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Urinary Boxes

Urinary Book Boxes

Functions of the Kidney: Urine formation, excretion of waste, regulation of: electrolytes, acid-base balance, RBC prod, cal/phos balance. Control of water and BP. Renal clearance, Synth of Vit D, Secretion of prostaglandins, activates growth hormone.
Age-related changes in kidney function, such as decreased renal blood flow and glomerular filtration rate and thickening of the renal tubules can alter the excretion of drugs in older adults increasing the risk of drug toxicity
Decreased ability to concentrate urine maylead to increased susceptibility to dehydration, further complicated by a deficit in thirst.
Urine formation increases during the night when leg elevation promotes blood return to the heart and kidneys and may interrupt sleep patterns. Older persons may need to drink more fluids throughout the day to allow for limiting their intake after the evening meal
Nephrotox may occur with the admin of certain drugs and is potentially serious because it decreases urinary excretion of the drug and increases the risk of drug toxicity.
Assessing the chief complaint related to the urinary system. the nurse collects info on the following: voiding changes/disturbances, urine volume changes, irritating voiding symptoms, obstructive voiding symptoms, urinary incontinence, urine characteristic changes, systemic manifestations, gastro s/s, pain, masses, abnormal appearance, sex dysfunction
Risk Factor: Childhood diseases ie strep throat, impetigo, nephrotic syndrome. POSSIBLE RENAL OR UROLOGIC DISORDER: Chronic Renal Failure
Risk Factor: Advanced Age POSSIBLE RENAL OR UROLOGIC DISORDER: Incomplete emptying of bladder, leading to UTI.
Risk Factor: Instrumentation of urinary tract, cystocopy, catheterization POSSIBLE RENAL OR UROLOGIC DISORDER: UTI, incontinence
Risk Factor: Immobilization POSSIBLE RENAL OR UROLOGIC DISORDER: Kidy stone formation
Risk Factor: Occupational, recreational, or enviro exposure to chemicals POSSIBLE RENAL OR UROLOGIC DISORDER: Acute renal failure
Risk Factor: Diabetes mellitus POSSIBLE RENAL OR UROLOGIC DISORDER: Chronic renal failure, neurogenic bladder
Risk Factor: Hypertension POSSIBLE RENAL OR UROLOGIC DISORDER: Renal insufficiency, chronic renal failure
Risk Factor: Systemic lupus erythematosus POSSIBLE RENAL OR UROLOGIC DISORDER: Nephritis, chronic renal failure.
Risk Factor: Gout, hyperparathyroidism, crohn's POSSIBLE RENAL OR UROLOGIC DISORDER: kidney stone formation
Risk Factor: sickle cell anemia, multiple myeloma POSSIBLE RENAL OR UROLOGIC DISORDER: chronic renal failure
Risk Factor: benign prostatic hypertrophy POSSIBLE RENAL OR UROLOGIC DISORDER: obstruction to urine flow, leading to frequencey, oliguria, anuria
Risk Factor: Radiation therapy to pelvis POSSIBLE RENAL OR UROLOGIC DISORDER: cystitis, fibrosis of ureter, or fistula in urinary tract
Risk Factor: Recent pelvic surgery POSSIBLE RENAL OR UROLOGIC DISORDER: inadvertent trauma to ureters or bladder
Risk Factor: obstetric surgery, tumors POSSIBLE RENAL OR UROLOGIC DISORDER: incontinence
Risk Factor: Spinal cord injury POSSIBLE RENAL OR UROLOGIC DISORDER: neurogenic bladder, uti, incontinence
Frequency frequent voiding, more than q3hours. Possible cause: infection, obstruction, anxiety, diuretics, BPH, urethral stricture, diabetic neuropathy
Urgency Strong desire to void. Possible cause: infection, chronic prostatitis, urethritis, obstruction, anxiety, diuretics, BPH, urethral stricture, diabetic neuropathy.
