The document outlines a lesson on renal system anatomy, physiology, and assessment. It begins with objectives to describe renal anatomy and physiology, discuss renal assessment techniques, and identify abnormal findings. An overview of renal system structures is provided, along with the functions of the kidneys in filtering waste, regulating fluids and electrolytes. Methods of renal assessment through history, physical exam, and diagnostic testing are then described in detail over multiple pages.
Unraveling the Enigma of Proteinuria A Deep Dive into Its Connection with Kid...jsomal
The human body is an intricate web of interconnected systems, each playing a vital role in maintaining overall health. Among these, the kidneys stand out as unsung heroes, diligently filtering waste and excess fluids to ensure a delicate balance within. However, when the kidneys encounter challenges, it can manifest in various ways, with proteinuria being a significant red flag. In this comprehensive exploration, we will unravel the complexities of proteinuria and its intricate relationship with kidney disease.
What is Proteinuria?
Proteinuria, a term that may sound intimidating at first, is simply the presence of an abnormal amount of protein in the urine. The kidneys act as meticulous gatekeepers, allowing essential substances to stay in the bloodstream while efficiently filtering out waste products. When this selective process goes awry, proteins, particularly albumin, may leak into the urine. This phenomenon is not a standalone condition; rather, it serves as a crucial indicator of underlying kidney issues.
The Role of Kidneys in Filtration
To appreciate proteinuria, one must understand the kidney’s primary function—filtration. The nephrons, the functional units of the kidneys, intricately filter blood, ensuring that essential components like red blood cells and proteins remain in circulation while waste products are excreted as urine. The glomerulus, a network of tiny blood vessels within the nephron, plays a pivotal role in this filtration process. Any disruption to this finely tuned system can lead to the escape of proteins into the urine, setting the stage for proteinuria.
The urinary system works with other excretory systems to remove waste from the body through urine production. It filters urea, a waste product of protein breakdown, from the blood and removes it. Problems can arise from aging, illness, or injury and be detected through urinalysis and urodynamic tests. Some common urinary system disorders include benign prostatic hyperplasia, painful bladder syndrome, kidney stones, prostatitis, proteinuria, and urinary tract infections.
Urinary tract infections and disorders can cause obstructions that impair renal function. Common causes of upper urinary tract obstruction include kidney stones, tumors, or inflammation, which can compress or block the ureters. Long-term obstruction leads to hydronephrosis as the kidney dilates above the blockage. This causes tubular damage and loss of kidney concentrating ability over time. Relieving obstruction can allow recovery, but permanent damage occurs with complete or long-term blockages.
This document discusses constipation, including its definition, challenges in defining it, epidemiology, pathophysiology, evaluation, classification, and management. Constipation is defined as difficulty passing stool or feeling of incomplete evacuation for at least 25% of bowel movements. It can be caused by normal or slow transit through the colon, or pelvic floor dysfunction. Evaluation involves clinical assessment, bowel diaries, and potentially tests of colonic transit time or pelvic floor function. Management focuses on lifestyle changes and medications or procedures to relieve symptoms and improve bowel movements.
The document provides definitions and explanations for 5 medical abbreviations related to the urinary system:
1. ARF stands for acute renal failure, which is the rapid breakdown of kidney function that occurs when toxins accumulate due to the kidneys' inability to excrete waste.
2. Cath refers to catheterization, where a tube is inserted into the bladder through the urethra to drain urine or deliver treatments.
3. Cysto is short for cystoscopy, an procedure where a thin camera is inserted into the urethra and bladder to examine the lower urinary tract.
4. BUN measures the level of urea nitrogen in the blood, which indicates how well the
Kidney Health Screenings Kidney Specialist in Ludhiana for Early Detection an...Lovina Kapoor
Your kidneys play a vital role in maintaining your overall health and well-being. These powerful organs are responsible for filtering waste and excess fluids from the bloodstream, regulating blood pressure, and producing essential hormones. However, many individuals overlook the importance of regular kidney health screenings, often leading to the late detection of kidney-related issues. In Ludhiana, a city renowned for its medical expertise, there are numerous kidney specialist in ludhiana dedicated to promoting early detection and prevention of kidney diseases through comprehensive screenings and education.
The document provides information on assessing and managing patients with renal disorders. It discusses the functions of the kidney, methods for assessing the renal system including history, physical exam, and diagnostic tests. Nursing management is described for acute pyelonephritis, chronic pyelonephritis, and urinary tract calculi. Interventions include pain management, monitoring fluid intake and output, administering medications, nutritional therapy, and relieving symptoms.
