Urinary Elimination

Objectives:
• Describe the process of urination.
• Identify factors that influence urinary
elimination.
• Describe diagnostic measure to assess kidney
function.
• Develop nursing diagnosis related to urinary
elimination
• Describe nursing intervention to maintain
normal urinary elimination.
 Kidneys:
Paired kidneys are situated on either side of spinal column,
behind the peritoneal cavity.
Function of kidneys:
Urine formation by three process filtration, re absorption
and excretion.
– Removes urea from blood
– Removes water & inorganic salts from blood
– Regulates blood acid/base by varying ph. of urine
– Production of vitamin D
– Synthesis of erythropoietin
Ureters:
• The Ureters are from 25 to 30 cm long in the adult and
1.25cm in diameter.& the lower end enters the bladder.
Bladder:
• Is a hollow, muscular organ
• Functions as temporary reservoir urine storage
• Full bladder can contain 0.5 -1 liter of urine
Urethra:
• The Male Urethra
• Extends from neck of urinary bladder
• To tip of penis (18–20 cm)
• The Female Urethra
• Is very short (3–5 cm)Extends from bladder to vestibule
• External urethral orifice is near anterior wall of vagina
 Urination:
• Micturition, voiding and urination all refer to
the process of emptying the urinary bladder.
• urine collects in the bladder until the pressure
stimulates special sensory nerve ending in the
bladder wall called stretch receptors.
 Alteration urine production:
• Polyuria: refer to the production of
abnormally large amount of urine by the
kidneys.
• Polydipsia: excessive fluid intake may be
associated with diabetes.
• Diuresis: another term of production large
amount of urine.
• Oliguria: is low urine output less than 500ml/
day.
• Anuria: lack of urine production less than 30
ml / day
Altered urinary elimination:
• Frequency: is the voiding more than normal
with frequent intervals.
• Nocturia: is voiding two or three time at night.
• Urgency: is the feeling of person must void.
• Dysuria: means voiding that is either painful
or difficulty.
• Enuresis: is defined as involuntary urination.
• Urinary incontinence: involuntary urination.
Symptom not a disease.
• Urine retention: accumulation of urine in the
bladder and become over distended
 Nursing Process:
Assessment:
• Nursing history:
• Voiding pattern, description of urine for any
changing.
• Urinary elimination problem.
• Presence of urinary diversion.
Physical assessment:
inspection, palpation, percussion and.
 Assessing urine:

• Color: straw, transparent.

• Amount: 1200 – 1500ml/d.
• Sterility: no microorganism present.
• Glucose: not present.
• Blood: not present.
• Ketone bodies: not present.
• Epithelial cell not present.
• Measuring urine output.
• Colleting urine specimen.
 Nursing Process:
Nursing diagnosis:
• Altered urinary elimination related to bladder neck
obstruction.
• Stress incontinence related to relaxation of sphincter.
• Risk for infection related to urinary retention.
• Self esteem disturbances related to urinary
incontinence.
Planning:
• Maintain normal voiding pattern.
• Regain normal urine output.
• Prevent infection.
 Nursing Process:
Intervention:
• Maintaining normal urinary elimination:
• Promote fluid intake.
• Maintain normal voiding habit.
• Assisting with toileting.
• Preventing urinary tract infection:
• Increased fluid intake.
• Practice frequent voiding process.
• Avoid any harsh soap.
• Girls should always wipe the perineal area from
front to back.