Which action would the nurse do when collecting a 24 hour urine specimen quizlet?
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Terms in this set (48)Urinary Elimination Kidneys Act of Urination SKIPP 1. Bladder volume increases Daily Fluid Intake & Output Average Adult Needs Intake Output Daily Water Needs 8-10 (8 ounces) per day= 236.588 ml "Tenting" is a sign of Dehydration Types of Patient Problems Needing I&O Disease states causing fluid retention Intake and Output—Measurement of Fluids into and out of the Body Intake Output
Oliguria Oliguria Anuria Anuria Normal Urinary Output Normal Urinary Output 60-120ml per hour Abnormal Urine Output Causes of Oliguria??? Abnormal Fluid losses - Vomiting and Diarrhea (Internal Hemorhaging) Factors Affecting Urination Growth & Development Women suffer (child birth) more than men until age 85 Factors Affecting Urination Effects of aging Decrease urine concentration How Aging Affects Urination Kidneys decrease in ability to concentrate
urine Decreasing Bladder Muscle Tone Strong Diuretics (Furosemide aka Lasix) Bladder Contractility Decreases Factors Affecting Urination Psychological drink water but cystoscopy if they have heart prob Alterations in Urinary Elimination Incontinence- lack of voluntary control over urination Urinary Tract Infection= s/sx dysuria Types of Urinary Dysfunction & Nursing Diagnosis Functional - couldn't get to the bathroom and theres nothing wrong with their organs Reflex - Stress - the sphincter muscles are looser from childbirth Overflow - when urine builds up Nursing History History: Urinary frequency and regularity, nocturia, control, volume, recent changes, hygiene Nursing History Assessment Physical Exam: Nursing History & Assessment of Urinary Tract Abnormal Characteristics of Urine - Abnormal - Change in color from yellow, not due to meds or food
Specific Gravity Test Density Specimen Collection Culture and sensitivity determine type of bacteria and antibiotic to use Grows within 72 hours Clean Catch Sterile specimen container No toilet paper in the container Wear gloves to handle specimen Urinalysis (UA) Specific gravity— Urinary concentration Dipstix Culture & Sensitivity Urinary Tract Tests - KUB(kidneys urinary bladder)/Flat Plate 24 Hour Urine Collection Post a sign at the bedside (better than a blood test for creatin) best test for the function of the kidneys Discard the 1st void specimen Keep collection bottle on ice Nursing Diagnosis Impaired Urinary Elimination - Urinary Retention-BPH (Benign prostatic hyperplasia) - Incontinence Involuntary Escape of Urine=Urinary Incontinence - What type of incontinence is due to weak pelvic muscles and can be precipitated by sneezing?????? Stress / Sneezing - Stress Kegal Exercises - Exercise pubococcygeal muscles Planning Goals—Patient Will: Stimulating Micturition Assume normal position
Preventing Infection Hygiene- wipe front to back (female) Foley Catheter Care - Protect catheter tubing when getting patient OOB. 2. A nurse caring for patients in an extended-care facility performs regular assessments of the patients' urinary functioning. Which patients would the nurse screen for urinary retention? Select all that apply. a. A 78-year-old male patient diagnosed with an enlarged prostate a, c, e Urinary retention occurs when urine is produced normally but is not excreted completely from the bladder. Factors associated with urinary retention include medications such as antihistamines, an enlarged prostate, or vaginal prolapse. Being on bedrest, having dementia, and having difficulty walking to the bathroom may place patients at risk for urinary incontinence. 1. A nurse caring for patients in a long-term care facility is often required to collect urine specimens from patients for laboratory testing. Which techniques for urine collection are performed correctly? Select all that apply. a. The nurse catheterizes a patient to
collect a sterile urine sample for routine urinalysis. d, e, f A urine culture requires about 3 mL of urine, whereas routine urinalysis requires at least 10 mL of urine. The preferred method of collecting a urine specimen from a urinary diversion is to catheterize the stoma. For a 24-hour urine specimen, the nurse should discard the first voiding, then collect all urine voided for the next 24 hours. A sterile urine specimen is not required for a routine urinalysis. Urine chemistry is altered after urine stands at room temperature for a long period of time. A specimen from the collecting receptacle (drainage bag) may not be fresh urine and could result in an inaccurate analysis. A nurse is preparing a brochure to teach patients how to prevent urinary tract infections. Which teaching points would the nurse include? Select all that apply. a. Wear underwear with a synthetic crotch. c, e, f It is recommended that a healthy adult drink eight to ten 8-oz glasses of fluid daily, limit caffeine because it is irritating to the bladder mucosa, and drink 10 oz of cranberry or blueberry juice daily to help prevent bacteriuria. It is also recommended to wear underwear with a cotton crotch, take showers rather than baths, and drink two glasses of water before and after sexual intercourse and void immediately after intercourse. 4. A patient who has pneumonia has had a fever for 3 days. What characteristics would the nurse anticipate related to the patient's urine output? a. Decreased and highly concentrated a Fever and diaphoresis cause the kidneys to conserve body fluids. Thus, the urine is concentrated and decreased in amount. 5. The physician has ordered an indwelling catheter inserted in a hospitalized male patient. What consideration would the nurse keep in mind when performing this procedure? a. The male urethra is more vulnerable to injury during insertion. a Because of its length, the male urethra is more prone to injury and requires that the catheter be inserted 6″ to 8″. This procedure requires surgical asepsis to prevent introducing bacteria into the urinary tract. The presence of an indwelling catheter places the patient at risk for a UTI. 6. A nurse is performing intermittent closed-catheter irrigation for a patient with an indwelling catheter. After attaching the syringe to the access port on the catheter, the nurse finds that the irrigant will not enter the catheter. What intervention would the nurse appropriately perform next? a. Apply pressure to the catheter to force the solution into the catheter. c If the irrigation solution will not enter the catheter, the nurse should not force the solution into the catheter; instead, the nurse should notify the primary care provider and prepare to change the catheter. 