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urinary system Cheat Sheet (DRAFT) by

This is a draft cheat sheet. It is a work in progress and is not finished yet.

Organs of urinary elimin­ation

removes wastes from the blood in form of urine
Transports urine from the kidneys to the bladder
reservoir for urine until the urge to urinate develops
Urine travells.
Differ­ences: Female urethra is shorter than male's so more prone to UTIs

Factors effecting urination

Disease conditions
neurogenic bladder, renal failure, etc
Medica­tions and medicla procedures
diuretics, fluids via IV, antidi­ure­tics, antich­oli­ner­gics,
Socioe­conomic factors
Nervous bladder, SRO Hotels, no water, etc
Psycho­logical factors
Fluid balance
Nocturia, polyuria, oliguria, anuria, diuresis, fever

Changes with aging

Prostate enlarg­ement: starst at 40's to 80's. Urinary frequency and possible retention.
Child bearin­g/h­ormonal change­s/m­eno­pause: causes urinary difficulty such as decreased muscle tone, urinary urgency and stress incont­inence.
Elderly tend to drink less.
Urinary incont­inence is not a normal part of aging
Decreased estrogen during & after menopause. increased risk of UTIs because urethral mucosa becomes thinner.

Common Urinary Problems

Urinary retension
bladder is unable to partially or completely empty.
socioe­con­omic, neurogenic bladder
Urinary tract infections (UTIs)
nosoco­mial, bacter­iuria, urosepsis
hygiene, holding in, dehydr­ation
Urinary incont­inence
loss of control over voiding
lots of patients have colonozed bladders, but not considered a UTI.

Contai­nment Devices

absorbent day pads
Condom Catheters
Foley catheters
SPC Subra Pubic Cather­iza­tions
Skin care is important


Steril­ization is extremely important to not introduce pathogens into the urethra.
Type A: straight. single us only
Type B: Indwelling Foley. Has a little balloon filled with sterile water or saline. Has a split section for a syringe and urinary elimin­ation.
Potential sites for infection
insertion point
where the tub attaches to the catheter
where the tube attaches to bag
when too close to the ground
bag too full
drainage point

SPC caths

CARE Urinary cath
inspect stoma daily
cleanse stoma
perineal care daily and prn
roll cath between fingers daily
urine drains freely into bag
cath bad below bladder,/ not touching floor
bag not above bladder/ not close to ground
cath secure, prevent pulling on skin.
avoid tube kink
drain when 1/2 - 2/3 full.
maintain aspepsis when emptying bag
change spic, bag, tubing per facili­ty/­phy­sician orders
wipe port with alcohol wipes prior to reconn­ecting when converting to alternate system.
document & care plan.
- no longer take samples from cath bag. most reside­ntial patients will be colonized.
- mid-stream is how to take a sample.
policy states that cath has to be removed and sample taken from new cath. do we need a CNS for this patient?

Normal charac­ter­istics of urin

Volume: >30mls per hour (intke­/ou­tput) | 1200-1­500mLs per 24hrs. Void 4/5x/day
colour: pale straw to amber, depends on concen­tration
clarity: transp­arent
pH 4.5-8.0
Specific gravity 1.010-­2.025
No glucose, ketones or blood
odour: mild ammonia in nature

Colors caused by medica­tions

Dark yellow: vit b12
Orange: sulphas; pyridium; warfarin
pink/red: ex-lax; dilantin
green/­blue: amitri­pty­line; methylene blue
brown/­black: iron;l­evo­dopa; nitrof­ura­ntoin; metron­idazole

Specimen collection

urinalysis (u/a): ph, presence of protein, glucose, ketones, blood, specific gravity SG
Clean voided or midstream, sterile colelction cup
Urine culture: may need 72hrs to determine bacterial growth.
clean coided or midstream, sterile collection cup.
time collec­tions- 12/24hrs: no urine or toilet tissue contam­ination
clean recept­acle, stored until collection finished.

Asssiting urination

promote bladder emptying and relaxation
bladder re-tra­ining, bladder diary, voiding regular intervals, 5-7x/day
streng­thening pelciv floor muscles (kegels)
precent infection, avoid indwelling caths.
encourage activi­ty/­mob­olity -> reduces pressur ulcers and possible need for indwelling cath.
drug therapy


squeeze pelvic muscles slowly increasing intensity over 8 seconds
hold for 8 sec
relax slowly over 8 sec


bladder scanner: see what kind of catheter is right for the patient. helps determine for full bladder and post-void residuals. PVR (post void residual).

Catheter assessment

asses meatus for swelling, redness, or discharge
patient, bed soaker pad, fram attached
no kinks
approx vol in drainage bag. bag not touching floor.
to drain bag place cylinder on floor and drain into without touching the cylinder.
assess urin color, smell, and texture when draining, close bag properly.
note volume. dispose urine according to policy.

condom cath

extern­ally, less invasive,
not too tight, not too loose
check id band, allergies? latex.
get supplies ready
wash up client. pericare.
cleanest to dirtiest.