Nursing 105

Essentials of Nursing Study Guide

©2018 Achieve Page 50 of 160 measures the concentration of solutes present in the urine. Normal ranges from 1.010 to 1.025. Concentrated urine has an increased specific gravity as with dehydration or fluid deficit. Urinary pH is slightly acidic. The average urine ph is 6. Glucose is normally negligible in the urine. Ingestion of large amounts of sugar may show small amounts of glucose in the urine. Ketones are products of the breakdown of fatty acids. Ketones are normally not present. Poorly controlled diabetes, alcoholism, fasting, starving or consuming high protein diets can cause the production of ketones. Protein is normally too large to escape from glomerular capillaries into the filtrate. • Urgency: Urgency is the feeling that one must void immediately whether or not there isa lot of urine in the bladder. The cause is psychological stress, irritation of the trigone, and irritation of the urethra. Urgency may also be seen with young children withpoor sphincter control. • Dysuria: Dysuria is voiding that is painful or difficult and requires pushing to void or burning that follows voiding. The causes are urinary stricture, urinary infection, and injury to the bladder and urethra. • Enuresis: Enuresis is involuntary urination in children older than 5-6 years. After urinary control is achieved, nocturnal (night) enuresis occurs more often in boys. Diurnal (day) enuresis occurs more often in girls. The causes may be pathological in nature or due to a neurological deficit, structural defects, renal insufficiency, or conditions such as diabetes. • Urinary incontinence: Urinary incontinence is a symptom, not a disease. Stress, sneezing, coughing, and lifting can all result in urinary incontinence. • Urinary retention: Urinary retention is an over distention of the bladder causing poor contractility of the detrusor muscle. This can be caused by surgery, enlarged prostate, and certain medications such as antispasmodics, phenothiazines, antihistamines, opioids, beta blockers, and anti- parkinsonian drugs. To diagnose the client is catheterized after voiding to assess the amount of residual urine left in the bladder. If over 50mls are presents, retention is confirmed. • Neurogenic bladder : Neurogenic bladder results from an impaired neurological function (tumors, spinal cord injuries, or trauma). Bladder function is altered because the person cannot perceive bladder fullness to control the external sphincter. The bladder becomes flaccid and distended or spastic with involuntary frequent urination. • Total incontinence: Total incontinence is a continuous and unpredictable loss of urine. • Stress incontinence: Stress incontinence is an involuntary loss of urine (less than 50mls) occurring with increased abdominal pressure (sneezing, coughing, laughing and lifting). • Urge incontinence: Urge incontinence is an involuntary loss of urine occurring very soon after a strong sense of the need to void. • Functional incontinence: Functional incontinence is an involuntary, unpredictable passage of urine. • Reflex incontinence: Reflex incontinence is an involuntary loss of urine occurring at somewhat predictable intervals when a specific bladder volume is reached. Nursing Procedures Specific gravity