ATI Fundamentals For Nursing Chapter 44 - Urinary Elimination
Kidneys
Urinary elimination
Urinary Diversion
Type of Urinary Diversion
Incontinent Urinary Diversion
Continent Urinary Diversion
Ureterostomy
Nephrostomy
an incontinent urinary diversion for which the surgeon attaches a tube from the renal pelvis via a stoma to the surface of the abdominal wall
Factors affecting urinary elimination
DIAGNOSTIC TESTS Bedside sonography with a bladder scanner
noninvasive portable ultrasound scanner for measuring bladder volume and residual volume after urination.
DIAGNOSTIC TESTS Kindeys, ureters, ballader
x-ray to determine size, shape, and position of these structures
DIAGNOSTIC TESTS Intravenous pyelogram
Injection of contrast media (iodine) for viewing of ducts, renal pelvis, ureters, bladder, and urethra
DIAGNOSTIC TESTS Renal scan
View of renal blood flow and anatomy of the kidneys without contrast
DIAGNOSTIC TESTS Renal ultrasound
View of gross renal structuresand structural abnormalities using
high‑frequency
sound waves
DIAGNOSTIC TESTS Cystoscopy
Use of a lighted instrument to visualize, treat, and obtain specimens from the bladder and urethra
DIAGNOSTIC TESTS Urodynamic testing
Test for bladder muscle function by filling the bladder with CO2 or 0.9% sodium chloride and comparing pressure readings with reported sensations
Usual size and type of catheter
LABORATORY TEST Urinalysis and urine culture and sensitivity
To identify UTI (presence of RBCs, WBCs, micro‑organisms)
LABORATORY TEST Serum creatinine and BUN
To assess renal function (elevated with renal dysfunction)
DIAGNOSTIC PROCEDURES Ultrasound
Detects bladder abnormalities and/or residual urine
DIAGNOSTIC PROCEDURES Voiding cystourethrography
Identifies the size, shape, support, and function of the urinary bladder, obstruction (prostate), residual urine
DIAGNOSTIC PROCEDURES Urodynamic testing
DIAGNOSTIC PROCEDURES Electromyography
Measures the strength of pelvic muscle contractions
Polyuria
Oliguria
Anuria
Dysuria
Urinary Incontinence
Urinary Retention
Urgency
Straight catheters
are for one-time use and are removed immediately after the insertion and drainage of urine.
Indwelling catheters
are used short-term and provide a closed drainage system for urine.
Retention catheters
are most commonly used postoperatively because they have multiple lumens to allow for the drainage of urine, irrigation of the bladder, and instillation of medications into the bladder.
Coude catheters
are used for patients who have prostatic hyperplasia (enlargement); this type of catheter has a curved tip to allow for easier insertion.
Suprapubic catheters
are similar to indwelling catheters except that they are placed through a surgical opening in the abdomen rather than through the urethra.
Condom catheters
have a latex or silicone sheath to place over the penis.