d. Odor. Normal, freshly voided urine has a faint aromatic odor. Old, stale
urine develops a strong ammonia odor from chemical breakdown.
A strongly offensive odor may indicate the presence of bacteria.
Diet selection can alter normal odor. Asparagus is a good example.
Some medications may alter the normal odor of urine. Ampicillin is one
e. Amount. The average, normal adult will excrete approximately 1,500 to
2,000 ml of urine each day (every 24 hours). This will vary with fluid intake and fluid
loss. Fluid losses other than urination include fluid lost through vomiting, diarrhea, and
"insensible" losses. Insensible fluid loss is that which is not perceptible or appreciable.
Such loss includes that fluid which is lost through respiration, evaporation from the skin,
and fecal content.
Section II. NURSING ASSESSMENT AND DIAGNOSTIC PROCEDURES
When performing a nursing assessment of a patient with a suspected disorder of
the urinary system, it is important to question the patient about urinary output and
changes in voiding patterns.
a. Urinary Output.
(1) During the act of micturition (urination), the bladder contracts and urine
is expelled from the body through the urethra. The average urine output for a normal
adult is considered to be about 1500-2000ml/24 hours. This, of course, will vary with
fluid intake and other fluid losses (as discussed in Section I).
(2) Polyuria is the passage of a large volume of urine in a given period of
time. Polyuria is seen with diabetes. It may also occur with excessive fluid intake.
(3) Oliguria is the passage of a small amount of urine in a given period of
time. This is generally considered to be 100-500 ml/24 hours. Oliguria may indicate
renal failure, shock, dehydration, or a fluid and electrolyte imbalance.
(4) Anuria is the absence of urine. Passage of less than 50 ml/24 hours is
considered to be anuria. This condition indicates a serious renal dysfunction and
requires emergency medical intervention.
b. Changes in Voiding Patterns. When interviewing the patient, ask about
changes in their normal voiding pattern. Identification of signs and symptoms is a