Urinary Disorder & Renal Disorders Chapters 63, 64, & 65 By Angie Lawson RN, BSN

Urinary A & P Review Kidneys – Nephron – Glomerular filtration – Tubular reabsorption – Tubular secretion Ureters Urinary Bladder Urethra

Assessment Health -History Physical Exam Diagnostic Tests – Urine Tests – Renal Function Tests – Radiological Studies – Endoscopic procedures – Ultrasound examination of the kidneys

Therapeutic Measures Management of urinary incontinence – Stress incontinence – Urge incontinence – Functional incontinence – Total incontinence Management of urine retention – Indwelling catheters – Intermittent catheterization – Suprapubic catheter

Urinary Tract Infections Urethritis – Inflammation of the urethra Cystitis – Inflammation of the urinary bladder Pyelonephritis – Infection of the kidneys

Urological Obstructions Urethral strictures – Narrowing of the lumen of the urethra caused by scar tissue Renal Calculi (kidney stones) – Small stones that form somewhere in the renal structures Hydronephrosis – Results from untreated obstruction in the urinary tract

Bladder Cancer (medical management) Incontinent urinary diversion (Ileal conduit) Continent urinary diversion (Koch pouch) Orthotopic bladder substitution

Kidney Cancer Risk factors – Smoking & exposure to industrial pollution Signs & symptoms – Hematuria, dull flank pain, & palpable mass

Chronic Renal Diseases Diabetic nephropathy – Long-term complication of diabetes Nephrosclerosis – Large amounts of protein are lost in the urin

Glomerulonephritis Acute Glomerulonephritis – Periorbital edema – Nocturia/hematuria – Oliguria/anuria Chronic Glomerulonephritis – Anasarca – Azotemia

Renal Failure Acute Renal Failure – Sudden rapid decrease in renal function & potentially reversible Chronic Renal Failure – Progressive and irreversible damage to the nephrons

Dialysis Hemodialysis – Arteriovenous fistula – Arteriovenous Graft Peritoneal Dialysis – Continuous ambulatory peritoneal dialysis – Continuous cyclic peritoneal dialysis – Intermittent peritoneal dialysis

Pediatrics Urine specimens – Collection bag – Clean catch – Catheterization – 24 hour urine collection Genitourinary tract defects (newborn) – Exstrophy of the bladder

Pediatrics (infant) Urinary tract infections – Fairly common in the diaper age – E. coli accounts for 80% Wilms’ Tumor (nephroblastoma) – Most common abdominal neoplasms of early childhood

Pediatrics (preschool) Nephrotic syndrome – Lipoid nephrosis – Idiopathic nephrotic syndrome – Minimal change nephrotic syndrome (MCNS) Acute glomerulonephritis – Appears to be an allergic reaction to a specific infection (usually group A strep)

Pediatrics (school age) Enuresis – Bedwetting, involuntary urination beyond the age when control is often acquired. Encopresis – Chronic involuntary fecal soiling beyond the age of when control is expected.