Ureteral obstructions are blockages that occur in your urinary tract. The article gives a detailed overview of the condition along with the associated medical codes.
Unraveling the Enigma of Proteinuria A Deep Dive into Its Connection with Kid...jsomal
The human body is an intricate web of interconnected systems, each playing a vital role in maintaining overall health. Among these, the kidneys stand out as unsung heroes, diligently filtering waste and excess fluids to ensure a delicate balance within. However, when the kidneys encounter challenges, it can manifest in various ways, with proteinuria being a significant red flag. In this comprehensive exploration, we will unravel the complexities of proteinuria and its intricate relationship with kidney disease.
What is Proteinuria?
Proteinuria, a term that may sound intimidating at first, is simply the presence of an abnormal amount of protein in the urine. The kidneys act as meticulous gatekeepers, allowing essential substances to stay in the bloodstream while efficiently filtering out waste products. When this selective process goes awry, proteins, particularly albumin, may leak into the urine. This phenomenon is not a standalone condition; rather, it serves as a crucial indicator of underlying kidney issues.
The Role of Kidneys in Filtration
To appreciate proteinuria, one must understand the kidney’s primary function—filtration. The nephrons, the functional units of the kidneys, intricately filter blood, ensuring that essential components like red blood cells and proteins remain in circulation while waste products are excreted as urine. The glomerulus, a network of tiny blood vessels within the nephron, plays a pivotal role in this filtration process. Any disruption to this finely tuned system can lead to the escape of proteins into the urine, setting the stage for proteinuria.
The urinary system works with other excretory systems to remove waste from the body through urine production. It filters urea, a waste product of protein breakdown, from the blood and removes it. Problems can arise from aging, illness, or injury and be detected through urinalysis and urodynamic tests. Some common urinary system disorders include benign prostatic hyperplasia, painful bladder syndrome, kidney stones, prostatitis, proteinuria, and urinary tract infections.
Urinary tract infections and disorders can cause obstructions that impair renal function. Common causes of upper urinary tract obstruction include kidney stones, tumors, or inflammation, which can compress or block the ureters. Long-term obstruction leads to hydronephrosis as the kidney dilates above the blockage. This causes tubular damage and loss of kidney concentrating ability over time. Relieving obstruction can allow recovery, but permanent damage occurs with complete or long-term blockages.
This document discusses constipation, including its definition, challenges in defining it, epidemiology, pathophysiology, evaluation, classification, and management. Constipation is defined as difficulty passing stool or feeling of incomplete evacuation for at least 25% of bowel movements. It can be caused by normal or slow transit through the colon, or pelvic floor dysfunction. Evaluation involves clinical assessment, bowel diaries, and potentially tests of colonic transit time or pelvic floor function. Management focuses on lifestyle changes and medications or procedures to relieve symptoms and improve bowel movements.
The document provides definitions and explanations for 5 medical abbreviations related to the urinary system:
1. ARF stands for acute renal failure, which is the rapid breakdown of kidney function that occurs when toxins accumulate due to the kidneys' inability to excrete waste.
2. Cath refers to catheterization, where a tube is inserted into the bladder through the urethra to drain urine or deliver treatments.
3. Cysto is short for cystoscopy, an procedure where a thin camera is inserted into the urethra and bladder to examine the lower urinary tract.
4. BUN measures the level of urea nitrogen in the blood, which indicates how well the
Kidney Health Screenings Kidney Specialist in Ludhiana for Early Detection an...Lovina Kapoor
Your kidneys play a vital role in maintaining your overall health and well-being. These powerful organs are responsible for filtering waste and excess fluids from the bloodstream, regulating blood pressure, and producing essential hormones. However, many individuals overlook the importance of regular kidney health screenings, often leading to the late detection of kidney-related issues. In Ludhiana, a city renowned for its medical expertise, there are numerous kidney specialist in ludhiana dedicated to promoting early detection and prevention of kidney diseases through comprehensive screenings and education.
The document provides information on assessing and managing patients with renal disorders. It discusses the functions of the kidney, methods for assessing the renal system including history, physical exam, and diagnostic tests. Nursing management is described for acute pyelonephritis, chronic pyelonephritis, and urinary tract calculi. Interventions include pain management, monitoring fluid intake and output, administering medications, nutritional therapy, and relieving symptoms.
