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Urinary Elimination ●

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The kidneys help maintain the composition and volume of body fluids. The kidneys filter and excrete blood constituents that are not needed and retain those that are. Body fluids remain relatively stable if the kidneys are functioning properly. Urine—the waste product excreted by the kidneys—contains organic, inorganic, and liquid wastes. The nephron is the basic structural and functional unit of the kidneys. Urine is transported from each kidney by the ureters to the urinary bladder. The urinary bladder is a smooth muscle sac that serves as a temporary reservoir for urine. The urethra conveys urine from the bladder to the exterior of the body. The process of emptying the bladder is known as urination, micturition, or voiding. Any involuntary loss of urine that causes a problem is referred to as urinary incontinence. Urinary retention occurs when urine is produced normally but is not excreted completely from the bladder. Factors affecting the amount and quality of urine produced by the body and the manner in which it is excreted include developmental considerations, food and fluid intake, psychological variables, activity and muscle tone, pathologic conditions, and medication use. Nursing assessment of urinary elimination includes collection of data about the patient’s voiding patterns, habits, and difficulties, along with a history of current or past urinary problems; physical examination of the bladder, if indicated, and urethral meatus; assessment of skin integrity and hydration; examination of the urine and measurement of urine volume; and correlation of these findings with the results of diagnostic tests and procedures for examining the urine and the urinary tract. Nurses use different techniques for collecting urine specimens. The nurse needs to understand the rationale for the specific test ordered, as well as the correct collection procedure associated with the required test in order to ensure obtaining the appropriate urine sample. Nurses are responsible for preparing the patient for diagnostic procedures related to urinary function and giving appropriate aftercare. The data collected about the patient’s urinary functioning may lead to one or more nursing diagnoses. Nursing outcomes related to urinary elimination include the following: the patient will produce urine output about equal to fluid intake; maintain fluid and electrolyte balance; empty the bladder completely at regular intervals; report ease of voiding, as appropriate; and maintain skin integrity. Nursing interventions focus on maintaining and promoting normal urinary patterns, improving or controlling urinary incontinence, preventing potential problems associated with bladder catheterization, assisting with care of urinary diversions, and care of vascular access for hemodialysis and peritoneal dialysis. Patient education is essential for independence in self-care related to urinary elimination.

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The nurse evaluates the effectiveness of a care plan to promote healthy urinary functioning by checking whether the patient has met the individualized patient goals specified in the plan.

Problems with Urination ● Urinary output ○ Anuria -...