7. A nurse is caring for a 56-year-old male patient diagnosed with bladder cancer who has a urinary diversion. Which actions would the nurse take when caring for this patient? Select all that apply a. Measure the patient's fluid intake and output. a, c, f When caring for a patient with a urinary diversion, the nurse should measure the patient's fluid intake and output to monitor fluid balance, change the appliance frequently, monitor the return of intestinal function and peristalsis, keep the skin around the stoma dry, watch for mucous in the urine as a normal finding, and encourage the patient to participate in care and look at the stoma. 8. A nurse is changing the stoma appliance on a patient's ileal conduit. Which characteristic of the stoma would alert the nurse that the patient is experiencing ischemia? a. The stoma is hard and dry. d A purple-blue stoma may reflect compromised circulation or ischemia. A pale stoma may indicate anemia. The stoma may be swollen at first, but that condition should subside with time. A normal stoma should be moist and dark pink to red in color. 9. After surgery, a patient is having difficulty voiding. Which nursing action would most likely lead to an increased difficulty with voiding? a. Pouring warm water over the patient's fingers. b Ignoring the urge to void makes urination even more difficult and should be avoided. The other activities are all recommended nursing activities to promote voiding. 10. A nurse caring for a patient's hemodialysis access documents the following: "5/10/15 0930 Arteriovenous fistula patent in right upper arm. Area is warm to touch and edematous. Patient denies pain and tenderness. Positive bruit and thrill noted." Which documented finding would the nurse report to the primary care provider? a. Positive bruit noted. b The nurse would report a site that is warm and edematous as this could be a sign of a site infection. The thrill and bruit are normal findings caused by arterial blood flowing into the vein. If these are not present, the access may be cutting off. No report of pain is a normal finding. 11. A nurse is caring for an alert, ambulatory, older resident in a long-term care facility who voids frequently and has difficulty making it to the bathroom in time. Which nursing intervention would be most helpful for this patient? a.
Teach the patient that incontinence is a normal occurrence with aging. c Kegel exercises may help a patient regain control of the micturition process. Incontinence is not a normal consequence of aging. Using absorbent products may remove motivation from the patient and caregiver to seek evaluation and treatment of the incontinence; they should be used only after careful evaluation by a health care provider. An indwelling catheter is the last choice of treatment. 12. A nurse is caring for a patient who is taking phenazopyridine (Pyridium, a urinary tract analgesic). The patient questions the nurse: "My urine was bright orangish-red today; is there something wrong with me?" What would be the nurse's best response? a. "This is a normal finding when taking phenazopyridine." a Pyridium is noted for turning the urine orange-red; the patient needs to be aware of this. 13. A nurse is caring for a male patient who had a condom catheter applied following hip surgery. What action would be a priority when caring for this patient? a. Preventing the tubing from kinking to maintain free urinary drainage a The catheter should be allowed to drain freely through tubing that is not kinked. It also should be removed daily to prevent skin excoriation and should not be fastened too tightly or restriction of blood vessels in the area is likely. Confining a patient to bedrest increases the risk for other hazards related to immobility. 14. A nurse forms the following nursing diagnosis for a patient: Impaired Urinary Elimination related to maturational enuresis. Based on this diagnosis, for which patient is the nurse caring? a. An adult older than 65 years of age who is incontinent b Maturational enuresis is involuntary urination after an age when continence should be present. A 12-month-old child is not expected to be continent, and incontinence and neurologic damage are not maturational problems. 15. Data must be collected to evaluate the effectiveness of a plan to reduce urinary incontinence in an older adult patient. Which information is least important for the evaluation process? a. The incontinence pattern d Incontinence is not a natural consequence of the aging process. All the other factors are necessary information for the plan of care. Students also viewedUrinary Elimination15 terms Skinner00PLUS HEMODIALYSIS/PERITONEAL DIALYSIS24 terms jessiewong1 NURS (FUNDAMENTAL): Ch 39 NCLEX Fluid, Electrolyte…78 terms MamkaNatka Exam 1: Spinal Cord Injury Questions30 terms danielle_white47PLUS Sets found in the same folderCh 37: Bowel Elimination54 terms bianca_pulido Ch 6: Values, Ethics, and Advocacy67 terms bianca_pulido Ch 7: Legal Dimensions of Nursing Practice37 terms bianca_pulido Ch 45: Spirituality35 terms bianca_pulido Other sets by this creator3. Antidiabetic Agents24 terms bianca_pulido Fluid and Electrolytes29 terms bianca_pulido HEART PULMONARY106 terms bianca_pulido Unit 5: Anti-Inflammatories, Disease Mod…78 terms bianca_pulido Recommended textbook solutions The Human Body in Health and Disease7th EditionGary A. Thibodeau, Kevin T. Patton 1,505 solutions
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What is the first action done in collecting a 24 urine specimen?It is important to collect all urine in the following 24-hour period. Don't save the urine from your first time urinating. Flush this first specimen, but note the time. This is the start time of the 24-hour collection.
Which action would be appropriate to implement when collecting a 24 hour?Which action would be appropriate to implement when collecting a 24-hour urine test? Start the time of the test after discarding the first voiding. Discard the last voiding in the 24-hour period for the test.
When giving a patient instructions for a 24 hour urine collection you should?Instructions:. Empty your bladder into the toilet when you get up in the morning. ... . For the remainder of the 24-hour period, collect all urine you pass and immediately add it to the special collection container.. The test ends 24-hours from the first (uncollected) specimen the day before.. |