Ureteral obstructions are blockages that occur in your urinary tract. The article gives a detailed overview of the condition along with the associated medical codes.
At the end of this lecture the student will be able to understand the following:
Anatomy and physiology of renal & urology system
Assessment of renal & urology system
Introduction to renal & urology system disorders
Definition of UTI
Etiology/Pathophysiology of UTI
Risk factors of UTI
Clinical manifestation UTI
Complications of UTI
Diagnostic test of UTI
Medical management UTI
Nursing management UTI
1. Neurogenic bladder is caused by damage to the nervous system that controls bladder function, resulting in the bladder being unable to empty completely or contract properly.
2. It is diagnosed through medical history, exams, bladder function tests and imaging to evaluate the bladder and kidneys.
3. Treatment includes physical therapy like timed voiding, electrical stimulation implants, catheterization, and sometimes surgery to address the bladder sphincter or install an artificial sphincter. Follow-up care monitors bladder and kidney health.
Diagnosis and treatment of Dyssynergic Defecation (Rao)Robert Berg
Dyssynergic Defecation(DD) affects up to on half of patients with Chronic Constipation(CC) and commonly coexists with STC and IBS-C. Anorectal Manometry (ARM) is essential for diagnosis of DD. Biofeedback therapy has been recommended as the first-line treatment for DD and has shown great results irrespective of co-existence with other conditions.
This document discusses chronic constipation. It notes that constipation prevalence increases with age and is affected by diet, lifestyle, and medical conditions. Diagnosis involves assessing symptoms, medical history, and tests of colon function. Treatment focuses on dietary fiber, laxatives, newer medications like lubiprostone and linaclotide, biofeedback therapy, and potentially surgery for severe cases not helped by other options.
Renal failure occurs when the kidneys are unable to remove waste and regulate fluids and electrolytes. This leads to the accumulation of waste in the blood and disruption of other body functions. There are two main types - acute renal failure, which develops rapidly over hours to days, and chronic kidney disease, which progresses over months to years. The main symptoms include leg swelling, fatigue, vomiting and confusion. Treatment focuses on fluid balance, electrolyte control, and renal replacement therapy such as dialysis. Prognosis depends on age and treatment.
10 Common Diagnostic Tests In Urology.pdfDr Ravi Gupta
Diagnostic checks are crucial in the subject of urology, imparting critical insights into patients' ailments and directing remedy plans. Urologists use lots of diagnostic methods to address an extensive variety of urinary and reproductive health troubles. These encompass both routine screenings and entire tests, which allow for the detection of a whole lot of situations including urinary tract infections, prostate cancer, kidney stones, and bladder anomalies. Familiarizing oneself with numerous diagnostic techniques and knowing their cost best empowers patients.
Age Related Changes to the Urinary System.pdfKhaileYutuc
This document discusses age-related changes to the urinary system and dysfunctions that can occur. It begins by outlining the objectives and functions of the urinary system. Key changes include decreased kidney function and loss of bladder control. Common urinary issues for older adults include incontinence, nocturia, benign hyperplasia, prostate cancer, pyelonephritis, kidney stones. Nursing interventions are provided for each issue to help patients manage symptoms and promote continence.
This document provides an overview of the urinary system and urinary tract infections for nursing students. It begins with the objectives and anatomy of the urinary system. It then discusses urinary problems like incontinence, retention, infections, and kidney stones. It covers types of urinary tract infections like cystitis and pyelonephritis. Nursing management is focused on prevention, treatment, patient teaching, and promoting normal urinary function. The goal is for students to understand urinary system disorders and provide appropriate nursing care.
Running Head Nursing Care Plan Nursing Care Plan for an 80-ye.docxtoltonkendal
Running Head: Nursing Care Plan
Nursing Care Plan for an 80-year-old female with Chronic Kidney Disease
Student’s name; Daysi Fernandez
South University
Course: Illness & Disease Management
Nursing Care Plan for an 80-year-old female with Chronic Kidney Disease
Case study
An 80-year-old female presents to the clinic with grievances of asthenia, malaise, headache, weight gain, and a decrease in urination. A tentative diagnosis of acute renal failure is made. She has a history of alcohol and drug abuse. Her medical history is unremarkable, and she has not been taking any medicines. The laboratory results include values of a serum sodium level of 151mg/dl. The potassium level is 2.7mg/dl, chloride is 123mg/dl, and bicarbonate is 14mg/dl. Blood urea nitrogen is 95mg/dl. Blood glucose is 757mg/dl. Serum calcium is 7.5mg/dl, and leukocyte counts are 8000/mm3. The patient is hydrated. She is diagnosed with diabetic ketoacidosis.
