Urinary System
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| what is the responsibility of the bladder | to collect, hold, secret urine.
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| how many mLs cause moderate bladder distention? | 200 to 250 ml
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| how many mLs cause uncomfortable sensation? | 400 to 600
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| what is the capacity of the bladder | 1 liter
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| what is another term for urination? | micturition and voiding
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| what are the assessment data for urinary system? | pain, urinary pattern, urine output, urine characteristics, peripheral edima (w/ kidney problem)
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| what is passing urin many times a day and only small amounts refers to? | frequency
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| what is dribbling? | passing of urine stream (strong or not steady), common in men with prostate problem. They pee a little bit at a time, not too steady.
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| what is retention? | urine building up inside even after voiding
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| what do you call the pain when passing the urine? | dysuria.
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| what are the dx tool apply to urinary system. | labs ( electrolytes, BUN, Creatinine, UA, C/S, radiological procedures , cystoscopy
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| what scope use for urinary system? | cystoscopy
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| what type of x-ray specifically use for urinary system? | KUB xray.
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| why BUN not specific for kidney? | if there is a bleeding or nitrogen issue
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| what are the causes of UTI? | frequency, urgency, burning upon urination, foul-smelling urine
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| What are UTI prevention? | "Younger, sexually active females more predisposed as well as people who hold urine and don’t
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| pee, females wiping back to front exposing urethra to E.coli, recommend that women pee after sexual intercourse." |
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| what are s/s of UTI | fevers, pain (back region or higher), hematuria
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| what are the UTI tx? | antimicrobial therapy sensitive to organism, analgesic, completion of antibiotic rx, adequate fluid intake, nutrition, rest and comfort, ask how they got it, teach prevention, and recurrence counseling
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| what is urethritis? | inflammation of urethra, caused by viral/bacteria, Sexually xmitted (gonorrhea in men)
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| s/s urethritis? | dysuria and frequency.
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| what is interstitial cystitis? | painful inflammation of the bladder, onset 40yo, more for women
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| s/s insterstitial cystitis? | dysuria relieved by urination, frequency, urgency
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| how to tx for interstitial cystitis? | no treatment med, treat sympomptoms (palliative), pee more frequently, don't hold
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| what are the problems of bladder control? | bladder emptying and bladder storage (incontinence)
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| what are the causes of urinary retention? | muscle can't stretch overdistended (hypertrophy/enlargmnt),stones, trauma to muscle, neurological/sensory prob(dementia, stroke pts), tumor obstruc, scar tissue due to sx (cystoscopies),sctricture( narrowing or tumor obstruction ), meds , lack of privacy
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| complications of urinary retention: | getting a bacterial infx, overdistended bladder could cause perforation; elevate BP and HR due to distention of bladder causes sympathetic response
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| what to assess pt that had cystoscopy and their system works? | ask the pt to urinate, take note of the urine color, consistency, stream(if unstable , scan bladder to check urine retention, if retention, call the doctor), ease, discomfort, burning? (1st few pees/days),
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| what are the s/s of blockage | pelvic region pain or discomfort and dribbling of urine but not enough to relieve pressure.
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| what is male retention problem? | large prostate (hugging the ureter).
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| what are the tx of urinary retention? | h/o of s/s , if problem persist, install urinary catheter even when they go home. This will prevents the urine go back to the ureter and cause UTI., Teach pt how to discontinue at home.
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| How sx and dx procedure (cystoscope) affect urine elimination and the properties of urine? | dysuria, hematuria (irritation, pink , cherry red, salmon color),
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| what are the s/s of enlarge protstate gland? | dysuria from enlargement and obstruction
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| What are the tx of enlarge prostate? | Digipan, Flomax(conservative meds for BPH), TURP (surgery to remove section of the prostate, TURBT (bladder tumor removal)
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| what is creatinine clearance normal values? | 70 to 135
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| Nursing care for BPH | if bleeding or clot suspicion in the ureter, the bladder needs to be irrigated continously with N. Saline and not sterile water (too many electrolytes shift), I/O, Pain control, Nutrition, rest, comfort, observe s/s UTI.
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| what is urinary incontinence disease | uncontrolled / involuntary leakage of urine from the bladder.
