ASSESSMENT OF RENAL AND URINARY TRACT INFECTION

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ASSESSMENT OF RENAL AND URINARY TRACT INFECTION

  1. 1. Chapter 43Assessment of Renal and Urinary Tract Function Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
  2. 2. Renal and Urinary Systems• Function to maintain the body’s state of homeostasis by regulating fluid and electrolytes, removing wastes, and providing hormones involved in red blood cell production, bone metabolism, and control of blood pressure.• Structures: – Kidneys – Ureters – Bladder – Urethra Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
  3. 3. Kidneys, Ureters, and Bladder Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
  4. 4. Internal Structure of the Kidney Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
  5. 5. Nephron Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
  6. 6. Formation of Urine Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
  7. 7. Renin Angiotensin System Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
  8. 8. Diagnostic Studies• Urinalysis and urine culture• Renal function tests (See Table 43-5)• Ultrasonography• CT and MRI• Nuclear scans• Intravenous urography, retrograde pyelography, cystography, renal angiography (See Chart 43-2)• Endoscopic procedures• Biopsies Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
  9. 9. Cystoscopic Examination Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
  10. 10. QuestionIs the following statement True or False?Urea is an abnormal constituent of urine. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
  11. 11. AnswerFalseUrea is not an abnormal constituent of urine. Glucose is an abnormal constituent of urine. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
  12. 12. Nursing Care of the Patient UndergoingDiagnostic Testing of the Renal-UrologicSystem—Assessment• Patient knowledge• Psychosocial and emotional factors; fear, anxiety• Urologic function, include voiding habits/pattern• Fluid intake• Hygiene• Presence of pain or discomfort• Allergies Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
  13. 13. QuestionWhat is the normal adult bladder capacity?A.50 – 100 mLB.100 – 200 mLC.300 – 500 mLD.600 – 800 mL Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
  14. 14. AnswerCThe normal adult bladder capacity is 300 – 500 mL of urine. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
  15. 15. Nursing Care of the Patient UndergoingDiagnostic Testing of the Renal-UrologicSystem—Diagnoses• Knowledge deficient• Pain• Fear Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
  16. 16. Nursing Care of the Patient UndergoingDiagnostic Testing of the Renal-UrologicSystem—Planning• Patient goals may include understanding of procedures, tests and expected behaviors; decreased pain or absence of discomfort; and decreased apprehension and fear. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
  17. 17. Interventions• Patient teaching: providing a description of the tests and procedures in language the patient can understand.• Use appropriate, correct terminology.• Encourage fluid intake unless contraindicated.• Instruct in methods to reduce discomfort; sitz baths, relaxation techniques.• Administer analgesics and antispasmodics as prescribed.• Assess voiding and provide instruction related to voiding practices and hygiene.• Provide privacy and respect. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
  18. 18. QuestionA 24-hour urine collection is scheduled to start at 1 am. When should the nurse start the procedure?A.At 1 am, with or without a specimen.B.At the first specimen that was voided at 4 am.C.2 hours after the urine was discarded.D.After discarding the 1 am specimen. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
  19. 19. AnswerDA 24-hour urine collection that starts at 1 am begins after discarding the 1 am specimen. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

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