Urinary Specimen Collection, Incontinence, and UTI's - Fundamentals of Nursing | @LevelUpRN
Summary
TLDRIn this video, Meris covers key topics related to urinary health, including normal urine characteristics, specimen collection, urinary incontinence, and urinary tract infections (UTIs). She explains expected urine output, specific gravity, and abnormal signs such as cloudy or malodorous urine. Meris also discusses how to collect clean catch and 24-hour urine samples, different types of incontinence, and key risk factors and symptoms of UTIs, particularly in older adults. Practical tips for UTI prevention and patient teaching are provided, making this video essential for nursing students.
Takeaways
- 💧 Normal urine output should range from 0.5 to 1.5 mL per kg per hour, aiming for about 1,500 mL per day.
- ⚠️ Notify the provider if urinary output is less than 30 mL per hour, indicating severe oliguria.
- 🔬 Specific gravity of urine ranges from 1.005 to 1.030, with lower values indicating dilute urine.
- 🌫️ Urine should be clear, and cloudy or malodorous urine is considered abnormal.
- 🧪 A midstream clean catch urine specimen is essential for accurate results and requires specific instructions for patients with different anatomy.
- ⏳ For 24-hour urine collections, the first void of the day should be discarded, and the sample should be kept refrigerated.
- 💪 Stress incontinence is associated with increased intra-abdominal pressure and is more common in patients with weakened pelvic floor muscles.
- 🚻 Urge incontinence involves the inability to reach the bathroom in time, and treatments include physical therapy and medications.
- ❗ People with a vulva are more at risk for urinary tract infections (UTIs) due to a shorter urethra.
- 🧼 Key UTI prevention tips include wiping front to back, wearing cotton underwear, avoiding bubble baths, and increasing fluid intake.
Q & A
What is the normal urine output per hour for a patient?
-The normal urine output is 0.5 to 1.5 milliliters per kilogram per hour, with a general goal of 1,500 mL or 1.5 liters per day.
When should a provider be alerted about a patient's urine output?
-The provider should be alerted if the patient's urine output is less than 30 mL per hour, as this indicates severe oliguria.
What does a low specific gravity in urine indicate?
-A low specific gravity (below 1.005) indicates dilute urine, meaning it is less concentrated.
How can you remember the relationship between dilute urine and specific gravity?
-Dilute urine starts with 'L,' and it corresponds to a low specific gravity, which also starts with 'L.'
What are the steps for a clean catch urine specimen for a patient with a penis?
-The patient should retract the foreskin if uncircumcised, clean around the urethral meatus, urinate into the toilet, stop, then urinate into the cup, and stop again to finish urinating into the toilet.
What patient education is important for a 24-hour urine specimen collection?
-The patient should discard the first void of the day, start collecting urine after that, and keep the container refrigerated.
Who is most at risk for stress urinary incontinence?
-Patients who have had multiple pelvic surgeries or multiple pregnancies and deliveries are most at risk due to weakened pelvic floor muscles.
What is the difference between stress incontinence and urge incontinence?
-Stress incontinence is urine leakage due to increased intra-abdominal pressure, such as from coughing or sneezing, while urge incontinence is the inability to make it to the bathroom in time when feeling the urge to urinate.
Who is most at risk for urinary tract infections (UTIs)?
-People with a vulva are at higher risk for UTIs because they have a shorter urethra, making it easier for bacteria to enter the urinary tract.
What is important patient teaching for preventing urinary tract infections?
-Patients should wipe from front to back, wear cotton underwear, avoid bubble baths, empty the bladder regularly, void after intercourse, increase fluid intake, and consider cranberry juice to help with UTI symptoms.
Outlines
💧 Urine Characteristics and Urinary Specimen Collection
Meris introduces the video by mentioning the topics to be covered: urine characteristics, urinary specimen collection, urinary incontinence, and urinary tract infections (UTIs). She uses flashcards from leveluprn.com to guide the discussion. The normal urine output is explained to be between 0.5 to 1.5 milliliters per kilogram per hour, with an average of 1,500 mls (1.5 liters) per day. A significant point is made about alerting healthcare providers if the patient's urinary output falls below 30 milliliters per hour, indicating severe oliguria. Specific gravity is discussed as a measure of urine concentration, with normal values ranging from 1.005 to 1.030. The video provides a mnemonic to remember the relationship between dilute urine and low specific gravity. Urine clarity is emphasized as a normal characteristic, with haziness, cloudiness, or bad odor being considered abnormal. Different types of urinary specimens are mentioned, including routine urinalysis, clean catch, 24-hour urine specimen collection, and sterile specimens. The clean catch method is detailed, highlighting the differences in collection for patients with penises and vulvas. The importance of midstream clean catch is underscored. The segment ends with a discussion on 24-hour urine collection, emphasizing the need to discard the first void of the day and keep the collection refrigerated.
