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NURSE 3170: TEST 2
What is a normal, expected urine output per hour? Per day?
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Hour: 60 mL
Day: 1200-1500 mL
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What is the normal pH range of urine? What is an average pH?
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Range: 4.8-8
Average: 6
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What is the accepted range for specific gravity of urine?
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1.015-1.025
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What does damaged skin around the perineal area indicate?
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Incontinece, or prolonged exposure to urine/feces
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What does CVA tenderness indicate?
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Infection |
What does bladder distention indicate?
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Urinary retention, inability to void
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What does dark amber urine indicate?
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That the urine is very concentrated, which means the patient may be dehydrated
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What does bright red, pink, or rusty brown urine indicate?
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Hematuria |
What does orange urine indicate?
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Patient may be on pyridium
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What does blue or green urine indicate?
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Patient may be on medication amitriptyline
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What does foul-smelling urine indicate?
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Infection
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What does sweet-smelling urine indicate?
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Diabetes mellitus
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What does cloudy/purulent urine indicate?
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Infection |
How much output per hour can be considered oliguria? How much output per day?
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Less than 30 mL/hour; less than 400 mL/day
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What does oliguria indicate?
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Decreased renal perfusion, dehydration
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How much output per day is considered anuria?
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Less than 50 mL/day
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What does anuria indicate?
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End stage renal failure (pt should start dialysis)
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What does polyuria indicate?
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Diabetes insipidus
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What might an acidic (less than 4) urine pH indicate?
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Pt is eating a protein-rich diet OR starvation/cachexia
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What might an alkaline (greater than 8) urine pH indicate?
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Alkalosis, UTI, diet high in fruits and veggies
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What might hematuria indicate?
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Infection, obstruction, kidney disease, trauma, menstruation
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What do high urine glucose levels indicate?
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Poor glucose control (diabetes)
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What do ketones in the urine indicate?
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Uncontrolled DM, starvation/cachexia, excessive aspirin
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What does proteinuria indicate?
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Kidney damage
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What does urinary urgency indicate?
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Full bladder, cystitis, overactive bladder (spasm in the detrusor muscle), psychological stress
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What does urinary retention indicate?
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There may be an obstruction, decreased sensory activity, prostate enlargement, or medications may be at fault
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What does dysuria indicate?
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Inflammation, infection, trauma, calculi (stones)
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What does urinary frequency indicate?
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Increased fluid intake, pt may be on diuretics, cystitis, pressure, alcohol consumption
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What does urinary hesitancy indicate?
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Prostate enlargement, anxiety, urethral edema
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What is urinary dribbling? What might it indicate?
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Leakage of urine despite voluntary control; might indicate overflow from urinary retention (BPH) or stress incontinence
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What should the nurse do if their patient is experiencing urinary dribbling?
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Put the patient on a toileting schedule
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What should the nurse do if their patient is experiencing stress incontinence?
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Have the patient do pelvic floor exercises or wear absorbent products. Might put in a sling via surgery.
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What is functional incontinence?
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Incontinence caused by factors not related to the urinary tract that affect voiding
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What is reflex incontinence? What does it indicate?
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The loss of sensation to void; may indicate neurological impairment, spinal cord injury, or post-catheterization
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What can the nurse do to handle a patient with reflex incontinence?
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Intermittent catheterization, condom catheter
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What pneumonic is used to assess incontinence?
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TOILETED - thin skin, obstruction, infection, limited mobility, emotional factors, therapeutic medications, endocrine disorders, delirium
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True or false: a straight catheter can be used to obtain a sterile urine sample.
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True, but only if a clean catch is unavailable
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What is the first method you should use to obtain a sterile urine sample?
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Clean-catch
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What should you use to examine urine residual after a void?
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Bladder scanner
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Plastic catheters are for what type of use only?
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Intermittent
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What is the most common material used for catheters?
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Latex |
What size catheter is used for children? What about women? Men?
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Kids: 8-10 fr.
Women: 14-16 fr.
Men: 16-18 fr.
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How much water does a catheter balloon typically hold?
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5-10 mL
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What type of fluid should you use to inflate the balloon?
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Sterile water
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How often should you empty the urine collection bag?
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When it's 1/3-1/2 full OR every 3-6 hours
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How much protein should be in each urine void?
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Less than 20 mg/dL
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What are the normal WBC and RBC values for urine per void?
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RBC: less than 5
WBC: less than 5
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What does a high specific gravity of urine indicate? What does a low specific gravity indicate?
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Dehydration; overhydration
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When collecting urine from a patient with a catheter, where should you draw the urine from for the sample? Why?
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From the tube itself, NOT the collection bag - the urine in the collection bag might not be fresh
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How much urine is needed for a culture & sensitivity?
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3 mL
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How much urine is needed to perform a routine urinalysis?
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10 mL
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