\documentclass[10pt,a4paper]{article}

% Packages
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\usepackage{multicol}           % Allows multicols in tables
\usepackage{tabularx}           % Intelligent column widths
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\usepackage{hhline}             % Border under tables
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%\usepackage[utf8x]{inputenc}    % For unicode character support
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\usepackage{seqsplit}           % Splits long words.
%\usepackage{opensans}          % Can't make this work so far. Shame. Would be lovely.
\usepackage[normalem]{ulem}     % For underlining links
% Most of the following are not required for the majority
% of cheat sheets but are needed for some symbol support.
\usepackage{amsmath}            % Symbols
\usepackage{MnSymbol}           % Symbols
\usepackage{wasysym}            % Symbols
%\usepackage[english,german,french,spanish,italian]{babel}              % Languages

% Document Info
\author{Roxanne (Reuben)}
\pdfinfo{
  /Title (urinary-system.pdf)
  /Creator (Cheatography)
  /Author (Roxanne (Reuben))
  /Subject (urinary system Cheat Sheet)
}

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% Commands
\newcommand{\SetRowColor}[1]{\noalign{\gdef\RowColorName{#1}}\rowcolor{\RowColorName}} % Shortcut for row colour
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% Header and Footer
\pagestyle{fancy}
\fancyhead{} % Set header to blank
\fancyfoot{} % Set footer to blank
\fancyhead[L]{
\noindent
\begin{multicols}{3}
\begin{tabulary}{5.8cm}{C}
    \SetRowColor{DarkBackground}
    \vspace{-7pt}
    {\parbox{\dimexpr\textwidth-2\fboxsep\relax}{\noindent
        \hspace*{-6pt}\includegraphics[width=5.8cm]{/web/www.cheatography.com/public/images/cheatography_logo.pdf}}
    }
\end{tabulary}
\columnbreak
\begin{tabulary}{11cm}{L}
    \vspace{-2pt}\large{\bf{\textcolor{DarkBackground}{\textrm{urinary system Cheat Sheet}}}} \\
    \normalsize{by \textcolor{DarkBackground}{Roxanne (Reuben)} via \textcolor{DarkBackground}{\uline{cheatography.com/69645/cs/17832/}}}
\end{tabulary}
\end{multicols}}

\fancyfoot[L]{ \footnotesize
\noindent
\begin{multicols}{3}
\begin{tabulary}{5.8cm}{LL}
  \SetRowColor{FootBackground}
  \mymulticolumn{2}{p{5.377cm}}{\bf\textcolor{white}{Cheatographer}}  \\
  \vspace{-2pt}Roxanne (Reuben) \\
  \uline{cheatography.com/reuben} \\
  \end{tabulary}
\vfill
\columnbreak
\begin{tabulary}{5.8cm}{L}
  \SetRowColor{FootBackground}
  \mymulticolumn{1}{p{5.377cm}}{\bf\textcolor{white}{Cheat Sheet}}  \\
   \vspace{-2pt}Not Yet Published.\\
   Updated 8th November, 2018.\\
   Page {\thepage} of \pageref{LastPage}.
\end{tabulary}
\vfill
\columnbreak
\begin{tabulary}{5.8cm}{L}
  \SetRowColor{FootBackground}
  \mymulticolumn{1}{p{5.377cm}}{\bf\textcolor{white}{Sponsor}}  \\
  \SetRowColor{white}
  \vspace{-5pt}
  %\includegraphics[width=48px,height=48px]{dave.jpeg}
  Measure your website readability!\\
  www.readability-score.com
\end{tabulary}
\end{multicols}}




\begin{document}
\raggedright
\raggedcolumns

% Set font size to small. Switch to any value
% from this page to resize cheat sheet text:
% www.emerson.emory.edu/services/latex/latex_169.html
\footnotesize % Small font.

