1. URINARY SYSTEM DISEASES

2. URINARY TRACT INFECTIONS (UTI)
A UTI is an infection of the urinary tract
Normally the urinary system is sterile.
Common causes of UTI’s are:
Catheterization
Urological exams
Sexual intercourse
Poor pericare
Incomplete bladder emptying
Poor fluid intake
(UTIs) are the second most common bacterial disease.
Nosocomial UTIs are responsible for 40% of all hospital acquired infections and the majority of these are related to catheterization.

3. URINARY TRACT INFECTIONS (UTI)
Women are at higher risk d/t a shorter urethra, as well as the close proximity to the rectum and vagina (microbes can enter easily).

4. URINARY TRACT INFECTIONS (UTI)
Prostate secretions help protect men from UTI’s, however, an enlarged prostate increases the risk for UTI’s in men.
Infection in one area of the urinary tract can lead to infection of the entire urinary system

5. URINARY TRACT INFECTIONS (UTI)
SIGNS/SYMPTOMS
Urinary frequency
Urinary urgency
Dysuria
Foul smelling urine
Pyuria
Oliguria DX
Urine for C & S TX
Antibiotics
Analgesics (pain meds)

6. CYSTITIS CYSTITIS SIGNS/SYMPTOMS/DX/TX
Cystitis is inflammation of the bladder.
Infection is the most common cause.
SIGNS/SYMPTOMS/DX/TX
the same as UTI

7. PYELONEPHRITIS PYELONEPHRITIS
Pyelonephritis is acute or chronic inflammation of the pelvis and kidney generally caused by infection.
Pyelonephritis usually ascends from the lower urinary tract. DX
Urine for C & S
Renal u/s

8. PYELONEPHRITIS SIGNS/SYMPTOMS Tx Fever Chills Vomiting Malaise
Flank pain
Hematuria Tx
Antibiotics
Analgesics

9. RENAL FAILURE

10. RENAL FAILURE
Renal failure is the severe impairment of total lack of kidney function.
In renal failure there is an inability to excrete waste products and water from the blood and the body retains fluids.
Renal failure is classified as acute or chronic.

11. RENAL FAILURE ACUTE RENAL FAILURE
Acute renal failure is characterized by a rapid decline in renal (kidney) function with progressive azotemia (an accumulation of waste products in the blood).
Azotemia then leads to uremia - the condition in which azotemia progresses to a symptomatic state. (you have signs/symptoms)
Acute renal failure may progress through 3 phases, oliguria, diuresis and recovery. In some situations the pt. does not recover from acute renal failure and chronic renal failure results.

12. RENAL FAILURE OLIGURIC PHASE DIURETIC PHASE
Acute renal failure is usually associated with a decrease in urinary output to < 400cc per day.
Acute renal failure usually develops over hrs or days with elevations in bloodwork (BUN, Creatinine, K+) and may last from a few days to several weeks.
The longer the oliguric phase the poorer the prognosis for recovery.
DIURETIC PHASE
Begins with a gradual increase in daily urine output of 1 to 3L but may reach 3-5L.
Kidneys are still not fully functional and there are decreases in bloodwork (Na, K+).
This phase may last 1-3 wks.

13. RENAL FAILURE RECOVERY PHASE Bloodwork starts to stabilize.
This phase can last anywhere from 2 weeks to 12 months.
The outcome of acute renal failure is influenced by the persons:
overall health
the severity of the renal failure
the number and type of complications

14. RENAL FAILURE CAUSES Hypovolemia hemorrhage, burns, dehydration,
prolonged vomiting
Decreased cardiac output MI
CHF
Arrhythmias

15. RENAL FAILURE SIGNS/SYMPTOMS Oliguria CHF Constipation
Hypotension (early )
Hypertension (after developments of fluid overload)
N & V
Anorexia
Diarrhea
Constipation
Anemia (develops within 48hrs)
Lethargy
Convulsions
Memory impairment
Bloodwork abnormalities (increased BUN, creatinine, K+)

16. RENAL FAILURE DIAGNOSTIC TESTS Bloodwork BUN Creatinine Electrolytes
Hx & physical exam
Urinalysis
Renal u/s

17. RENAL FAILURE Tx
Treatment depends on the severity of the renal failure and may include:
Diuretics
Close monitoring of intake/output (fluid restrictions)
Frequent bloodwork
Therapies to reduce K+ levels (Insulin, Na Bicarb, Dialysis, dietary restrictions)
Daily wt. (to assess fluid loss)
Proper skin care
Frequent oral care
Measures to prevent infection

18. RENAL FAILURE CHRONIC RENAL FAILURE CAUSES
Chronic renal failure involves progressive, irreversible destruction of the nephrons in both kidneys. The disease progresses until most nephrons are destroyed and replaced by non-functional scar tissue. There is no cure.
CAUSES
Hypertension
Diabetes
Infections
Urinary tract obstructions
Tumors

19. RENAL FAILURE SIGNS/SYMPTOMS
Every body system is involved with chronic renal failure as waste products build up in the blood. Signs/symptoms appear when 80-90% of kidney function is lost and may include
Anxiety
Hypertension
Anorexia
Sexual dysfunction
Gout
Anemia
Headache
Dyspnea
Dry skin
Motor weakness

20. RENAL FAILURE Tx
At the end stages of chronic renal failure, the pt. either needs a kidney transplant or dialysis is used to filter the blood. There are 2 types of dialysis.
Hemodialysis
Peritineal Dialysis

21. RENAL FAILURE
PERITONEAL DIALYSIS
HEMODIALYSIS

22. URINARY ASSESSMENT OBJECTIVE (signs) SUBJECTIVE (symptoms)
Urine amount
Urine colour
Urine clarity
Urine odour
Particles
Hematuria
SUBJECTIVE (symptoms)
Pain
Incontinence
Hx of urinary disease
Diet

23. RENAL CALCULI To be done independently Pg 278 Definition
Who is at greatest risk?
Risk Factors
Signs & symptoms Tx