Urinary system function - A system of filtration, reabsorption, and excretion., Oliguria - less than 30ml/hr or 400ml/24-notify the provider, Anuria - No urine production- notify provider, urinary Diversions - Are created to reroute urine, and can be temporary or permanent., Nephrostomy - An incontinent urinary diversion in which the surgeon attaches a tube from the renal pelvis via a stoma to the surface of the abdominal wall, Factors that affect bladder elimination - chronic illness, age, pregnancy, childbirth, pain, diet, medication, immobility, Promoting urinary elimination for clients - provide urinal , bedpan for fracture or immobile client, schedule bathroom, privacy, Bladder retraining - Timed voiding, relaxation techniques, incontinent underpants, positive reinforcement, Client education about urine elimination - Pelvic floor exercise, Don't ignore the urge to void, reduce or stop taking caffeine, sodas or alcohol , Urine collection - Urinalysis is nonsterile and clean catch-collect midstream after cleaning meatus, 24 hour urine collection - discard the first void then collect the rest for 24 hours, Sterile from catheter - Use sterile procedure- not from collecting bag., Indweling catheter care - clean 3 times a day with soap and water, assess for kinks, empty bag 2/3 full, bag below bladder, anchored to the thigh, Risk factors for UTI - female gender, frequent sexual intercourse, uncircumcised,  proximity of anus to vaginal, menopause, Client teaching to prevent UTI - clean from front to back, drink cranberry juice, void after sex, use cotton underwear, avoid douching, Stress incontinence - Loss of small amounts of urine from increased abdominal pressure without bladder muscle contraction with laughing, sneezing, or lifting. Can occur in females due to weak pelvic floor muscles following childbirth or menopause,, Urge Incontinence  - Inability to stop urine flow long enough to reach the bathroom due to an overactive detrusor muscle with increased bladder pressure. Can occur due to bladder irritation from a UTI or an overactive bladder, Overflow Incontinence - Urinary retention from bladder overdistention and frequent loss of small amounts of urine due to obstruction of the urinary outlet or an impaired detrusor muscle., Functional Incontinence  - Loss of urine due to factors that interfere with responding to the need to urinate (cognitive, mobility, and environmental barriers), Risk factors for urine incontinence - Vaginal birth, diet, spinal cord injury, immobility, , Nursing care of urine incontinence - No fluid 2 hours before bedtime, establish toileting schedule, remove barriers to toileting, undergarment, bedpan, urinal, avoid caffeine, and alcohol, soda., Urinary incontinence medication - Tricyclic antidepressants (TCA), Oxybutynin and dicyclomine decrease urgency, TCAs - monitor for orthostatic hypotension, drowsiness, do not operate machinery, Oxybutynin and dicyclomine - Contraindicated for glaucoma, monitor tachycardia, dizziness, report constipation, Phenazopyridine - bladder analgesic of UTIs pain. risk for liver damage-report jaundice, External urinary catheter care - Condom for male, and pure wick for female-Remove daily and clean the penis with soapy water, fasten the sheath to prevent leakage,ensure no kinks, and space between tip of tubing and penis, and watch for excoriation , Kidney function lab test - BUN and creatine- elevated with renal impairment, Urinalysis for UTI - odor, presence of RBCs, WBCs, micro-organisms,

Urinary Elimination

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