain skin integrity. Promoting Normal Urination. Maintaining normal voiding habits. Promoting fluid intake. Strengthening muscle tone. Stimulating urination and resolving urinary retention.

    15. 15 Reasons for Catheterization Relieving urinary retention. Obtaining a sterile urine specimen. Measuring amount of urine in bladder. Obtaining a urine specimen. Emptying bladder before during or after surgery. Monitoring of critically ill patients.

    16. 16 Patient Education for Urinary Diversion Explain reason for diversion and rationale for treatment. Demonstrate effective self-care behaviors. Describe follow-up care and support resources. Report where supplies may be obtained in community. Verbalize related fears and concerns. Demonstrate a positive body image.

    17. 17 Evaluating Effectiveness of Plan Maintain fluid, electrolyte, and acid-base balance. Empty bladder completely at regular intervals with no discomfort. Provide care for urinary diversion and when to notify physician. Develop a plan to modify factors contributing to problem. Correct unhealthy urinary habits.

    18. 18 Maintaining Normal Voiding Timing. Positioning. Provide privacy. Assisting with toileting.

    19. 19 The End

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