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urinary system consists of
two kidneys, two ureters, bladder, and urethra
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function of the urinary system
- –Manufacture urine
- –Remove waste products
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Cessation of urine production
anuria
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Difficult urination
dysuria
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blood in the urine
hematuria
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Excessive urination at night
nocturia
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decreased urinary production
oliguria
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Need to urinate immediately
urgency
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excessive urinary production
polyuria
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increase changes in aging
- •Blood urea nitrogen increases
- •Renal function increases when lying down
- •Incidence of stress incontinence
- increases in females
- •Prostate may enlarge in males
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decreased changes in aging
- •Bladder and perineal muscles weaken
- •Nephrons decrease
- •Glomerular filtration rate decreases
- •Sodium-conserving ability diminishes
- •Bladder capacity decreases
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common urinary diagnostic tests
- •Radiographic tests
- •Urine tests
- •Blood tests
- •Urodynamic tests
- •Biopsy
- •Endoscopic exam
- (RUB U BE)
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urinary retension
•Person unable to void when an urge
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what may urinary retension lead to
- infection
- distended bladder
- incontinence
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what may urinary retension be caused by
stress, obstruction,stones, tumor, infection, medications, or trauma
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symptoms of urinary retension
- Frequency
- voiding small amounts
- distended bladder
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Tx for urinary retension
- Urinary analgesics
- antispasmodics
- catheterization
- urgery
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Involuntary loss of urine from bladder
urinary incontinence
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types of urinary incontinence
- –Stress
- •Leakage of urine on straining
- –Urge
- •Sudden need to urinate
- –Overflow
- •Full bladder leads to leakage
- –Total
- •No control of voiding
- –Nocturnal enuresis
- •Nighttime incontinence
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goal of treatment for urinary incontinence
Keep perineum clean, dry, and intact
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potential treatment for urinary incontinence
- –Medications
- –Pelvic floor exercises
- –Bladder retraining
- –Catheter insertion
- –Surgery
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•Inflammation of urinary bladder
•Caused by escherichia coli, candida albicans, coitus, prostatitis, and diabetes
mellitus
cystitis
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treatment and testing for cystitis
- –Culture/sensitivity testing,
- antimicrobial medication, and urinary tract analgesic
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cystitis diet treatment
- •Increase fluid intake, acidic foods, and monitor
- intake and output
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•Bacterial infection of renal pelvis,
tubules, and interstitial tissue of one or both kidneys
-also known as nephropyelitis
pyelonephritis
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treatment for pyelonephritis
- –Urine culture/sensitivity testing,
- antimicrobials, antipyretics, analgesics, increase fluids, intake and output,
- and daily weight
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•Glomerulus within nephron unit becomes
inflamed
•May be bacterial or viral
acute glomerulonephritis
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treatment for acute glomerulonephritis is to:
- prevent renal complications,
- cardiac complications, and complications to cerebral functioning
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treatment for acute glomerulonephritis
- –Drug therapy, fluid restriction,
- monitor labs, I&O, bed rest, and VS
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•Slowly progressive, destructive process
affecting glomeruli
•Causes loss of kidney function
chronic glomulonephritis
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treatmenr for chronic glomerulonephritis is to:
- •prevent further renal damage and cardiac
- or cerebral complications
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treatment for chronic glomerulonephritis
- –Medications, protein and fluid
- restriction, bed rest, intake and output, VS, and monitor labs, daily weight,
- and lung sounds
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Calculus, or stone, formed in urinary
tract
urinary calculi
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what is the treatment for very small calculi
- Very small calculi may be flushed out by
- peristalsis and fluids
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when calculi is excreted what should be done
- strain urine
- collect stones
- send to lab for composition
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what is the treament for urinary calculi
Lithotripsy, surgery, analgesics, medications, and dietary changes
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•May be cancerous or benign papillomas
•Surgery may remove tumor, part of
bladder, or entire bladder
–Makes urinary diversion necessary
•Other treatment:
–Chemotherapy, analgesics, and
sometimes low-residue diet
urinary bladder tumors
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•Cancer in kidneys
•Radical nephrectomy may be performed if
other kidney healthy and disease localized
renal tumors
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•Multiple grape-like clusters of
fluid-filled cysts develop in and greatly enlarge both kidneys
•Treat to preserve kidney function,
prevent infections, and relieve pain
polycystic tumor
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Tx for polycystic tumors
•Control hypertension
- •Eventually, may need dialysis or renal
- transplantation
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•Any acute or chronic loss of kidney
function when some kidney function remains
renal failure
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Total, or nearly total, permanent kidney failure
ESRD
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acute real failure with
–Disrupted urine flow
postrenal
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ARF w/
–Disrupted blood flow to kidney
prerenal
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ARF w/
–Renal tissue damage
intrarenal
-can be reversed if detected early
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Tx for ARF
- –Medication, dietary changes, fluid
- restrictions, and dialysis (peritoneal or hemodialysis)
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•Slow, progressive condition
•Kidney’s ability to function ultimately
deteriorates
•Not reversible
•Multisystem disease process
CRF/ESRD
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•Mechanical means of removing waste from
blood
dialysis
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–Machine with artificial membrane used to filter blood
hemodialysis
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–Uses peritoneal lining of abdominal cavity as membrane through which diffusion and osmosis occur
peritonial dialysis
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•Client must be tissue- and blood-typed to
determine compatible donor
•immunosuppressive drug therapy is used to decrease chance of organ rejection
•Greatest complication:
–Infection
kidney transplantation
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what are some signs of kidney disease
- burning or difficult urination
- nocturia
- passage of blood in urine
- puffiness or sweeling around eyes hands and feet
- pain in small of the back below the ribs
- high BP
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what does the kidneys manufacture
urine
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what is the usual capacity of bladder
500 ml
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where are the kidneys located
in the retroperitonial space (behind the peritonium behond the peritonial cavity)
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what do the kidneys assist with:
- acid-base balance
- secrete renin
- produce erythropoetin, responsible for erythropoesis
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production of red blood cells produced by bone marrow
erythropoesis
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microscopic units responsible for urine formation
nephrons
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incomplete emptying of the bladder in men can be a result of
an enlarged prostate gland
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two types of UTI's
- Cystitis (affects bladder)
- pyelonephritis (affects kidneys)
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bacteria count greater than ____ confirms urinary bacterial infection
100,000
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