What are some cues that the nurse may notice when assessing a patients urinary
pattern
(the patient is suffering elimination issues, what could the nurse assess visually) -
ANSWER Urine COPA Is abnormal
The meatus is not slit like or free of drainage
The female perineum is not free of drainage or inflammation
Erythema, edema, and signs of scratching, or drainage are present
What are potential cues that help The nurse assess a patient's elimination patterns
as it relates to skin integrity - ANSWER Skin maceration is common in incontinent
patients
The skin erodes, i.e. erythemic, burning, swollen, painful, itchy
Urine is created by _______ - ANSWER The kidneys
What are the three urinary alterations We focus on at CSCC? - ANSWER Urinary
incontinence (stress vs urgent)
Urinary tract infection (lower vs upper)
Urinary retention (acute vs chronic)
What are the signs and symptoms an individual is suffering with stress related
urinary incontinence - ANSWER (Women) common after childbirth
Leaking when coughing, sneezing or laughing
(Women) Weekend pelvic floor
Nocturia is NOT present
What are signs and symptoms of a lower UTI - ANSWER Located in bladder/urethra
Dysuria
Cloudy or foul smelling urine
Increased urgency, frequency, and accidents
Suprapubic tenderness
,What are the signs and symptoms of an upper UTI? - ANSWER Stems from the
kidneys
Flank pain
Fever and chills
Flu like symptoms
Hematuria
Pyuria
Dysuria
Increased urgency, frequency in accidents
Suprapubic tenderness
What are the causes for UTIs? - ANSWER Poor hygiene
Indwelling catheter
Sexually active
Incontinent
Bacteria build up (E. coli)
What are the signs and symptoms of an older adult that has a UTI - ANSWER In
addition to general symptoms, older adults may have:
Altered mental status
Increased frequency of falls
Sub normal temperature
loss of appetite
How are UTIs generally treated - ANSWER Lower UTIs: topical medication
PO antibiotics
Upper UTIs : PO antibiotics
IV Medication/antibiotics
Hospitalization required
What is urinary retention? - ANSWER An accumulation of urine due to the inability of
the bladder to empty
, Urinary retention _______ the risk for UTI - ANSWER Increases
What is acute onset urinary retention? - ANSWER The bladder stretches due to
overinflation
Restlessness and diaphoresis common
Typically occurs after surgery, spinal cord, injury, or removal of a Foley catheter
What is chronic onset urinary retention? - ANSWER Slow/gradual onset
Decreased in void volume
Straining to void
Occurs with aging
Increased frequency to void
What are the signs and symptoms that an individual is suffering from urgency related
urinary incontinence - ANSWER Strong sudden urge to void
Involuntary contractions of the bladder
Leaking when coughing, sneezing, laughing is common
Frequency of void is increased
Nocturia is present
What are factors that can affect urinary elimination - ANSWER Anxiety and stress:
impair pelvic floor/sphincter
Depression: decreased desire for continence (risk for UTI)
Diuretics: increase frequency, increase risk for falls in older population
Surgical patients after catheter removal, have a decreased sensation to void,
causing an increase occurrence of urinary retention
What are physiologic considerations for urinary elimination in women - ANSWER
Pelvic floor weakness by childbirth: stressed induced incontinence
Menopause: thinning of urethra walls, making incontinence and UTIs more common
What are physiologic considerations for urinary elimination in men - ANSWER
Prostate enlargement: urinary retention
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