NRS 312 Study Guide - Final Guide: Dysuria, Anuria, Radiography
Urinary elimination
• Essentials
o Flushing the tube is not done until you know it is safe!! –Gasto/nutrition section
o How do we know it is safe: confirm it is in the right place
▪ xray:initial placement
• KUB: kidneys urinary bladder radiograph – x ray
▪ pH of gastric aspirate:
o Knowing it is safe:
▪ abdominal assessment: bowel sounds
▪ gastric volume residual: less than 500 ml ok
▪ check to see markings on tube have not moved at the nares
o Pt tolerating feeding:
▪ nausea vomiting coughing
• Function of the Kidneys
o Eliminate waste, electrolyte balance, pH
o Peristaltic activity in the uriteres
o Urethra: shorter distance for females are more likely to get UTIs
• Urine Production Factors
o Amount of fluid we take in and pressure gradients.
o Any obstruction in the kidney itself(renal calculi)
o Encourage pts to take 1500-2000 ml of fluid a day.
o ADH
o Hypovolemia
• Urine Elimination Factors
o Any obstructions in urethra
o Damage to nervous tissue
o Enlarged prostate
o Urethral trauma ( blood in urine-hematourea)
o Older aged, bladder atrophies. 20-30% decrease in size
o ADH- increase or decrease
o 30-50% of elder loss glomerular function
o Women lose pelvic support
• Assessment Subjective
o Ask about pain with urination, frequency, any nocturnal changes, nocturia- urination at
night. More common in older adults. Urinary incontinence or retention problems
▪ Oliguria- low urinary output. Opposite of polyuria
▪ Anuria: no output
▪ Dysuria: diffuclty or pain with urination
o Normal urine production: 1-2 L/day .5 ml/kg/hr
o Look for intact skin, drainage for unusual odors, look at mobility status will contribute to
ability to toilet themselves
o Functional incontinence: cant get to the restroom soon enough
o Urge to void at 200-250 ml of fluid any more you get oressure and distension.
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