2 Types of Fluid Imbalance Fluid volume defecit (dehydration)- decreased fluidintake. Causes: illness- diarrhea, vomiting, diaphoresis,wound drainage, NPO, etc. Age. Altered mental status.Fluid Volume Excess (overload)- increased fluid intake

Abnormal Particles Found inUrine

Fat globules, Red or whiteblood cells, bacteria, crystals

Anuria Failure of the kidneys to produce urine.The absence of urine or minimal amountof urine.

Bladder Training A program to assist patients with improving their urinary function.Educate and assist with frequent toileting, avoiding caffeine, drinkmore in the AM and less in PM, toileting offered during times whenpatient would normally void (i.e after meals, in the morning uponwaking, etc)

Blood Urea Nitrogen (BUN) a test that measures the amount of urea nitrogen inblood. Urea nitrogen is usually filtered OUT of thebllod by the kidneys. Used to asses renal (kidney)function.

Causes of Urinary Retention Kidney stones, enlarged prostate gland, tumor,pregnant uterus, infection or scar tissue, nervedisorders, postoperative complications

Dialysis The filtering of blood to remove toxins.Used in patients with kidney functionproblems.

Dysuria Painful urination

Fluid Volume Overload Signsand Symptoms

WEIGHT GAIN, edema, dyspnea,crackles, bounding pulse, confusion,

noisy lung sounds, bradycardia

Hematuria Presence of red or white bloodcells in the urine.

How much liquid does ahealthy adult require per day?

Healthy adults require 2000-2500 mls of fluid per day. See, Intakeis proportional to output. Roughly what goes into a person per dayalso comes out of them. TO MAINTAIN HOMEOSTASIS, INTAKESHOULD EQUAL OUTPUT.

Incontinence Inability to control one'surinary or bowel functions.

Indwelling Catheter Stays in the bladder, usually for a few days, todrain urine on a continuous basis. Also known as adouble-lumen catheter or Foley catheter.

Insensible Water (Fluid) Loss Fluid lost by exhalation and perspiration.Not felt by individual. Cannot beaccurately measured.

Intake and Output (I&O) The amount of liquid a person drinks or eats (Intake). The amount ofurine the person passes (output). Measured by mls normally. Intake isusually added up by serving container size (juice glass size, mug size,etc), output is usually measured by pouring urine into a graduatedmeasuring container or noting amount on catheter drainage bag.

Nocturia Having to wake up at night tourinate.

Normal Characteristics ofUrine

Color: straw, Clarity: Clear, Amount: 1,000to 3,000 ml per day, Odor: mild, PH: 4.6 to8, Specific Gravity: 1.010 to 1.025

Normal Urine Output Minimum of 30ml per hour, and between1,000ml to 3,000 ml per day.

Nursing Interventions forDehydration (fluid volume deficit)

Eliminate cause of decreased intake (i.e give meds forvomiting or diarrhea), monitor I&O, Measure dailyweights, monitor tissue turgor, check vitals,encourage fluids

Nursing Interventions for FluidVolume Retention or Overload

Monitor I&O, weight (at same time each day), vitalsigns, breathing, assess for edema, limit fluids ifneeded, monitor mental status. Correct underlyingcause, restrict fluids

Oliguria Low output of urine (below 30 ml perhour). Report to charge nurse orphysician.

PH of Urine Normally 4.6 to 8.0, depending on diet. Diets high in protein or cranberriescauses PH to be lower ( acidic), diets high in dairy products, vegetables, etccauses the PH to be higher (alkaline). PH is important to diagnosing urinarytract infections. UTI urine is more alkaline (higher PH than normal). PH canbe used to also detect some types of kidney stones.

Polyuria High output of urine (greaterthan 3,000 ml per day )

Renal Calculi Kidney stones

Residual Urine Urine that remains in thebladder even after eliminating.

Specific Gravity The result of comparing the weight of a substance with an equalamount of water. Normal for urine is 1.010 to 1.025. A high resultmeans urine is more concentrated (i.e dehyration or diabetes), alow result means urine is more dilute (i.e. excessive fluid intake orimpaired kidney function)

Straight Catheter Used only for insertion in the bladder to obtain asterile urine specimen or for a ONE TIME drainageof urine. Also known as a single-lumen catheter.

Stress Incontinence Losing (being incontinent of) urine(usually small amounts) without one'scontrol due to coughing, laughing etc.

Urge incontinence Strong, sudden need to urinate dueto bladder spasms or contractions.

Urinary Diversion Any one of several proceduresto re-route the urine.

Urinary Retention The inability to empty the bladder at allor the inability to completely empty thebladder. It can be acute or chronic.

Urinary Tract Infection (UTI) A bacterial infection that attacks the urinary tract. UTI urine has a high(alkaline) PH. Encourage acidic beverages like cranberry juice. Signsinclude urge to urinate frequently, passing small amounts of urine ornone an all, painful urination(dysuria), low abdominal pain, fever, chills,lethargy, nausea, vomiting. If left untreated UTIs can attack the kidneys.

Void To urinate