🚫 Urinary Incontinence and UTI Prevention
The second paragraph delves into urinary incontinence, focusing on stress incontinence and urge incontinence. Stress incontinence is linked to increased abdominal pressure during activities like coughing or laughing, leading to urine leakage. The risk factors are identified as multiple pelvic surgeries or pregnancies, which can weaken pelvic floor muscles. Urge incontinence is characterized by an inability to reach the bathroom in time upon feeling the urge to urinate. Treatment options range from pharmacological interventions to physical therapy, pelvic floor therapy, and Kegel exercises. Mechanical devices like pessaries are also mentioned. The discussion transitions to urinary tract infections (UTIs), emphasizing their commonality and the importance of patient education. Risk factors are highlighted, particularly for individuals with vulvas due to the shorter urethra, which makes it easier for bacteria to enter the urinary stream. Signs and symptoms of UTIs are listed, including abdominal pain, dysuria, frequency, urgency, burning, and malodorous urine. It's noted that older adults may present differently, with confusion and abdominal pain being significant indicators. The video suggests checking lab values for diagnosis and provides patient education tips to prevent UTIs, such as wiping from front to back, wearing cotton underwear, avoiding bubble baths, emptying the bladder regularly, and voiding after sexual activity. The importance of increased fluid intake and the potential benefits of cranberry juice are also mentioned. The video concludes with a call to action for viewers to like, comment, subscribe, and share the video, and to look forward to the next video on bladder scanners and urinary catheters.
Mindmap
Keywords
💡Urine Output
💡Specific Gravity
💡Clean Catch Urine Specimen
💡24-Hour Urine Collection
💡Urinary Incontinence
💡Oliguria
💡Dysuria
💡Urinary Tract Infection (UTI)
💡Pelvic Floor Exercises
💡Cranberry Juice
Highlights
Introduction to urine characteristics, urinary specimen collection, urinary incontinence, and urinary tract infections (UTIs).
Normal urine output should be 0.5 to 1.5 mL per kg per hour, with about 1,500 mL per day as the average.
Alert the provider if urinary output drops below 30 mL per hour, indicating severe oliguria.
Specific gravity of urine ranges from 1.005 to 1.030, with low specific gravity indicating dilute urine.
Cloudy or malodorous urine is abnormal and should be assessed further.
Clean-catch urine specimen collection requires different procedures based on anatomy (penis or vulva).
For clean-catch urine specimens, patients should start urinating in the toilet, collect midstream in a cup, and finish in the toilet.
24-hour urine collection requires discarding the first void and keeping the collected urine refrigerated.
Stress incontinence is caused by increased intra-abdominal pressure (e.g., coughing, sneezing) and is common in patients with weakened pelvic muscles due to surgeries or pregnancies.
Urge incontinence refers to the inability to make it to the bathroom in time when feeling the urge to urinate.
Treatment for urinary incontinence includes medications, pelvic floor therapy, Kegel exercises, and devices like pessaries.
People with vulvas are at higher risk for UTIs due to a shorter urethra, making it easier for bacteria to enter the urinary tract.
UTI symptoms include dysuria, frequency, urgency, and malodorous urine. Older adults may present with confusion.
Patient teaching for UTIs: Wipe front to back, wear cotton underwear, avoid bubble baths, and void after intercourse.
Increasing fluid intake and consuming cranberry juice can help decrease UTI symptoms.
Transcripts
Hi. I'm Meris. And in this video, we're going to be talking about urine characteristics,
urinary specimen collection, urinary incontinence, and urinary tract infections, UTIs. I'm going to
be following along using our Fundamentals of Nursing flashcards. These are available on our
website, leveluprn.com. And if you already have a set and you'd like to follow along with me,
I'm starting on card number 115. Let's get started. So first up, let's just kind of talk
about normal, expected characteristics of urine and things that we need to know as our normal
values and limits. Our urine output should be, basically, 0.5 to 1.5 milliliters per kilogram
per hour. Obviously, this is kind of just a big range. But in general, we are hoping to
see about 1,500 mls, which is 1.5 liters per day of urinary output. We do, however, need
to alert the provider if our patient's urinary output is ever less than 30 milliliters an hour.
That's already below what the standard is for a patient's output. But that indicates that they
are actually having severe oliguria, and that needs to be brought to the provider's attention.
Now, specific gravity is a measurement that you'll see reflected in urinalysis, and it talks about
how concentrated urine is. So if we have a low specific gravity-- so our normal range is 1.005
to 1.030. Check the lab values deck if you want more on that. But if we have a low urine-specific
gravity, this means that we have dilute urine, so it's not concentrated. So we do have a nice,
cool, chicken hint here on this card, that dilute urine, with an L, dilute, is going to have low,
with an L, specific gravity. So that's how you can remember those, because it can get confusing.
Urine should be clear. So if it is hazy or cloudy or malodorous, if it smells bad, that's not
a good thing. We want to consider that abnormal. So moving on. Let's talk about the different types
of urinary specimens that we can collect. And there's a lot of information on this
part because we talk about routine urinalysis, clean catch, 24-hour urine specimen collection,
sterile specimens, all of those things. But big ones I want to bring to your attention,
a clean catch urine specimen. So this is going to be done by the patient while they
are urinating. And we have different teaching for people who have a penis versus a vulva.
