urinary system

urinary system composed of

urinary system composed of

• kidneys

• uretus

• bladder

• urethra

glomeruli

clusters of capillaries of the kidney that filters more than 1L/min

landmarks of the urninary system

• costovertebral angle (CVA)

• rectus abdominis

• symphysis pubis

urinary elimination

-is a major concern as individuals advance in age

Occurs in elderly

• urinary retention

• incontinence

• frequent voiding/ urgency

By age 75+

loss of nephrons in the kidney leads to less frequent glomeruli filtration leading to susceptibility to drug toxicity

Benign prostatic hypertrophy (BPH)

at age 85+ about 95% of men will have BPH resulting from urinary retention or trickling voiding

urolithiasis/ renal calculi/ renal stones

stones that block the urinary tract

• most common in caucasians

• nursing actions: strain all urine to collect stones and notify MD

Associated risk for urolithiasis

familial history

client education of urolithiasis

increase fluid intake to at least 3L/day if client is not on fluid restrictions

kidneys are rarely palpable except in the presence of

• cancer

• neoplasms

• polycystic diseases

bladder cancer

most common in males

• linked to smoking

3 stages of acute renal failure

1. oliguria

2. diuresis

3. recovery

hallmark for chronic renal failure

uremia

uremia

urine product buildup in the blood, leading to kidney failure

uremic frost

crystalized urea on the skin

azotemia

high levels of nitrogen compound in the blood due to inefficient function of the kidneys

incontinence

-inability to retain urine

5 types of incontinence

• functional

• reflex

• stress

• urge

• total

functional incontinence

inability to reach the toilet on time

• could be due to psychosocial or physical factors

reflex incontinence

due to spinal cord damage

stress incontinence

increased abdominal pressure

• due to

  • coughing

  • sneezing

  • aging

urge incontience

increased fluid intake in a short period of time

• or small bladder capacity

total incontience

from neurologic conditions

urinary retention

inability to empty the bladder

when urine output is < intake

patient is retaining fluids

dysuria

painful urination

noturia

frequent urination at night

anuria

<100cc/24 hrs

oliguria

<400cc/24hrs

glycosuria

sugar in the urine

hematuria

blood in the urine

normal output of urine in a 24hr period

800-2000 cc

sudden drop of BP

major role for kidneys is to release renin to help regulate BP

enuresis

involuntary urination especially at night

• common in 5yrs and younger

• familial tendency