\begin{multicols*}{2}

\begin{tabularx}{8.4cm}{x{1.2 cm} x{6.8 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{8.4cm}}{\bf\textcolor{white}{Organs of urinary elimination}}  \tn
% Row 0
\SetRowColor{LightBackground}
\seqsplit{Kidneys} & removes wastes from the blood in form of urine \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
\seqsplit{Ureters} & Transports urine from the kidneys to the bladder \tn 
% Row Count 4 (+ 2)
% Row 2
\SetRowColor{LightBackground}
\seqsplit{Bladder} & reservoir for urine until the urge to urinate develops \tn 
% Row Count 6 (+ 2)
% Row 3
\SetRowColor{white}
\seqsplit{Urethra} & Urine travells. \tn 
% Row Count 8 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{8.4cm}}{Differences: Female urethra is shorter than male's so more prone to UTIs}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{x{3.68 cm} x{4.32 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{8.4cm}}{\bf\textcolor{white}{Factors effecting urination}}  \tn
% Row 0
\SetRowColor{LightBackground}
Disease conditions & neurogenic bladder, renal failure, etc \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
Medications and medicla procedures & diuretics, fluids via IV, antidiuretics, anticholinergics, \tn 
% Row Count 5 (+ 3)
% Row 2
\SetRowColor{LightBackground}
Socioeconomic factors & Nervous bladder, SRO Hotels, no water, etc \tn 
% Row Count 7 (+ 2)
% Row 3
\SetRowColor{white}
Psychological factors & . \tn 
% Row Count 9 (+ 2)
% Row 4
\SetRowColor{LightBackground}
Fluid balance & Nocturia, polyuria, oliguria, anuria, diuresis, fever \tn 
% Row Count 12 (+ 3)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{8.4cm}}{\bf\textcolor{white}{Changes with aging}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{8.4cm}}{Prostate enlargement: starst at 40's to 80's. Urinary frequency and possible retention.} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{8.4cm}}{Child bearing/hormonal changes/menopause: causes urinary difficulty such as decreased muscle tone, urinary urgency and stress incontinence.} \tn 
% Row Count 5 (+ 3)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{8.4cm}}{Elderly tend to drink less.} \tn 
% Row Count 6 (+ 1)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{8.4cm}}{Urinary incontinence is not a normal part of aging} \tn 
% Row Count 7 (+ 1)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{8.4cm}}{Decreased estrogen during \& after menopause. increased risk of UTIs because urethral mucosa becomes thinner.} \tn 
% Row Count 10 (+ 3)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{x{2.28 cm} x{2.888 cm} x{2.432 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{3}{x{8.4cm}}{\bf\textcolor{white}{Common Urinary Problems}}  \tn
% Row 0
\SetRowColor{LightBackground}
Urinary retension & bladder is unable to partially or completely empty. & \seqsplit{socioeconomic}, neurogenic bladder \tn 
% Row Count 4 (+ 4)
% Row 1
\SetRowColor{white}
Urinary tract infections (UTIs) & nosocomial, bacteriuria, urosepsis & hygiene, holding in, dehydration \tn 
% Row Count 7 (+ 3)
% Row 2
\SetRowColor{LightBackground}
Urinary \seqsplit{incontinence} & loss of control over voiding &  \tn 
% Row Count 9 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}---}
\SetRowColor{LightBackground}
\mymulticolumn{3}{x{8.4cm}}{lots of patients have colonozed bladders, but not considered a UTI.}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}---}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{x{2.508 cm} p{0.836 cm} x{4.256 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{3}{x{8.4cm}}{\bf\textcolor{white}{Containment Devices}}  \tn
% Row 0
\SetRowColor{LightBackground}
absorbent day pads & \seqsplit{Briefs} & Condom Catheters \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
Foley catheters &  & SPC Subra Pubic Catherizations \tn 
% Row Count 4 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}---}
\SetRowColor{LightBackground}
\mymulticolumn{3}{x{8.4cm}}{Skin care is important}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}---}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{p{0.8 cm} p{0.8 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{8.4cm}}{\bf\textcolor{white}{Catheterizations}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{8.4cm}}{Sterilization is extremely important to not introduce pathogens into the urethra.} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{8.4cm}}{Type A: straight. single us only} \tn 
