Urinary Elimination

…..is defined as the excretion of waste products. Elimination Concept …..is defined as the excretion of waste products. Urinary Elimination ….is the passage of urine through the urinary tract by means of the urinary sphincter and urethra. Giddens 2013

Organs of Urinary Elimination Kidneys Remove waste from the blood to form urine Ureters Transport urine from the kidneys to the bladder Bladder Reservoir for urine until the urge to urinate develops Urethra Urine travels from the bladder and exits through the urethral meatus.

Alterations in urinary elimination

Pre-class Assignment

Urinary Tract Infection

Urinary Incontinence

Conditions Affecting Urination Conditions that make it difficult to reach and use toilet facilities Cognitive impairments Diseases that slow or hinder physical activity

Indications for Catheterization

Benign Prostatic Hyperplasia (BPH)

Urinary Tract Infection Consequences Results from catheterization or procedure CAUTIs (Catheter-associated Urinary Tract Infections) Increased hospitalization Increased morbidity and mortality Longer hospital stay Increased hospital cost

Absorbent Products

Types of Urinary Diversions

Urinary Diversion

An accumulation of urine due to the inability of the bladder to empty Urinary Retention An accumulation of urine due to the inability of the bladder to empty Signs and Symptoms Bladder distention No UO in several hours May void small amounts of urine 2-3 times an hour Treatment Residual urine Bladder scan I & O catheter

Bladder Scanner

Case study

Urinary Assessment on Admission hemodialysis buried penis burning upon urination congenital anomalies continuous ambulatory PD decreased urination enlarged prostrate hematuria hernia Incontinence hx interstitial cystitis kidney disease kidney stones nephrotic syndrome nocturia ostomy GU renal failure sexually transmitted disease ureteropelvic junction obstruction urinary frequency, hesitancy, tract infection, reflux, urgency, retention

KUB right left IVP CT

Skill Lab

Assessment of Urine Intake and output (I&O) Characteristics of urine Color Pale-straw to amber color Clarity Transparent unless pathology is present Odor Ammonia in nature Urine testing Specimen collection

Types of Male Urinals

Alternatives for Male Urination: Condom Catheter

External Urinary Device

Types of Bedpans

Catheterization Catheter insertion Closed drainage systems Catheter care Perineal hygiene Fluid intake Removal of indwelling catheter

Closed drainage systems Important points Closed drainage systems Catheter care

Types of Catheters

Obtaining a Urine Specimen from an Indwelling Foley Catheter