Chronic Kidney Disease Patient Questionnaire
1. Have you been diagnosed with kidney disease? Y / N
2. How long has it been your first diagnosed? ____Months / ____years
3. Do you take pain or anti-inflammatory medication? Y / N
4. Do you use herbal treatments? Y / N
5. Do you take blood pressure medication? Y / N
6. Do you check your blood pressure at home? Y /N
7. Have you heard any family heart diseases? Y /N
8. Have you had a history of diabetes or prediabetes? Y /N
9. Have you ever been diagnosed with anemia, or low hemoglobin count? Y / N
10. Have you had any history of osteoporosis, osteopenia, brittle, thin or broken bones? Y / N
11. Summary
I. If you responded yes to any of the questions above, please give more detail___
II. Do you have any question about your Kidney disease that we can help you? ___
Chronic kidney disease (CKD) according to (Bomback and Bakris, 2011) is a continuous decrease of working renal tissue whereby the residual kidney mass cannot sustain the body’s internal environment. CKD is an illness that progressively develops for years or as an effect from an occurrence of kidney related diseases from which the patient has not improved. Acute Renal Failure (ARF) is a continuous and quick weakening of the working of the kidneys (Healthy people 2010, 2013). It occurs when there is a high accumulation of toxic substances in the kidney and left unattended. Development of ARF happens when the kidney fails to remove waste materials from the kidney in the form of urine. Therefore kidney disorders have stopped functioning and lost their strength to remove water and waste from the blood. Deterioration of kidney functioning will lead to other problems in the body such as anemia, poor nutritional health, high blood pressure and nerve damage (Wong et al., 2010). Early diagnosis of this disorder is essential when it comes to its management. Researchers assert that when CKD is detected early, its progression is slowed down and managed (Bomback an ...
Guide on improving prostate health for a better urinary stream.docxRichard Smith
Chapter 1: Introduction
The importance of prostate health cannot be overstated, as the prostate gland plays a crucial role in the male reproductive system and overall well-being. Here are some key points highlighting its significance:
Reproductive Function: The prostate is responsible for producing seminal fluid, which nourishes and transports sperm during ejaculation. A healthy prostate is essential for fertility and successful reproduction.
Urinary Function: The prostate surrounds the urethra, the tube that carries urine from the bladder out of the body. When the prostate is healthy, it doesn't obstruct the urethra, allowing for normal urine flow. Prostate problems, such as enlargement (BPH), can obstruct the urethra, leading to urinary issues like weak flow, frequent urination, and difficulty emptying the bladder.
Quality of Life: Prostate issues, if left untreated, can significantly impact a man's quality of life. Symptoms like urinary urgency, nocturia (frequent nighttime urination), and discomfort can disrupt daily activities, sleep, and overall well-being.
Cancer Risk: Prostate cancer is one of the most common cancers in men. Regular screenings and early detection are vital for successful treatment. Maintaining prostate health can reduce the risk of developing prostate cancer or catching it in its early stages when it's more treatable.
Aging and Hormones: Prostate health is closely tied to hormonal changes, especially with age. An imbalance in hormones, particularly the male sex hormone testosterone, can affect prostate growth and function. Understanding these hormonal dynamics is essential for maintaining prostate health.
Preventative Measures: Proactive measures, including a healthy diet, regular exercise, and avoiding known risk factors (like smoking and excessive alcohol consumption), can promote prostate health. Awareness of family history and risk factors also helps in early intervention.
Renal failure refers to damage to the kidneys resulting in loss of function. There are two types - acute onset and potentially reversible, and chronic which progresses over 3+ months and can become permanent. In the US over 9,800 children have end-stage renal disease and rely on dialysis or transplantation. Causes in children include birth defects, infections, diseases. Diagnosis involves blood and urine tests and imaging tests. Treatment depends on severity and may include medications, diet, dialysis, and transplantation. Complications can include anemia, bone disease, heart disease, and fluid/electrolyte issues if not properly managed.
As Hiranandani Hospital Kidney navigates the journey of aging, understanding the changes that occur in our kidneys is paramount for maintaining overall health and well-being. While age-related alterations in kidney function are inevitable, adopting a proactive approach to kidney health can significantly impact the trajectory of these changes.
