2 Types of Fluid Imbalance

Fluid volume defecit (dehydration)- decreased fluid

intake. Causes: illness- diarrhea, vomiting, diaphoresis,
wound drainage, NPO, etc. Age. Altered mental status.
Fluid Volume Excess (overload)- increased fluid intake

Abnormal Particles Found in

Urine

Fat globules, Red or white

blood cells, bacteria, crystals

Anuria

Failure of the kidneys to produce urine.

The absence of urine or minimal amount
of urine.

Bladder Training

A program to assist patients with improving their urinary function.

Educate and assist with frequent toileting, avoiding caffeine, drink
more in the AM and less in PM, toileting offered during times when
patient would normally void (i.e after meals, in the morning upon
waking, etc)

Blood Urea Nitrogen (BUN)

a test that measures the amount of urea nitrogen in

blood. Urea nitrogen is usually filtered OUT of the
bllod 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, nerve
disorders, postoperative complications

Dialysis

The filtering of blood to remove toxins.

Used in patients with kidney function
problems.

Dysuria

Painful urination

Fluid Volume Overload Signs

and Symptoms

WEIGHT GAIN, edema, dyspnea,

crackles, bounding pulse, confusion,
noisy lung sounds, bradycardia

Hematuria

Presence of red or white blood

cells in the urine.

How much liquid does a

healthy adult require per day?

Healthy adults require 2000-2500 mls of fluid per day. See, Intake
is proportional to output. Roughly what goes into a person per day
also comes out of them. TO MAINTAIN HOMEOSTASIS, INTAKE
SHOULD EQUAL OUTPUT.

Incontinence

Inability to control one's

urinary or bowel functions.

Indwelling Catheter

Stays in the bladder, usually for a few days, to

drain urine on a continuous basis. Also known as a
double-lumen catheter or Foley catheter.

Insensible Water (Fluid) Loss

Fluid lost by exhalation and perspiration.

Not felt by individual. Cannot be
accurately measured.

Intake and Output (I&O)

The amount of liquid a person drinks or eats (Intake). The amount of

urine the person passes (output). Measured by mls normally. Intake is
usually added up by serving container size (juice glass size, mug size,
etc), output is usually measured by pouring urine into a graduated
measuring container or noting amount on catheter drainage bag.

Nocturia

Having to wake up at night to

urinate.

Normal Characteristics of
Urine

Color: straw, Clarity: Clear, Amount: 1,000

to 3,000 ml per day, Odor: mild, PH: 4.6 to
8, Specific Gravity: 1.010 to 1.025

Normal Urine Output

Minimum of 30ml per hour, and between

1,000ml to 3,000 ml per day.

Nursing Interventions for

Dehydration (fluid volume deficit)

Eliminate cause of decreased intake (i.e give meds for

vomiting or diarrhea), monitor I&O, Measure daily
weights, monitor tissue turgor, check vitals,
encourage fluids

Nursing Interventions for Fluid

Volume Retention or Overload

Monitor I&O, weight (at same time each day), vital

signs, breathing, assess for edema, limit fluids if
needed, monitor mental status. Correct underlying
cause, restrict fluids

Oliguria
PH of Urine

Low output of urine (below 30 ml per

hour). Report to charge nurse or
physician.
Normally 4.6 to 8.0, depending on diet. Diets high in protein or cranberries
causes PH to be lower ( acidic), diets high in dairy products, vegetables, etc
causes the PH to be higher (alkaline). PH is important to diagnosing urinary
tract infections. UTI urine is more alkaline (higher PH than normal). PH can
be used to also detect some types of kidney stones.

Polyuria

High output of urine (greater

than 3,000 ml per day )

Renal Calculi

Kidney stones

Residual Urine

Urine that remains in the

bladder even after eliminating.

Specific Gravity

The result of comparing the weight of a substance with an equal

amount of water. Normal for urine is 1.010 to 1.025. A high result
means urine is more concentrated (i.e dehyration or diabetes), a
low result means urine is more dilute (i.e. excessive fluid intake or
impaired kidney function)

Straight Catheter

Used only for insertion in the bladder to obtain a

sterile urine specimen or for a ONE TIME drainage
of urine. Also known as a single-lumen catheter.

Stress Incontinence

Losing (being incontinent of) urine

(usually small amounts) without one's
control due to coughing, laughing etc.

Urge incontinence

Strong, sudden need to urinate due

to bladder spasms or contractions.

Urinary Diversion

Any one of several procedures

to re-route the urine.

Urinary Retention

The inability to empty the bladder at all

or the inability to completely empty the
bladder. 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. Signs
include urge to urinate frequently, passing small amounts of urine or
none an all, painful urination(dysuria), low abdominal pain, fever, chills,
lethargy, nausea, vomiting. If left untreated UTIs can attack the kidneys.

Void

To urinate