Skills Written Test 2 Study Guide

Functional incontinence urge to void but does not

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Functional incontinence- urge to void, but does not reach the toilet in time Overflow incontinence- lack urge to void, unaware of full bladder, but bladder still expels urine when certain volume is reached Other types of incontinence: developmental (enuresis) and OAB -> see previous pages Urinanalysis- normal values in parenthesis o pH balance (4.6-8.0)- If alkaline, urine has been there several hours (urine retention?) o Protein (none-8mg/ml)- protein in urine is common in renal disease o Glucose (none)- sign of diabetes mellitus or ingestion of high concentrations of glucose o Ketones (none)- poorly controlled diabetes, dehydration, starvation, or excessive aspirin use o Blood- erythrocytes, hemoglobin, or myoglobin is present. In women, could be from contamination with menstruation o Specific gravity- measures concentration of particles in urine/ high=concentrated urine; low=diluted urine o RBCs (up to 2)- kidney damage, trauma, disease, or surgery of lower urinary tract o WBCs (0-4)- urinary tract infection o Bacteria (none)- UTI o Casts (none)- casts are cylindrical bodies (hyaline, WBCs, RBCs, granular cells, epithelial cells)/ indicates renal alterations o Crystals (none)- kidney stones (uric acid or calcium phosphate) Diagnostic urinary system exams (p.1055): Abdominal roentgenogram (i.e. KUB or flat plate xray), computerized axial tomography scan (CT or CAT scan), Intravenous Pyelogram (IVP), renal/bladder ultrasound, urodynamic testing (uroflowmetry), endoscopy-cystoscopy, arteriogram (angiography) Male urinal
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Cathterization o Intermittent Uses: Relieve discomfort from bladder distension, provide decompression Obtain sterile urine sample when clean-catch is unobtainable Assess residual urine after urination Pts with spinal cord injuries, neuromuscular degeneration, or incometent bladders long term Straight single-use catheter UTI rate lower than pts w/ long-term indwelling catheters Plastic material Only 1 lumen o Short-term indwelling (Foley)- up to 3 weeks Uses: Obstruction to urine outflow (prostate enlargement) Surgical repair of bladder, urethra, or surrounding structures Prevention of urethral obstruction from blood clots after genitourinary surgery Measure urinary output in critically ill patients Continuous or intermittent bladder irrigations Latex material 2-3 lumens o Long-term indwelling (Foley) Uses:
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Severe urinary retention w/ recurrent UTI Skin rashes, ulcers, or wounds irritated by contact w/ urine Terminal illness when bed linen changes are painful to the patient Silicon or Teflon material 2-3 lumens o Coude catheter- used on male patients who may have enlarged prostates that partially obstruct the urethra. Stiffer and easier to control than a straight tip catheter-> less traumatic during insertion o From top to bottom: triple lumen catheter, foley, coudé (notice curved tip), intermittent/straight (bottom two catheters) o Condom Catheter Secured with: elastic tape or rubber that encircles the top of the
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