The document discusses several topics related to the urinary system:
1. Acute Kidney Injury (AKI), previously called Acute Renal Failure, which is a rapid loss of kidney function caused by factors like low blood volume, toxins, and urinary obstruction.
2. Blood Urea Nitrogen (BUN) testing, which measures the amount of urea in the blood and is used to evaluate kidney function.
3. Catheterization, where a plastic tube is inserted into the bladder through the urethra to allow urine drainage or administer treatment for bladder conditions.
Urology is the branch of medicine that focuses on the urinary tract and male reproductive system. It covers conditions of the kidneys, ureters, bladder, urethra, and male genitals. Common diseases treated in urology include benign prostatic hyperplasia (BPH), urinary tract infections (UTIs), kidney stones, incontinence, and cancers of the urinary system. Urology departments are staffed by urologists, nurses, and have various equipment like cystoscopes, uretroscopes, and holmium lasers. NABH standards for urology focus on communication between staff, respecting patient privacy, and informing patients of critical test results
Undergraduate nurses year three FINAL reviewed October 2020Renal Association
This document provides an overview of acute kidney injury (AKI) for undergraduate nurses. It defines AKI, discusses risk factors and causes, and outlines steps for identifying, managing, and referring patients with AKI. Key points include:
- AKI is a spectrum of injury that can lead to renal failure if unrecognized. It is identified by rises in creatinine and decreases in urine output.
- Patients with chronic conditions, sepsis, hypotension, or those on certain medications are at higher risk. Causes include reduced renal blood flow (pre-renal), direct kidney damage (intrinsic), or urinary tract obstruction (post-renal).
- For patients with AKI, nurses should monitor vital
This document discusses urinary incontinence in elderly men. It defines types of incontinence such as stress, urgency, mixed, and overflow incontinence. It describes age-related changes to the urinary tract that can lead to incontinence. Risk factors in elderly men include poor general health, medications, and treatments for prostate cancer. Evaluation involves history, physical exam, voiding diary, pad testing, and urodynamic testing. Treatment is individualized and may include conservative measures, medications, minimally invasive options like slings or electrical stimulation, or major surgery like artificial urinary sphincters. Care must be taken with treatments in frail elderly patients due to risks of side effects.
This document provides information about acute kidney injury (AKI) for undergraduate nurses. It defines AKI and explains that it is a spectrum of injury that can lead to renal failure and death if unrecognized. The document outlines objectives related to understanding AKI, reviewing kidney anatomy and physiology, establishing the causes and risk factors of AKI, and understanding the role of the multidisciplinary team in diagnosis and management. It then provides details on identifying and staging AKI, discussing causes and risk factors, and outlines recommendations for plans of management for patients with AKI.
This document discusses nutrition for critically ill patients. It outlines nutritional risk assessment tools, energy and protein needs, and enteral feeding protocols. For the case, it recommends starting enteral nutrition as soon as hemodynamically stable, with a calorie target of 25-30 kcal/kg ideal body weight per day, or 1250-1500 kcal for a 50kg man. Locally available formulas like Plumpy'Nut and Mumbai formula are options for enteral feeding in the ICU.
This document provides an overview of sedation, analgesia, and delirium management in the intensive care unit (ICU). It discusses pain in critically ill patients, common painful procedures, and tools for pain assessment. It covers pharmacological and non-pharmacological approaches to pain management, including regional analgesia, opioid analgesics like fentanyl and morphine, and non-opioid options. The document also addresses goals of sedation in the ICU, scales for sedation monitoring, benzodiazepines, dexmedetomidine, propofol and their properties and adverse effects. Finally, it briefly discusses delirium and its management.
At the end of this lecture the student will be able to understand the following:
Anatomy and physiology of renal & urology system
Assessment of renal & urology system
Introduction to renal & urology system disorders
Definition of UTI
Etiology/Pathophysiology of UTI
Risk factors of UTI
Clinical manifestation UTI
Complications of UTI
Diagnostic test of UTI
Medical management UTI
Nursing management UTI
1. Neurogenic bladder is caused by damage to the nervous system that controls bladder function, resulting in the bladder being unable to empty completely or contract properly.
2. It is diagnosed through medical history, exams, bladder function tests and imaging to evaluate the bladder and kidneys.
