Urinary Disorder

1
Urinary Disorder Renal DisordersChapters
63, 64, 65

• By Angie Lawson RN, BSN

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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

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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

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Chronic Renal Diseases

• Diabetic nephropathy
• Long-term complication of diabetes
• Nephrosclerosis
• Large amounts of protein are lost in the urin

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Glomerulonephritis

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

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Renal Failure

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

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Dialysis

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

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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)

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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.