% Row Count 3 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{8.4cm}}{Type B: Indwelling Foley. Has a little balloon filled with sterile water or saline. Has a split section for a syringe and urinary elimination.} \tn 
% Row Count 6 (+ 3)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{8.4cm}}{{\bf{Potential sites for infection}} \newline insertion point \newline where the tub attaches to the catheter \newline where the tube attaches to bag \newline when too close to the ground \newline bag too full \newline drainage point}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{x{4 cm} x{4 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{8.4cm}}{\bf\textcolor{white}{SPC caths}}  \tn
% Row 0
\SetRowColor{LightBackground}
CARE - SPC & CARE Urinary cath \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
inspect stoma daily & handwashing \tn 
% Row Count 2 (+ 1)
% Row 2
\SetRowColor{LightBackground}
cleanse stoma & perineal care daily and prn \tn 
% Row Count 4 (+ 2)
% Row 3
\SetRowColor{white}
roll cath between fingers daily & urine drains freely into bag \tn 
% Row Count 6 (+ 2)
% Row 4
\SetRowColor{LightBackground}
cath bad below bladder,/ not touching floor & bag not above bladder/ not close to ground \tn 
% Row Count 9 (+ 3)
% Row 5
\SetRowColor{white}
cath secure, prevent pulling on skin. & avoid tube kink \tn 
% Row Count 11 (+ 2)
% Row 6
\SetRowColor{LightBackground}
drain when 1/2 - 2/3 full. & maintain aspepsis when emptying bag \tn 
% Row Count 13 (+ 2)
% Row 7
\SetRowColor{white}
change spic, bag, tubing per facility/physician orders & wipe port with alcohol wipes prior to reconnecting when converting to alternate system. \tn 
% Row Count 18 (+ 5)
% Row 8
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{8.4cm}}{document \& care plan.} \tn 
% Row Count 19 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{8.4cm}}{- no longer take samples from cath bag. most residential patients will be colonized. \newline - mid-stream is how to take a sample.  \newline policy states that cath has to be removed and sample taken from new cath. do we need a CNS for this patient?}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{x{0.988 cm} x{3.876 cm} x{2.736 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{3}{x{8.4cm}}{\bf\textcolor{white}{Normal characteristics of urin}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{3}{x{8.4cm}}{Volume: \textgreater{}30mls per hour (intke/output) | 1200-1500mLs per 24hrs. Void 4/5x/day} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
\seqsplit{Sterile} & colour: pale straw to amber, depends on concentration & clarity: transparent \tn 
% Row Count 5 (+ 3)
% Row 2
\SetRowColor{LightBackground}
pH \seqsplit{4.5-8.0} & Specific gravity 1.010-2.025 & No glucose, ketones or blood \tn 
% Row Count 7 (+ 2)
% Row 3
\SetRowColor{white}
\mymulticolumn{3}{x{8.4cm}}{odour: mild ammonia in nature} \tn 
% Row Count 8 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}---}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{x{3.12 cm} x{4.88 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{8.4cm}}{\bf\textcolor{white}{Colors caused by medications}}  \tn
% Row 0
\SetRowColor{LightBackground}
Dark yellow: vit b12 & Orange: sulphas; pyridium; warfarin \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
pink/red: ex-lax; dilantin & green/blue: amitriptyline; methylene blue \tn 
% Row Count 4 (+ 2)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{8.4cm}}{brown/black: iron;levodopa; nitrofurantoin; metronidazole} \tn 
% Row Count 6 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{x{4 cm} x{4 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{8.4cm}}{\bf\textcolor{white}{Specimen collection}}  \tn
% Row 0
\SetRowColor{LightBackground}
urinalysis (u/a): ph, presence of protein, glucose, ketones, blood, specific gravity SG & Clean voided or midstream, sterile colelction cup \tn 
% Row Count 5 (+ 5)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{8.4cm}}{.} \tn 
% Row Count 6 (+ 1)
% Row 2
\SetRowColor{LightBackground}