3. Treatment includes physical therapy like timed voiding, electrical stimulation implants, catheterization, and sometimes surgery to address the bladder sphincter or install an artificial sphincter. Follow-up care monitors bladder and kidney health.
Diagnosis and treatment of Dyssynergic Defecation (Rao)Robert Berg
Dyssynergic Defecation(DD) affects up to on half of patients with Chronic Constipation(CC) and commonly coexists with STC and IBS-C. Anorectal Manometry (ARM) is essential for diagnosis of DD. Biofeedback therapy has been recommended as the first-line treatment for DD and has shown great results irrespective of co-existence with other conditions.
This document discusses chronic constipation. It notes that constipation prevalence increases with age and is affected by diet, lifestyle, and medical conditions. Diagnosis involves assessing symptoms, medical history, and tests of colon function. Treatment focuses on dietary fiber, laxatives, newer medications like lubiprostone and linaclotide, biofeedback therapy, and potentially surgery for severe cases not helped by other options.
Renal failure occurs when the kidneys are unable to remove waste and regulate fluids and electrolytes. This leads to the accumulation of waste in the blood and disruption of other body functions. There are two main types - acute renal failure, which develops rapidly over hours to days, and chronic kidney disease, which progresses over months to years. The main symptoms include leg swelling, fatigue, vomiting and confusion. Treatment focuses on fluid balance, electrolyte control, and renal replacement therapy such as dialysis. Prognosis depends on age and treatment.
10 Common Diagnostic Tests In Urology.pdfDr Ravi Gupta
Diagnostic checks are crucial in the subject of urology, imparting critical insights into patients' ailments and directing remedy plans. Urologists use lots of diagnostic methods to address an extensive variety of urinary and reproductive health troubles. These encompass both routine screenings and entire tests, which allow for the detection of a whole lot of situations including urinary tract infections, prostate cancer, kidney stones, and bladder anomalies. Familiarizing oneself with numerous diagnostic techniques and knowing their cost best empowers patients.
Age Related Changes to the Urinary System.pdfKhaileYutuc
This document discusses age-related changes to the urinary system and dysfunctions that can occur. It begins by outlining the objectives and functions of the urinary system. Key changes include decreased kidney function and loss of bladder control. Common urinary issues for older adults include incontinence, nocturia, benign hyperplasia, prostate cancer, pyelonephritis, kidney stones. Nursing interventions are provided for each issue to help patients manage symptoms and promote continence.
This document provides an overview of the urinary system and urinary tract infections for nursing students. It begins with the objectives and anatomy of the urinary system. It then discusses urinary problems like incontinence, retention, infections, and kidney stones. It covers types of urinary tract infections like cystitis and pyelonephritis. Nursing management is focused on prevention, treatment, patient teaching, and promoting normal urinary function. The goal is for students to understand urinary system disorders and provide appropriate nursing care.
Running Head Nursing Care Plan Nursing Care Plan for an 80-ye.docxtoltonkendal
Running Head: Nursing Care Plan
Nursing Care Plan for an 80-year-old female with Chronic Kidney Disease
Student’s name; Daysi Fernandez
South University
Course: Illness & Disease Management
Nursing Care Plan for an 80-year-old female with Chronic Kidney Disease
Case study
An 80-year-old female presents to the clinic with grievances of asthenia, malaise, headache, weight gain, and a decrease in urination. A tentative diagnosis of acute renal failure is made. She has a history of alcohol and drug abuse. Her medical history is unremarkable, and she has not been taking any medicines. The laboratory results include values of a serum sodium level of 151mg/dl. The potassium level is 2.7mg/dl, chloride is 123mg/dl, and bicarbonate is 14mg/dl. Blood urea nitrogen is 95mg/dl. Blood glucose is 757mg/dl. Serum calcium is 7.5mg/dl, and leukocyte counts are 8000/mm3. The patient is hydrated. She is diagnosed with diabetic ketoacidosis.
