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Urinary Elimination
Urinary System
Kidneys and ureters
Bladder
Urethra
Bladder
Urethra
Act of Urination
Developmental considerations
Food and fluid intake
Psychological variables
Activity and muscle tone
Pathologic conditions
Medications
Developmental Considerations
Children
Toilet training 2 to 3 years old, enuresis
Effects of aging
Nocturia
Increased frequency
Urine retention and stasis
Voluntary control affected by physical problems
Physical Assessment of
Urinary Functioning
Kidneys: Palpation of the kidneys is usually performed by
an advanced health care practitioner as part of a more
detailed assessment.
Urinary bladder: Palpate and percuss the bladder or use a
bedside scanner.
Urethral orifice: 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.
Urine Specimens
Routine urinalysis
Clean-catch or midstream specimens
Sterile specimens from indwelling catheter
Urine specimen from a urinary diversion
24-hour urine specimen
Specimens from infants and children
Diagnostic Procedures
Cystoscope
Intravenous Pyelogram (IVP)
Retrograde Pyelogram
Ultrasound procedures
CAT scan
KUB (kidneys, ureters, bladder) scan
Biopsy
Nursing Diagnoses
Urinary functioning as the problem
Incontinence
Pattern alteration
Urinary retention
Urinary functioning as the etiology
Anxiety
Caregiver role strain
Risk for infection
Impaired skin integrity
Types of Catheterization
Straight catheterization
External (Texas or condom) catheter
Indwelling (Foley) catheter
Suprapubic catheter
Ileal conduit
A portion of the ileum is used as an ostomy
Ureterostomy
Ureters are re-routed outside the body
Urinary (continent) pouch
Ureters are redirected to a reservoir which is able to
be catheterized for drainage