Chapter 36 Urinary System

Nephro

Nephro

Related to the kidneys

Renal

Related to the kidneys

BPH

Benign prostatic hyperplasia

Benign prostatic hyperplasia

Age-associated prostate gland enlargement that can cause urination difficulty (prostate glans pushes against the urethra)

cystoscopy

a procedure to look inside the bladder using a thin camera called a cystoscope

ureteroscopy

a procedure to address kidney stones, and involves the passage of a small telescope, called a ureteroscope, through the urethra and bladder and up the ureter to the point where the stone is located

nephrologist

medical doctors who specialize in the care of kidneys

urologist

a doctor who specializes in the study or treatment of the function and disorders of the urinary system.

ureterostomy

a surgery to create a urinary diversion (a change in the path by which urine leaves the body)

urostomy

an opening in the belly (abdominal wall) that's made during surgery. It re-directs urine away from a bladder that's diseased, has been injured, or isn't working as it should.

CNA consideration urostomy

• provide good skin care around the ostomy site, if urine leaks and stays on skin for long period of time skin breakdown can occur

• urostomy bag has to be emptied at regular intervals

• monitor urine for changes in color and odor

CKD

chronic kidney disease

lithotripsy

a procedure that uses shock waves to break up stones in the kidney and parts of the ureter

function of the urinary system

removal of liquid waste, maintenance of homeostasis

effects of aging on the urinary system

less efficient filtration, decreased muscle tone, enlargement of the prostate gland, increased risk of UTI’s

prevention of UTI’s

push fluids (helps kidneys work properly and regular urination flushes harmful bacteria from the bladder)

urethritis

infection of the urethra

cystitis

infection of the bladder (more common in women due to smaller urethra and being close to anus)

pyelonephritis

infection of the kidneys (can be serious and cause permanent damage to kidneys)

s/s UTI for older adult

delirium (confusion)

general s/s for UTI

urinary frequency, burning, cramping, change in voiding habits, change in color/ odor of urine

neurogenic bladder

condition caused by a problem with the nerves that control the bladder Ex. spinal cord injury/ stroke

neurogenic bladder CNA considerations

potential for urinary incontinence (leakage may cause skin breakdown) or retention (think s/s urinary retention: urinating frequently but only small amounts and feeling of bladder fullness)

kidney stones

• caused by concentration of waste products in the kidneys that clump together over time and leads to formation of “stones”

• associated with hematuria as stone travels down ureters and into bladder damaging lining

• often stones are voided in their own if not will need lithotripsy to remove surgically

renal calculi

kidney stone

kidney stones CNA consideration

may be asked to “strain urine” to collect any kidney stones that are voided out, have patient push fluids to get all stones out

kidney (renal) failure

• inability of the kidneys to filter blood effectively

• waste and fluid collects in the body causing many difficulties

• caused by acute renal failure or chronic renal failure

• symptoms usually managed with dialysis

dialysis

a procedure to remove waste products and excess fluid from the blood when the kidneys stop working properly (2 types: hemodialysis and peritoneal dialysis)

hemodialysis

the person’s blood is drawn intravenously through a machine with filters and solutions that clean the blood of waste and then returned to the person’s body through another vessel

HD

Hemodialysis

PD

peritoneal dialysis

fistula/ graft

surgically created access for hemodialysis treatments

peritoneal dialysis

solutions that absorb waste products are placed into a person’s abdominal cavity through a tube that has been surgically placed for this purpose, the solution stays in the abdominal cavity for a period of time to collect any waste and then the fluid is removed taking the waste with it

s/s kidney failure

• edema

• hypertension

• oliguria followed by anuria

oliguria

less than 400 ml of urine output in 24 hours