Chronic Kidney Disease Patient Questionnaire
1. Have you been diagnosed with kidney disease? Y / N
2. How long has it been your first diagnosed? ____Months / ____years
3. Do you take pain or anti-inflammatory medication? Y / N
4. Do you use herbal treatments? Y / N
5. Do you take blood pressure medication? Y / N
6. Do you check your blood pressure at home? Y /N
7. Have you heard any family heart diseases? Y /N
8. Have you had a history of diabetes or prediabetes? Y /N
9. Have you ever been diagnosed with anemia, or low hemoglobin count? Y / N
10. Have you had any history of osteoporosis, osteopenia, brittle, thin or broken bones? Y / N
11. Summary
I. If you responded yes to any of the questions above, please give more detail___
II. Do you have any question about your Kidney disease that we can help you? ___
Chronic kidney disease (CKD) according to (Bomback and Bakris, 2011) is a continuous decrease of working renal tissue whereby the residual kidney mass cannot sustain the body’s internal environment. CKD is an illness that progressively develops for years or as an effect from an occurrence of kidney related diseases from which the patient has not improved. Acute Renal Failure (ARF) is a continuous and quick weakening of the working of the kidneys (Healthy people 2010, 2013). It occurs when there is a high accumulation of toxic substances in the kidney and left unattended. Development of ARF happens when the kidney fails to remove waste materials from the kidney in the form of urine. Therefore kidney disorders have stopped functioning and lost their strength to remove water and waste from the blood. Deterioration of kidney functioning will lead to other problems in the body such as anemia, poor nutritional health, high blood pressure and nerve damage (Wong et al., 2010). Early diagnosis of this disorder is essential when it comes to its management. Researchers assert that when CKD is detected early, its progression is slowed down and managed (Bomback an ...
Guide on improving prostate health for a better urinary stream.docxRichard Smith
Chapter 1: Introduction
The importance of prostate health cannot be overstated, as the prostate gland plays a crucial role in the male reproductive system and overall well-being. Here are some key points highlighting its significance:
Reproductive Function: The prostate is responsible for producing seminal fluid, which nourishes and transports sperm during ejaculation. A healthy prostate is essential for fertility and successful reproduction.
Urinary Function: The prostate surrounds the urethra, the tube that carries urine from the bladder out of the body. When the prostate is healthy, it doesn't obstruct the urethra, allowing for normal urine flow. Prostate problems, such as enlargement (BPH), can obstruct the urethra, leading to urinary issues like weak flow, frequent urination, and difficulty emptying the bladder.
Quality of Life: Prostate issues, if left untreated, can significantly impact a man's quality of life. Symptoms like urinary urgency, nocturia (frequent nighttime urination), and discomfort can disrupt daily activities, sleep, and overall well-being.
Cancer Risk: Prostate cancer is one of the most common cancers in men. Regular screenings and early detection are vital for successful treatment. Maintaining prostate health can reduce the risk of developing prostate cancer or catching it in its early stages when it's more treatable.
Aging and Hormones: Prostate health is closely tied to hormonal changes, especially with age. An imbalance in hormones, particularly the male sex hormone testosterone, can affect prostate growth and function. Understanding these hormonal dynamics is essential for maintaining prostate health.
Preventative Measures: Proactive measures, including a healthy diet, regular exercise, and avoiding known risk factors (like smoking and excessive alcohol consumption), can promote prostate health. Awareness of family history and risk factors also helps in early intervention.
Renal failure refers to damage to the kidneys resulting in loss of function. There are two types - acute onset and potentially reversible, and chronic which progresses over 3+ months and can become permanent. In the US over 9,800 children have end-stage renal disease and rely on dialysis or transplantation. Causes in children include birth defects, infections, diseases. Diagnosis involves blood and urine tests and imaging tests. Treatment depends on severity and may include medications, diet, dialysis, and transplantation. Complications can include anemia, bone disease, heart disease, and fluid/electrolyte issues if not properly managed.
As Hiranandani Hospital Kidney navigates the journey of aging, understanding the changes that occur in our kidneys is paramount for maintaining overall health and well-being. While age-related alterations in kidney function are inevitable, adopting a proactive approach to kidney health can significantly impact the trajectory of these changes.
The document discusses several topics related to the urinary system:
1. Acute Kidney Injury (AKI), previously called Acute Renal Failure, which is a rapid loss of kidney function caused by factors like low blood volume, toxins, and urinary obstruction.
2. Blood Urea Nitrogen (BUN) testing, which measures the amount of urea in the blood and is used to evaluate kidney function.
3. Catheterization, where a plastic tube is inserted into the bladder through the urethra to allow urine drainage or administer treatment for bladder conditions.
