Elimination Disorders

Page 2: Brief A&P Review

• Functions of the Kidney:

  • Urine formation

  • Excretion of waste products

  • Regulation of electrolytes

  • Regulation of acid-base balance

  • Control of water balance & blood pressure

  • Regulation of red blood cell production

  • Synthesis of vitamin D to active form

  • Regulates calcium & phosphorus balance

Page 3: Anatomy

• Structures:

  • Kidneys

  • Ureters

  • Bladder

  • Urethra

Page 5: Age Related Changes

• Ages 30-90

• 7th decade of life

• Changes:

  • Atherosclerosis

  • Decreased blood flow

  • Altered hormone levels

  • Loss of elasticity in females

  • Prostate enlargement in males

Page 7: Health History & Assessment

• Aspects to Assess:

  • Pain

  • UTI history

  • Changes in urinary pattern

  • Dysuria, Nocturia, Hematuria, Anuria

  • Nutritional lifestyle

  • Weight changes

  • Medications, Smoking

  • Vital signs, Intake/output, Weight/BMI

• Physical Examination:

  • Inspect, Palpate, Percussion, Auscultation

  • Normal Findings

Page 9: Diagnostic Assessment

• Parameters:

  • Color, Odor, Protein, Glucose, Ketones, Bilirubin

  • Specific gravity, Osmolality, pH

  • RBCs, WBCs, Casts, Culture

Page 10: Lab Tests and Imaging Studies

• Tests:

  • Urinalysis

  • Creatinine clearance

  • Composite urine collection

  • Urine clean catch

  • Concentration test

  • Residual urine

Page 13: Urinary Tract Infections

• Characteristics:

  • More common in females

  • E. Coli is a common pathogen

• Risk Factors

Page 17: Urinary Tract Infections

• Diagnostics:

  • Dipstick Urinalysis

  • Urine Cultures

  • Imaging: CT and US

Page 18: UTI Medical Therapy

• Uncomplicated UTI:

  • Phenazopyridine for pain

  • Antibiotics like trimethoprim/sulfamethoxazole

• Recurrent UTI

• Nursing Interventions

Page 21: Pyelonephritis

• Inflammation of renal parenchyma

• Etiology and Clinical Manifestations

Page 25: Urinary Tract Calculi

• Nephrolithiasis

• Risk Factors

Page 27: Risk Factors for Calculi

• Metabolic, Climate, Diet, Genetic, Lifestyle

Page 32: Urinary Tract Calculi Diagnostics

• Tests:

  • Non-contrast CT, U/A, KUB, IVP

• Interprofessional Care

Page 34: Nursing Interventions for Kidney Stones

• Pain relief, Monitoring, Fluid intake

• Patient education

Page 38: Benign Prostatic Hyperplasia (BPH)

• Enlargement of prostate gland

• Risk factors

Page 40: BPH Diagnostics and Treatment

• Goals and Treatment

• Drug Therapy

Page 42: Nursing Implementation for BPH

• Preoperative care

• **Import