Urine culture: may need 72hrs to determine bacterial growth. & clean coided or midstream, sterile collection cup. \tn 
% Row Count 9 (+ 3)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{8.4cm}}{.} \tn 
% Row Count 10 (+ 1)
% Row 4
\SetRowColor{LightBackground}
time collections- 12/24hrs: no urine or toilet tissue contamination & clean receptacle, stored until collection finished. \tn 
% Row Count 14 (+ 4)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{p{0.8 cm} p{0.8 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{8.4cm}}{\bf\textcolor{white}{Asssiting urination}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{8.4cm}}{promote bladder emptying and relaxation} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{8.4cm}}{bladder re-training, bladder diary, voiding regular intervals, 5-7x/day} \tn 
% Row Count 3 (+ 2)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{8.4cm}}{strengthening pelciv floor muscles (kegels)} \tn 
% Row Count 4 (+ 1)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{8.4cm}}{precent infection, avoid indwelling caths.} \tn 
% Row Count 5 (+ 1)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{8.4cm}}{encourage activity/mobolity -\textgreater{} reduces pressur ulcers and possible need for indwelling cath.} \tn 
% Row Count 7 (+ 2)
% Row 5
\SetRowColor{white}
\mymulticolumn{2}{x{8.4cm}}{drug therapy} \tn 
% Row Count 8 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{p{0.8 cm} p{0.8 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{8.4cm}}{\bf\textcolor{white}{Kegels}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{8.4cm}}{squeeze pelvic muscles slowly increasing intensity over 8 seconds} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{8.4cm}}{hold for 8 sec} \tn 
% Row Count 3 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{8.4cm}}{relax slowly over 8 sec} \tn 
% Row Count 4 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{p{0.8 cm} p{0.8 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{8.4cm}}{\bf\textcolor{white}{s}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{8.4cm}}{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).} \tn 
% Row Count 4 (+ 4)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{p{0.8 cm} p{0.8 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{8.4cm}}{\bf\textcolor{white}{Catheter assessment}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{8.4cm}}{asses meatus for swelling, redness, or discharge} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{8.4cm}}{patient, bed soaker pad, fram attached} \tn 
% Row Count 2 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{8.4cm}}{no kinks} \tn 
% Row Count 3 (+ 1)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{8.4cm}}{approx vol in drainage bag. bag not touching floor.} \tn 
% Row Count 5 (+ 2)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{8.4cm}}{to drain bag place cylinder on floor and drain into without touching the cylinder.} \tn 
% Row Count 7 (+ 2)
% Row 5
\SetRowColor{white}
\mymulticolumn{2}{x{8.4cm}}{assess urin color, smell, and texture when draining, close bag properly.} \tn 
% Row Count 9 (+ 2)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{8.4cm}}{note volume. dispose urine according to policy.} \tn 
% Row Count 10 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{p{0.8 cm} p{0.8 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{8.4cm}}{\bf\textcolor{white}{condom cath}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{8.4cm}}{condom} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{8.4cm}}{externally, less invasive,} \tn 
% Row Count 2 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{8.4cm}}{not too tight, not too loose} \tn 
% Row Count 3 (+ 1)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{8.4cm}}{check id band, allergies? latex.} \tn 
% Row Count 4 (+ 1)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{8.4cm}}{get supplies ready} \tn 
% Row Count 5 (+ 1)
% Row 5
\SetRowColor{white}
\mymulticolumn{2}{x{8.4cm}}{wash up client. pericare.} \tn 
% Row Count 6 (+ 1)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{8.4cm}}{cleanest to dirtiest.} \tn 
% Row Count 7 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}


% That's all folks
\end{multicols*}

\end{document}