Nursing 105

Essentials of Nursing Study Guide

©2018 Achieve Page 49 of 160 Factors Influencing Urinary Elimination • Developmental factors : Neonate’s urine is colorless and odorless and has a specific gravity of 1.008. Kidneys double in size between ages 5-10 years. Complaints of urinary urgency impacts older adults. In men, it is often due to an enlarged prostate gland and in women because of weakened muscles supporting the bladder or weakness of the urethral sphincter. • Psychosocial factors : Privacy, normal position, sufficient time and occasionally, running water, all influence urination. • Fluid and food intake: Sodium causes retention of urine, while alcohol and caffeine increase fluid output. • Medications: Diuretics such as HCTZ and Lasix prevent water from being reabsorbed in the renal tubules. • Muscle tone and activity: Regular exercise increases muscle tone and metabolic rate. • Pathologic conditions: The ability of nephrons to produce urine is important. Abnormal amounts of protein or blood cells causes abnormal urination. • Abnormal amounts of fluid lost : Processes that interfere with flow include stones or enlarged prostrate. • Surgical and diagnostic procedures: Inflammation following cystoscopy or use of spinal anesthetics effect urination. Altered Urine Production • Polyuria: Polyuria is the production of abnormally large amounts of urine. Several liters eliminated more than intake can cause excessive fluid loss, leading to intense thirst, dehydration, and weight loss. Causes are polydipsia, diabetes mellitus, diabetes insipidus and chronic nephritis. • Oliguria: Oliguria is low urine output, less than 500 ml/day or 30 ml/hour. This usually indicates impaired blood flow to the kidneys or impending renal failure. Causes are often indicative of impaired blood flow to the kidney, abnormal fluid loss, lack of fluid intake, and impending kidney failure. • Anuria: Anuria is a lack of urine production. Causes are kidney failure and loss of blood flow to the kidneys. • Frequency: Frequency is voiding at frequent intervals, more often than usual. Causes are increased fluid intake, urinary tract infection, stress, and pregnancy. • Cystitis: Cystitis is an infection of the bladder. The cause is bacterial and is generally resolved with antibiotic therapy. • Nocturia: Nocturia is voiding two to three times at night. The cause is congestive heart failure or dependent edema. When the legs are elevated at night time, excess fluid is processed through the kidneys, resulting in diuresis and ultimately voiding.