Dysuria Painful or difficult voiding. Possible cause: Lower UTI, inflammation of bladder or urethra, acute prostatitis, stones, foreign bodies, tumors in bladder
Hesitancy delay, difficulty in initiating voiding. Possible cause: BPH, compression of urethra, outlet obstruction, neurogenic bladder
Nocturia excessive urination at night. Possible cause: decreased renal concentrating ability, heart failure, diabetes, incomplete bladder emptying, excessive fluid intake, nephro syndrome, cirrhosis
Incontinence Involuntary losso f urine
Enuresis involuntary voiding during sleep
polyuria increased volume of urine voided
oliguria urine output less than 400mL/day
anuria urine output less than 50mL/day
hematuria RBC in urine. due to: cancer of genitourinary tract, acute glomerulonephritis, renal stones, renal tuber, blood dyscrasia, trauma, extremem exercise, rhematic fever, hemophilia
proteinuria abnormal amounts of protein in urine; due to: acute and chronic renal disease, nephrotic syndrome, vigorous exercise, heat stroke, severe heart failure, diabetic neuropathy, multiple myeloma
Undergoing renal angiography drink extra fluids on the day before. do not eat anyfood or fluids before the test. iv will be given. meds will be given for relaxation. local anesthesia. Expect burning sensation w/contrast media. Remain on strict bed rest 4-8hrs. Drink extra fluids.
Normal urine flow rates: male young adult: 21 middle aged: 12 older:9
Normal urine flow rates: female young: 18 middle: 15 old: 10
needle renal biopsy minimally invasive, renal tissue is removed through a needle, useful when CT or MRI findings are inconclusive.
Fine-needle aspiration renal biopsy minimally invasive, performed under local anesthesiain the OR, needle placement guided by fluoroscopy
open renal biopsy small incision made into flank, usually performed if needle biopsy tissue samples are not satisfactory.
Normal urine color yellow
normal urine clarity clear
normal urine specific gravity 1.003-1.029
normal urine osmolality 50-1200
normal urine pH 4.5-7.5
normal urine ketones none
normal urine protein none
normal urine glucose none
normal urine rbcs 0-3
normal urine wbcs 0-4
normal urine bilirubin none
Obtaining a clean-catch midstream urine specimen wash hands. cleanse peepee area, begin voiding (hold labia apart ladies) into cup, and stop after 30-50mL. urinate the rest in the toilet!
Dietary intake can affect urine characteristics as well as Urinary tract disorders and their mgmt. A highproteine low carb diet can cause ketonuria. megadoses of vitamin c can interfere with certain lab tests, asparagus causes stinky pee and is a light diuretic.
Diuretic therapy can result in increased sodium, chloride, and magnesium levels with 24 hour urine electrolyte testing.
Risk factors for acute pyelonephritis instrimentation of the urethra and bladder, inability to empty bladder, prego, urinary stasis, urinary obstruction, diabetes mellitus, renal disease, neurogenci bladder, slutty ladies, men who take it up the booty.
Risk factors for chronic pyelonephritis recurrent episodes of acute pyelonephritis, chronic obstruction, reflux disorders (urine goes back UP)
Urinary obstruction is the most common cause of pyelonephritis in the older adult. when present, the older adult may not experience the fever and difficulty voiding common in younger adults.
Urinalysis results with acute pyelonephritis bacteria, leukocytes, casts, RBCs, low specific gravity, slightly alkaline pH, proteinuria, urine culture shows organism coloy count of >100,000 organisms
Urinalysis results with chronic pyelonephritis leukocytes, proteinuria, bacteria, casts, low specific gravity
Use caution when giving drugs excreted by the kidney to those with renal disease. If the drug is deemed necessary, it may be given in lower doses, observe the lclient closely for any changes in renal status. pay special attention to urinary output.
Client and family teaching acute pyelonephritis Consume acid forming foods such as meat, fish, poultry, eggs, grains, corn, lentils, and cranberries, prunes plums to prevent stone formation. avoid booze and coffee, show them how to do clean catch. have bp monitored, call doc for low back pain.
Created by: christinego