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

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

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

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

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

6. 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

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

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

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

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

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

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

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

14. 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

15. 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)

16. 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.