Chapter 9 – Urinary System Definitions Rosa Razo October 17, 2012Sources: http:// www.webmd.com/a-to-z-guides
Blood Urea Nitrogen (BUN)• A blood urea nitrogen (BUN) test measures the amount of nitrogen in your blood that comes from the waste product urea. Urea is made when protein is broken down in your body. Urea is made in the liver and passed out of your body in the urine• A BUN test is done to see how well your kidneys are working. If your kidneys are not able to remove urea from the blood normally, your BUN level rises.. Heart failure, dehydration or a diet high in protein can also make your BUN level higher. Liver disease or damage can lower your BUN level. A low BUN level can occur normally in the second or third trimester of pregnancy
BUN to Creatinine Ratio (BUN:creatinine)• A BUN test may be done with a blood creatinine test. The level of creatinine in your blood also tells how well your kidneys are working• A BUN-to-creatinine ratio can help your doctor check for problems, such as dehydration, that may cause abnormal BUN and creatinine levels.
Why a BUN Test is Done• To see if your kidneys are working normally.• To see if your kidney disease is getting worse.• To see if treatment of your kidney disease is working• Check for severe dehydration. Dehydration generally causes BUN levels to rise more than creatinine levels• Kidney disease or blockage of the flow of urine from your kidney causes both BUN and creatinine levels to rise
Retrograde Pyelogram (RP)• RP is a diagnostic x-ray in which dye is inserted through the urethra to outline the bladder, ureters, and renal pelvis• Generally, this test is performed during a procedure called cystoscopy – evaluation of the bladder with an endoscope• During a cystoscopy, contrast dye, which helps enhance the X-ray images, can be introduced into the ureters via a cathete.
Extracorporeal Shockwave Lithotripsy (ESWL)• ESWL uses shock waves to break a kidney stone into small pieces that can more easily travel through the urinary tract and pass from the body• ESWL may be used on people with a kidney stone that is causing pain or blocking the urine flow. Stones that are between 4 mm (0.16 in.) and 2 cm (0.8 in.) in diameter are most likely to be treated with ESWL.
What to Expect During ESWL Procedure• You lie on a water-filled cushion, and the surgeon uses X- rays or ultrasound tests to precisely locate the stone. High- energy sound waves pass through your body without injuring it and break the stone into small pieces. These small pieces move through the urinary tract and out of the body more easily than a large stone.• The process takes about an hour.• You may receive sedatives or local anesthesia• Your surgeon may use a stent if you have a large stone. A stent is a small, short tube of flexible plastic mesh that holds the ureter open; this helps the small stone pieces to pass without blocking the ureter
Urinary Tract Infection (UTI)• A UTI is an infection in the urinary tract• Infections are caused by microbes—organisms too small to be seen without a microscope—including fungi, viruses, and bacteria• Bacteria are the most common cause of UTIs. Normally, bacteria that enter the urinary tract are rapidly removed by the body before they cause symptoms.• Bacteria may overcome the body’s natural defenses and cause infection, causing an infection in the urethra (urethritis)• A bladder infection is called cystitis• A kidney infection is called pyelonephritis
What causes UTIs?• Most are caused by bacteria that live in the bowel• The bacterium Escherichia coli (E. coli) causes the majority of UTIs• Microbes called Chlamydia and Mycoplasma can infect the urethra and reproductive system but not the bladder• Chlamydia and Mycoplasma infections may be sexually transmitted and require treatment of sexual partners
Who is at risk for a UTI?• People with spinal cord injuries• People with other nerve damage around the bladder• Anyone with an abnormality of the urinary tract that obstructs the flow of urine (i.e.kidney stone or enlarged prostate)• People with diabetes
Catheterization (cath)• Urinary catheterization is the insertion of a catheter into a patients bladder. The catheter is used as a conduit to drain urine from the bladder into an attached bag or container
Purpose of Catheterization• Urinary catheterization is used to maintain urine output in patients who are undergoing surgery• Patients who are confined to the bed and physically unable to use a bedpan• Critically ill patients who require strict monitoring of urinary output
Risks of Catheterizations• Trauma to the urethra and/or bladder may result from incorrect insertion of the catheter• Repeated irritation to the urethra during catheter insertion may cause scarring and/or stricture, or narrowing, of the urethra• Catheter may introduce bacteria into the urethra and bladder, resulting in urinary tract infection