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Disturbance in Urinary & Renal Function
By: Ronald Joseph J. Rebollido, R.N. M.N.
OBJECTIVES
Learning Objectives: On completion of this lecture concept, the students will be able to
1. Describe the anatomy & physiology of the urinary/renal system.
2. Identify the assessment parameters used for determining the status of renal function.
3. Describe diagnostic studies used to determine renal function.
4. Discuss the role of the kidneys in regulating fluid & electrolyte balance, acid-base balance & blood pressure.
5. Explain the different disorders of the urinary tract system.
6. Described the nursing management of the hospitalized client with renal diseases.
7. Use the nursing process as a framework of care of clients with renal problems.
COURSE OUTLINE
I. Anatomic & Physiology Overview:
a. Anatomy of the kidneys and urinary system
b. Functions of the kidneys, ureters, bladder and urethra
II. Assessment of the renal & urinary system:
a. Health history & clinical manifestations
- Physical assessment
- Genitourinary pain (characteristics)
- Problems associated with changes in voiding
b. Diagnostic Examinations
- Urinalysis (urine color & possible causes)
- Urine Specific Gravity
- Creatinine clearance test (24-hour urine test)
- Serum creatinine & BUN test
- Uric acid test
- KUB (kidneys, ureters, bladder studies)
- Bladder ultrasonography
- Computed tomography (CT scan) & Magnetic Imaging Resonance
- Nuclear scans
- Intravenous pyelography
- Cystography
- Voiding cystourethrography
- Renal angiography
- Urologic endoscopic procedure
- Biopsy
- Urodynamic test
III. Management of patients with renal & urinary dysfunctions:
a. Fluid & electrolyte imbalance in renal disorders
b. Dysfunctional voiding pattern
- Urinary retention
- Urinary incontinence
Stress incontinence
Urge incontinence
Reflex incontinence
Overflow incontinence
- Neurogenic bladder

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Spastic/reflex bladder
Flaccid bladder
c. Dialysis
- Hemodialysis
- Continuous Renal Replacement Therapies
- Peritoneal dialysis
- Care of the hospitalized dialysis patient
d. Kidney surgery
IV. Renal and urinary disorders:
a. Infections of the urinary tract
- Lower urinary tract infections
- Upper urinary tract infections
Acute pyelonephritis
Chronic pyelonephritis
b. Primary glomerular diseases
- Acute glomerulonephritis
- Chronic glomerulonephritis
- Nephrotic syndrome
c. Renal Failure
- Acute renal failure (ARF)
- Chronic renal failure (CRF)
Kidney Transplantation
d. Urolithiasis
e. Genitourinary Trauma
- Renal trauma
- Ureteral trauma
- Bladder trauma
- Urethral trauma
f. Renal tumors
g. Cancer of the bladder
h. Urinary diversion
i. Other renal & urinary tract disorders
- Nephrosclerosis - Urethral strictures
- Hydronephrosis - Renal cysts
- Urethritis - Congenital anomalies
- Renal abscess - Interstitial cystitis
Anatomy and Physiology of the Renal System
Kidneys:
- Each person has two kidneys, each is attached to the abdominal wall at the level of the last thoracic & first three lumbar
vertebrae.
- Kidneys are enclosed in the renal capsule.
- Cortex is the outer layer of the renal capsule.
- Medulla is surrounded by the cortex.
- Nephron makes up the functional unit of the kidneys.
Functions of the Kidneys:
1. Maintain homeostasis of the blood & acid-base balance.
2. Excrete end products of body metabolism.
3. Control fluid & electrolyte balance.
4. Excrete bacterial toxins, water-soluble drugs & drug metabolites.
5. Secrete renin & erythropoietin which play a role in the function of PTH & vitamin D.

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Disturbance in Urinary & Renal Function By: Ronald Joseph J. Rebollido, R.N. M.N. OBJECTIVES Learning Objectives: On completion of this lecture concept, the students will be able to 1. Describe the anatomy & physiology of the urinary/renal system. 2. Identify the assessment parameters used for determining the status of renal function. 3. Describe diagnostic studies used to determine renal function. 4. Discuss the role of the kidneys in regulating fluid & electrolyte balance, acid-base balance & 5. Explain the different disorders of the urinary tract system. blood pressure. 6. Described the nursing management of the hospitalized client with renal diseases. 7. Use the nursing process as a framework of care of clients with renal problems. COURSE OUTLINE I. Anatomic & Physiology Overview: a. Anatomy of the kidneys and urinary system b. Functions of the kidneys, ureters, bladder and urethra II. Assessment of the renal & urinary system: a. Health history & clinical manifestations - Physical assessment - Genitourinary pain (characteristics) - Problems associated with changes in voiding b. Diagnostic Examinations - Urinalysis (urine color & possible causes) - Urine Specific Gravity - Creatinine clearance test (24-hour urine test) - Serum creatinine & BUN test - Uric acid test - KUB (kidneys, ureters, bladder studies) - Bladder ultrasonography - Computed tomography (CT scan) & Magnetic Imaging Resonance - Nuclear scans - Intravenous pyelography - Cystography - Voiding cystourethrogr ...
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