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| what are the s/s of incontinence | frequency, urgency, urge incontinence
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| what are the types of incontinence? | stress(sneez, cough), urge(spasms in bladder), overflow(bladder fill up and overcome sphincter control), reflex(d/t spinal cord inj), trauma to spincter, functional(older can't go bathroom because they hold full bladder too long, or bathroom too far)
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| what are the dx test for urinary incontinence? | h&p, PE, labs, bladder scan
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| How to measure residual urine? | bladder scanner
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| What are altered urine production? | polyuria, oliguria, anuria , need to monitor for 24 hours
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| what is polyuria? | lots of urine, abnormal if other disease process , diabetes, neurological condition, )
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| what is oliguria? | (too little urine) 100 to 400 ml per day (less than normal range) normal range is about 1500 ml per day
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| what is anuria? | (almost no urine) < 100 ml per day (very dehydrated) r/t renal failure or kidney disease.
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| what is the normal urine output | 60 ml/hour or 1500 ml/day, below 30ml (give 2 hours of information) per hour is acceptable
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| what is the most important nursing assessment for client with indwelling urinary cateter and why? | check if the catheter is patent, palpate bladder, flush bladder if needed, check cat. Bag
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| what is ileal conduit? | ileal loop /urinary diversion: cut a small piece of ileum (ex. 2 inches), take out bladder, connect ureter to small piece of ileum, connect small piece of ileum to abd wall. (suture the remaining ileum back GI tract)
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| what is ureterostomy? | connect ureter directly to abd wall. Not used anymore due to more complications.
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| what is ureteroileosigmoidostomy? | ureter connected to small piece of ileum, small piece of iluim connected to sigmoid colon.
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| what is nephrostomy | surgically insert catheter through the back of the pelvis, and connect the catheter right after the kidney.
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| what is neobladder | create bladder, no nerve, no sensation, scheduled pee use abd muscle to void.
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| what is acute pyelonephritis? | inflammation of renal parenchyma, lower UTI, urosepsis, septic shock
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| s/s pyelonephritis? | fatigue, chills, fever, vomiting , flank pain, dysuria, urgency, frquency, CVA pain.
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| what organism caused by pyelonephritis? | gram negative bacteria
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| what is glomerulonephritis? | inflammation of glomeruli., GFR < 125 per hour, autoimmune, streptococcus, acute vs chronic, 3rd leading cause of acute renal failure.
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| s/s glumerulonephritis? | hematuria, WBC, proteinuria, inc. BUN/creatine.
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| what is goodpasture syndrome? | cytotoxic autoimmune disease, affect kidney and lungs, yung male smoker.
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| what is nephrotic syndrome | loss of plasma protein, fluid shift and fluid retention,
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| causes of nephrotic syndrome | glomerular disease SLE, DM, Bcterial, viral, protozoal , leukemia, tumors, hodgkins, allergen, Drugs (NSAID, Captopril, heroin)
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| s/s nephrotic syndrome | labs and pt s/s
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| what is nephrolithiasis | kidney stones (renal calculi)
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| cause of nephrolithiasis | metabolic, dietary, genetic, lifestyle, and occupational.
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| what are the calculi? | ca phospate, ca oxalate, uric acid, cystine, struvite (mg ammonium phospate)
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| what is polycistic kidney disease | genetic, cysts that damage (need transplant)
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| alport sysndrome | gene mutation, altered synthesis of glomerular
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| foods to avoid with oxalate renal problem | spinach rhubarb, asparagus, tomatoes, chocolate, nuts, celery, and parsley
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| kidney pain of infection | flank pain
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| kidney pain of hydronephrosis | acute colicky pain.
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| bladder & pelvis obstruction | distentionn and pressure.
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| priority RN dx for pt with renal failure | fluid excess management
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| when should RN infuse 1 pack of blood xfusion | between 1 to 3 hours
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| sign of lower UTI | burning sensation while voiding
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| sing of pyeloneprhonitis | flank pain, costovertebral angle tenderness, chills
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| what tx for renal calculi pt | Opiods (NSAID and salicylates are anti-inflammatory)
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| tx specific to bladder | tylenol and pyridium (turn urine orange)
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| how much amount of water should pt with renal calculi drink per day | 3 liters (12 cups ) per day
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| Why pt with renal disease's skin feels itchy? | because of Calcium-phosphat deposits.
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| what to do if patient have muscle cramps after hemodialysis? | infuse N. Saline. Muscle cramp occurs when Na and Water are removed too quickly.
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| organisam in glomurelonephrotitis what could be the symptoms | streptococcus infection / sore throat problem.
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| what pt could be done to prevent recurrence of UTI? | Urinate every 2 to 3 hours
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| after TURP, notify provider any signs of: | infection such as fever, urinary frequency, or painful urination.
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| what nutrition diet of pt with renal problem? | fluid intake. Eat food low in K, Phos, and protein 'coz kidney can't excrete them and will retain inside the body. Eat food high in Calcium
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| signs of hyperkalemia | RR 28/min, nausea, dull headache, palpitation, general malaise.
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