Common Urinary Elimination Problems
● Urinary retention: an accumulation of urine due to the inability of the bladder to
empty
● Urinary tract infections (UTIs): results from catheterization or procedure
● Urinary incontinence: involuntary leakage of urine
● Urinary diversions: involuntary leakage of urine
Assessment of Urine
● Record intake and output
● Characteristics of Urine
○ Color
○ Clarity
○ Order
Laboratory & Diagnostic Testing
● Label all specimens
● Preserve according to laboratory protocol
● Infection control policies
Renal Failure Identification Test
● Blood Urea Nitrogen Test (BUN)= measure the amount of urea nitrogen in the
blood
● Creatinine Test= measure the levels of creatine in the blood
Nursing Diagnosis
● Nursing diagnoses common to patients with urinary elimination problems
○ Urinary Incontinence:
■ Transient: incontinence caused by medical conditions that in many
cases are treatable and reversible
■ Functional: loss of continence because of causes outside the
urinary tract, usually related to functional deficits
■ Overflow: involuntary loss of urine caused by an overdistended
bladder often related to bladder outlet obstruction or poor bladder
emptying because of weak or absent bladder contractions
■ Reflux: involuntary loss of urine occuring at somewhat predictable
intervals when patient reaches specific bladder volume related to
spinal cord damage between C1 and S2
■ Stress: involuntary leakage of small volumes of urine associated
with increased intra abdominal or an incompetent urinary sphincter
■ Urge: involuntary passage of urine often associated with strong
sense of urgency related to an overactive bladder caused by
neurological problems, bladder inflammation, or bladder outlet
obstruction
, ● An immediate and strong desire to void that is not easily
deferred
○ Infection
○ Impaired Self Toileting
○ Impaired Skin Integrity
○ Urinary Retention
Polyuria: abnormally excessive amounts of urination
● Common causes:
○ High volumes of fluid intake
○ Uncontrolled diabetes mellitus
○ Diabetes insipidus
○ Diuretic therapy
Oliguria: abnormally reduced amounts of urination
● Common causes:
○ Fluid and electrolyte imbalance
○ Kidney dysfunction and failure
○ Increased secretion of antidiuretic hormone (ADH)
○ Urinary tract obstruction
Other Common Symptoms of Urinary Alteration:
● Frequency: voiding more than 8 times during waking hours and/org at decreased
intervals
● Hesitancy: delay in start of urinary stream when voiding
● Nocturia: awakened from sleep because of the urge to void
● Dribbling: leakage of small amounts of urine despite voluntary control of
micronutrition
● Hematuria: presence of blood in urine
● Acute Retention: suddenly unable to void when bladder is adequately full or
overfull
● Chronic Retention: Bladder does not empty completely during voiding and urine is
retained in the bladder
● Urinary retention: an accumulation of urine due to the inability of the bladder to
empty
● Urinary tract infections (UTIs): results from catheterization or procedure
● Urinary incontinence: involuntary leakage of urine
● Urinary diversions: involuntary leakage of urine
Assessment of Urine
● Record intake and output
● Characteristics of Urine
○ Color
○ Clarity
○ Order
Laboratory & Diagnostic Testing
● Label all specimens
● Preserve according to laboratory protocol
● Infection control policies
Renal Failure Identification Test
● Blood Urea Nitrogen Test (BUN)= measure the amount of urea nitrogen in the
blood
● Creatinine Test= measure the levels of creatine in the blood
Nursing Diagnosis
● Nursing diagnoses common to patients with urinary elimination problems
○ Urinary Incontinence:
■ Transient: incontinence caused by medical conditions that in many
cases are treatable and reversible
■ Functional: loss of continence because of causes outside the
urinary tract, usually related to functional deficits
■ Overflow: involuntary loss of urine caused by an overdistended
bladder often related to bladder outlet obstruction or poor bladder
emptying because of weak or absent bladder contractions
■ Reflux: involuntary loss of urine occuring at somewhat predictable
intervals when patient reaches specific bladder volume related to
spinal cord damage between C1 and S2
■ Stress: involuntary leakage of small volumes of urine associated
with increased intra abdominal or an incompetent urinary sphincter
■ Urge: involuntary passage of urine often associated with strong
sense of urgency related to an overactive bladder caused by
neurological problems, bladder inflammation, or bladder outlet
obstruction
, ● An immediate and strong desire to void that is not easily
deferred
○ Infection
○ Impaired Self Toileting
○ Impaired Skin Integrity
○ Urinary Retention
Polyuria: abnormally excessive amounts of urination
● Common causes:
○ High volumes of fluid intake
○ Uncontrolled diabetes mellitus
○ Diabetes insipidus
○ Diuretic therapy
Oliguria: abnormally reduced amounts of urination
● Common causes:
○ Fluid and electrolyte imbalance
○ Kidney dysfunction and failure
○ Increased secretion of antidiuretic hormone (ADH)
○ Urinary tract obstruction
Other Common Symptoms of Urinary Alteration:
● Frequency: voiding more than 8 times during waking hours and/org at decreased
intervals
● Hesitancy: delay in start of urinary stream when voiding
● Nocturia: awakened from sleep because of the urge to void
● Dribbling: leakage of small amounts of urine despite voluntary control of
micronutrition
● Hematuria: presence of blood in urine
● Acute Retention: suddenly unable to void when bladder is adequately full or
overfull
● Chronic Retention: Bladder does not empty completely during voiding and urine is
retained in the bladder
