1. URINARY SYSTEM

3. FUNCTIONS OF URINARY SYSTEM 1. Urine production 2. Maintain fluid & electrolyte balance (Water and salt balance) 3. Manage and balance chemistry of blood

4. NATURAL AGING CHANGES WITH THE ELDERLY Bladder capacity decreases—f requent urination Kidney function increases at rest— more frequent urination at night Bladder muscles weaken--- leaking of urine and inadequate emptying of bladder Prostate gland in males frequently enlarges--- frequency of urination, urinary obstruction, retention, increase in prostate cancer

5. ORGANS OF THE URINARY SYSTEM Ureters- Connect kidney to bladder; 10-12 inches long, carry urine Bladder- Stores urine Urethra- Tube that carries urine from bladder to outside of body. females: 1 ½ inches males: 6-8 inches Urinary meatus - outside of body; where urine is excreted out Kidneys- Filtering organs that produce urine

9. WHO IS MORE AT RISK FOR INFECTION? Think about this in terms of UTI for elderly…who is more at risk??? Male or Female???

11. KIDNEYS Kidneys: Bean shaped organs located in RETROPERITONEAL cavity. (Behind Peritoneum )Filtering organs that produce urine.

12. INSIDE THE KIDNEY… Nephron -Functional unit of kidney, more than a million in each kidney, filters blood and removes waste. Located in cortex of kidney Glomerulus -Coil of capillaries w/in nephron. Lies w/in Bowman’s capsule Bowman’s Capsule- Encloses glomerulus; site of filtration

14. FORMATION OF URINE Urine is secreted by the kidneys, stored in the bladder, and excreted through the urethra. Urine formation is the complex process that cleans the blood of unnecessary substances while selectively reabsorbing other essential material. What are the essential materials?

16. FACTS ABOUT URINE Normal urine is acidic and pale to deep yellow Dilute urine has more water and fewer dissolved substances, so it is colorless to pale yellow Concentrated urine has less water and more dissolved substances, so it is darker in color and has a stronger odor

17. SPEAKING ABOUT URINE…. Let’s learn the medical word for urinating…. VOID VOIDED VOIDING

18. HOMEOSTASIS Body’s attempt to keep its internal environment (temp, BP, fluid balance) stable or in balance. The urinary system determines the content of tissue fluid (watery environment around the cell). Specifically, waste products are removed, and fluids, electrolytes, blood pressure and pH (acid balance) are regulated to help the body maintain its normal state. The urinary system is responsible to maintain the fluid homeostasis of the body.

21. WHAT COLOR URINE WOULD YOU EXPECT TO SEE WITH…… DEHYDRATION? EDEMA???

22. FLUID BALANCE AND FLUID IMBALANCE Fluid Balance- same amount of fluid is taken in by the body that is excreted by the body Fluid Imbalance- occurs when the body Keeps or retains too much fluid OR When the body loses too much fluid.

23. DEHYDRATION/EDEMA DEHYDRATION A decrease in the amount of water in the tissues. Occurs when fluid output exceeds input or intake. Fluid can be lost by: Vomiting, bleeding, diarrhea, too much urination (polyuria) EDEMA Abnormal swelling of a body part caused by fluid collecting in that area; usually extremities

24. FLUID IMBALANCE DEHYDRATION Causes: Fever, decreased fluid intake, abnormal loss of fluid/blood, disease S&S: dry membranes, coated tongue, low BP, low UO, wt. loss EDEMA Causes: Heart disease, CHF, kidney disease, infections, immobility, burns, increased salt S&S: edema, SOB, wt. gain, low UO

25. NURSING INTERVENTIONS DEHYDRATION Water @ bedside Accurate I&O Offer fluids Check weight Check VS EDEMA Avoid tight shoes Elevate legs Check extremities Accurate I&O Check weight Check VS

26. 3 STEPS OF URINE FORMATION Step 1: Glomerular Filtration: Urine formation starts. Filtering of blood. The filtrate contains essential and nonessential materials. These waste products, helpful products, and water are filtered through the capillary walls of the glomerulus into Bowman’s capsule, forming a liquid called FILTRATE. Step 2: Tubular Reabsorption: Taking back water and essential materials that the body needs. Moves it out of the filtrate and into the blood. 99% is reabsorbed back into the blood. Step 3: Tubular Secretion: Moves non essential material out of blood and into filtrate for excretion out of the kidneys. The urine, containing wastes, is now passed out of the kidney and into the ureter.

27. URINE FORMATION