Question

23-year-old healthy female college student, presents with a 2-day history of "on and off" dysuria, urgency, and frequency and a single episode of gross hematuria. There is no fever or back pain. She has self-medicated with cranberry juice and pyridium 200 mg, which was left over from a previous urinary tract infection (UTI). Her urine is consequently dark-colored. 1. What data should the nurse obtain? 2. Describe the normal characteristics of urine. 3. What instructions should the nurse give to the patient regarding collection of clean catch urine specimen? 3. What measures can be used to reduce the reoccurrence of UTI? 4. Identify 3 potential/actual nursing diagnoses related to urinary elimination

Answer 1

Ans) The nurse must make an assessment:

- Urine colour, output, frequency, urgency, dysuria, burning etc.

- Evaluate the urine routine and Culture report

2)

Physical characteristics that can be applied to urine include color, turbidity (transparency), smell (odor), pH (acidity – alkalinity) and density. Many of these characteristics are notable and identifiable by by vision alone, but some require laboratory testing.

Color: Typically yellow-amber, but varies according to recent diet and the concentration of the urine. Drinking more water generally tends to reduce the concentration of urine, and therefore causes it to have a lighter color. Dark urine may indicate dehydration. Red urine indicates red blood cells within the urine, a sign of kidney damage and disease.
Smell: The smell of urine may provide health information. For example, urine of diabetics may have a sweet or fruity odor due to the presence of ketones (organic molecules of a particular structure) or glucose. Generally fresh urine has a mild smell but aged urine has a stronger odor similar to that of ammonia.
The pH of normal urine is generally in the range 4.6 – 8, with a typical average being around 6.0. Much of the variation occurs due to diet. For example, high protein diets result in more acidic urine, but vegetarian diets generally result in more alkaline urine (both within the typical range of 4.6 – 8).
Density: Density is also known as “specific gravity.” This is the ratio of the weight of a volume of a substance compared with the weight of the same volume of distilled water. The density of normal urine ranges from 0.001 to 0.035.
Turbidity: The turbidity of the urine sample is gauged subjectively and reported as clear, slightly cloudy, cloudy, opaque or flocculent. Normally, fresh urine is either clear or very slightly cloudy. Excess turbidity results from the presence of suspended particles in the urine, the cause of which can usually be determined by the results of the microscopic urine sediment examination. Common causes of abnormal turbidity include: increased cells, urinary tract infections or obstructions.

3) To collect a clean urine sample:

- Label the container with your name, date of birth and the date
- wash your hands
- start to urinate and collect a sample of urine "mid-stream" in a sterile screw-top container
- screw the lid of the container shut
- wash your hands thoroughly

A mid-stream urine sample means you don't collect the first or last part of urine that comes out. This reduces the risk of the sample being contaminated with bacteria from:

- your hands
- the skin around the urethra, the tube that carries urine out of the body.

4) To prevent reoccurrence of UTI:

- urinate as often as needed (especially after intercourse)
- wipe front to back after urinating.
- drink plenty of water to flush bacteria out of your system.
- drink cranberry juice daily.
- wear cotton underwear.
- avoid tight-fitting pants.

- maintain strict hygiene