If a patient has a penis and is uncircumcised, we need to teach him to retract the foreskin and
then clean around the urethral meatus, the opening of the urethra. And then they should replace the
foreskin after they're done urinating. If somebody has a vulva, though, we want them to separate
the labia so that the urethral opening is exposed and clean from front to back using the designated
wipes. Usually, these are Castile soap wipes, but they are going to clean away any kind of
grime or dead skin cells from the area so we can get a really good look at what's going on.
No matter what, your patient should begin urinating into the toilet,
stop, then urinate into the cup, stop, and then finish urinating into the toilet. This is called
midstream clean catch. Another thing here that I want to bring your attention to is the 24-hour
urine collection. This is going to be where the patient collects their urine for 24 hours in
a designated container, but big patient teaching here is to discard the first void of the day. So
if we're saying at 7:00 AM you need to start, so urinate at 7:00 AM and then start collecting
the rest of the urine from then on. We don't want that from prior to 7:00 AM to be reflected
in the collection. Make sure that they know to keep the container refrigerated as well.
All right. Moving on, let's talk about urinary incontinence. We've got a couple listed here,
stress incontinence and urge incontinence. Stress incontinence is when there is urine leaking
as a result of increased intra-abdominal pressure. What does this mean? It means when I
cough or sneeze or jump or laugh really hard, the pressure in my abdomen's going to increase.
And then that's going to put pressure on my bladder, which is going to let a little bit of
urine leak. So who is most at risk for this? I'm going to ask you, and pause the video, all right?
Okay. So I hope you paused the video. Who is most at risk for stress incontinence? It's going to be
patients who have had multiple pelvic surgeries or patients who have had multiple pregnancies or
deliveries of infants. That's going to weaken the pelvic floor muscles. Now, urge incontinence means
I can't make it to the bathroom when I feel the urge to urinate. In either case, there's
different treatments. We have pharmacological, so medications that can be prescribed. And then
we also have things like physical therapy, pelvic floor therapy, and things like Kegel exercises,
or Kegel exercises, depending on who you ask. And we also have mechanical devices
like pessaries which can be inserted to put pressure and decrease the risk of urine leaking.
All right. Last up, let's talk about urinary tract infections. I would say this is one of the things
for nursing school you got to know everything about. It just comes up time and time again.
It's so common, and there's really important patient teaching. So who is most at risk?
Pause the video. Think about it. All right. I hope you paused. Who's most at risk? It's going
to be people who have a vulva. The urethra is much shorter if I have a vulva versus a penis.
The penis has a longer urethra, so it's harder for bacteria to enter into the urinary stream. Now,
that doesn't mean that those are the only people that can get it, but it is an important thing
to keep in mind. Signs and symptoms are going to depend based on the patient, but
big ones would be abdominal pain, dysuria, which means painful urination, frequency, and urgency,
"I have to go to the bathroom all the time. I feel like I really have to go," burning and bad smell,
malodorous urine. All of those are going to be big signs. But in the older adult, what is the biggest
sign? The biggest sign is going to be confusion and abdominal pain. Very important to know. They
may not present with classical symptoms. So we do have some information on how we can diagnose that,
here on this card, including things to look for on the urine analysis, which will be very
helpful for you. I'd also encourage you to check out that lab values stack for more information.
And then this card, card number 119, we talk about the patient teaching for urinary tract infections.
So hugely important for nursing school. Big thing is if you have a vulva, you need to
be wiping from front to back. We don't want to bring fecal bacteria up to the urethra,
so wipe from front to back. Also, wear cotton underwear, no synthetic fabrics,
because these are better at wicking moisture away and not trapping moisture, which bacteria love.
Also, avoid bubble baths. Be sure to empty the bladder regularly, and be sure to void after
vaginal penetrative intercourse. Very important patient teaching there. A few other things
would be increase fluid intake. And cranberry juice can also help to decrease UTI symptoms.
All right. I hope that was a very helpful review for you. If it was, please like this video. Let me
know in a comment. And if you have any other great ways to remember things, I would love to hear how
you remember that, in the comments, and so would everybody else watching this. Be sure to subscribe
to the channel. You want to be the first to know when the next video comes out. And our next
video's going to talk about bladder scanners, how to use them, and we're also going to talk about
urinary catheters. Super important stuff. I hope I see you there. Thanks so much, and happy studying.
I invite you to subscribe to our channel and share a link with your classmates and
friends in nursing school. If you found value in this video, be sure and hit the like button,
and leave a comment and let us know what you found particularly helpful.
Ver Más Videos Relacionados
Understanding Urinary Tract Infections
Recurrent UTI (Urinary Tract Infection) Lecture
Urinary incontinence - causes, symptoms, diagnosis, treatment, pathology
Urinary Tract Infection - Overview (signs and symptoms, pathophysiology, causes and treatment)
Anatomy Presentation 1
How Your Urinary System Works? - The Dr. Binocs Show | Best Learning Videos For Kids | Peekaboo Kidz
5.0 / 5 (0 votes)