FUNDAMENTAL

OF NURSING PRACTICE

SUBMITTED TO:

Wenna May S. Ramojal RN.

SUBMITTED BY:

Sobani A. Hadji Motalib 1BSN-B

 URINARY ELIMINATION
TITLE
URINARY ELIMINATION

➢ Is essential to health and avoiding can be postponed for only so long before the urge
normally becomes too great to control.

➢ Elimination from the urinary tract is usually taken for granted. Only when a problem arises do
most people become aware of their urinary habits and any associated symptoms.

NURSING MANAGEMENT

Assessing

A complete assessment of a client's urinary function includes the following:

★ Nursing history

★ Physical assessment of the genitourinary system, hydration status, and examination of the
urine

★ Relating the date obtained to the results of any diagnostic tests and procedures

Nursing History

The nurse determines the client's normal voiding pattern and frequency, appearance of the
urine and any recent changes, any past or current problems with urination, the presence of an
ostomy, and factors influencing the elimination pattern.

Examples of interview questions to elicit this information are shown in the Assessment
Interview. The number of the questions asked depends on the individual and the responses to
the first three categories.

Physical Assessment
Complete physical assessment of the urinary tract usually includes percussion of the kidneys to
detect areas of tenderness. Palpation and percussion of the bladder are also performed. If the
client's history or current problems indicate a need for it, the urethral meatus of both male and
female clients is inspected for swelling, discharge, and inflammation.

Because problem with urination can affect the elimination of wastes from the body, it is
important that the nurses assess the skin for color, texture, and tissue turgor as well as the
presence of edema. 8f incontinence, dribbling, or dysuria is noted in the history, the skin of the
perineum should be inspected for imitation because contact with urine can excoriate the skin.

Assessing Urine

Normal urine consists of 96% water and 4% solutes. Organic solutes include urea, ammonia,
creatinine, and uric acid. Urea is the chief organic solute. Inorganic solutes include sodium
chloride is the most abundant inorganic salt. Variations in color can occur.

DESMEASURING URINARY OUTPUT

Normally, the kidneys produce urine at a rate of approximately 60 mL per hour or about
1,500 mL per day. Urine output is affected by many factors including fluid intake, body fluid
losses through other routes such as perspiration and breathing or diarrhea, and the
cardiovascular and renal status of the individual.

ASSESSMENT INTERVIEW OF URINARY ELIMINITION

VOIDING PATTERN

• How many times do you urinate during a 24-hour period?

• Has this pattern changed recently?

• Do you need you get out of bed to void at night? How often?

DESCRIPTION OF URINE AND ANY CHANGES

• How would you describe your urine in terms of color, clarity (clear, transparent, or cloudy),
and odor (faint or strong)?

URINARY ELIMINATION PROBLEMS

• What problems have you had or do you now have with passing your urine?

• Passage of small amounts of urine?

• Voiding at intervals the are more frequent?

• Trouble getting to the bathroom in time or feeling an urgent need to void?

• Painful voiding?

• Difficulty starting urine stream?

• Frequent dribbling of urine or feeling of bladder fullness associated with voiding small
amounts of urine?

• Reduced force of stream?

• Accidental leakage of urine? It so, when does this occur (e.g., when coughing, laughing, or
sneezing, at night; during the day)?

• Past urinary tract illness such as infection of the kidney, bladder, or urethra: urinary calculi;
surgery of kidney, ureters, or bladder?

FACTORS INFLUENCING URINARY ELIMINATION

• Medications. Do you take any medications that could increase urinary output or cause
retention of urine? Note specific medication and dosage.

• Fluid intake. What amount and kind of fluid do you take each day (e.g., six glasses of water,
two cups of coffee, three cola drinks with or without caffeine)?

• Environmental factors. Do you have any problems with toileting (mobility, removing clothing,
toilet seat too low, facility without grab bar)?

• Stress. Are you experiencing any major stress? If so, what are the stressors? Do you think
these affect your urinary pattern?

• Disease. Have you had or do you have any illnesses that may affect urinary function, such as
hypertension, heart disease, neurologic disease, cancer, prostatic enlargement, or diabetes?

• Diagnostic procedures and surgery. Have you recently had a cystoscopy or anesthetics?

Reference:
(2008). Kozier & Erb’s fundamentals of nursing (Eighth Edition): concepts, process, and practice.
Upper Saddle River, N.J.: Pearson Prentice Hall,