Urology is the branch of medicine that focuses on the urinary tract and male reproductive system. It covers conditions of the kidneys, ureters, bladder, urethra, and male genitals. Common diseases treated in urology include benign prostatic hyperplasia (BPH), urinary tract infections (UTIs), kidney stones, incontinence, and cancers of the urinary system. Urology departments are staffed by urologists, nurses, and have various equipment like cystoscopes, uretroscopes, and holmium lasers. NABH standards for urology focus on communication between staff, respecting patient privacy, and informing patients of critical test results
Undergraduate nurses year three FINAL reviewed October 2020Renal Association
This document provides an overview of acute kidney injury (AKI) for undergraduate nurses. It defines AKI, discusses risk factors and causes, and outlines steps for identifying, managing, and referring patients with AKI. Key points include:
- AKI is a spectrum of injury that can lead to renal failure if unrecognized. It is identified by rises in creatinine and decreases in urine output.
- Patients with chronic conditions, sepsis, hypotension, or those on certain medications are at higher risk. Causes include reduced renal blood flow (pre-renal), direct kidney damage (intrinsic), or urinary tract obstruction (post-renal).
- For patients with AKI, nurses should monitor vital
This document discusses urinary incontinence in elderly men. It defines types of incontinence such as stress, urgency, mixed, and overflow incontinence. It describes age-related changes to the urinary tract that can lead to incontinence. Risk factors in elderly men include poor general health, medications, and treatments for prostate cancer. Evaluation involves history, physical exam, voiding diary, pad testing, and urodynamic testing. Treatment is individualized and may include conservative measures, medications, minimally invasive options like slings or electrical stimulation, or major surgery like artificial urinary sphincters. Care must be taken with treatments in frail elderly patients due to risks of side effects.
This document provides information about acute kidney injury (AKI) for undergraduate nurses. It defines AKI and explains that it is a spectrum of injury that can lead to renal failure and death if unrecognized. The document outlines objectives related to understanding AKI, reviewing kidney anatomy and physiology, establishing the causes and risk factors of AKI, and understanding the role of the multidisciplinary team in diagnosis and management. It then provides details on identifying and staging AKI, discussing causes and risk factors, and outlines recommendations for plans of management for patients with AKI.
This document discusses nutrition for critically ill patients. It outlines nutritional risk assessment tools, energy and protein needs, and enteral feeding protocols. For the case, it recommends starting enteral nutrition as soon as hemodynamically stable, with a calorie target of 25-30 kcal/kg ideal body weight per day, or 1250-1500 kcal for a 50kg man. Locally available formulas like Plumpy'Nut and Mumbai formula are options for enteral feeding in the ICU.
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A 29-year old male with no previous medical history was admitted to the ICU after a car crash with multiple trauma requiring laparotomy. He is intubated, sedated and on noradrenaline with low blood pressure and heart rate. A feeding tube was inserted into his jejunum. The discussion points are about when to start nutrition, what the energy target should be, and how to manage hypoglycemia. The document discusses the risks and benefits of early enteral nutrition in the ICU, optimal routes, timing and formulations of feeding as well as monitoring for complications. It also covers indications for parenteral nutrition and management of hypoglycemia.
Electrolytes like sodium, potassium, calcium, and magnesium are important minerals in the body that regulate functions like nerve impulses, muscle contraction, and fluid balance. Sodium is the main cation in extracellular fluid and helps maintain fluid balance and nerve transmission. Potassium is mainly intracellular and regulates muscle contraction and acid-base balance. Common electrolyte imbalances include hyponatremia (low sodium), hypernatremia (high sodium), hypokalemia (low potassium), and hyperkalemia (high potassium). Their causes, clinical effects, and management strategies are discussed.
Critically ill patients are susceptible to short- and long-term complications. Implementing proven best practices through checklists, bundles, and interdisciplinary rounds can help prevent these complications. A bundle is a set of evidence-based interventions that improve patient outcomes more than any single intervention alone, such as the ABCDEF bundle which is shown to reduce ICU length of stay, delirium, and mortality.
This document discusses various clinical syndromes related to COVID-19 including:
- Mild to severe pneumonia characterized by cough and respiratory symptoms. Severe pneumonia can progress to ARDS.
- ARDS is identified by acute hypoxemic respiratory failure, bilateral lung opacities, and onset within one week of a known clinical insult or infection.
- Sepsis is defined as a dysregulated immune response to infection leading to life-threatening organ dysfunction. Septic shock involves circulatory and metabolic abnormalities requiring vasopressors.
This document describes the case of a 35-year-old obese woman presenting with fever, myalgia, fatigue, cough, shortness of breath, and respiratory distress who is suspected of having COVID-19 or another respiratory infection. Upon initial examination, she requires high-flow oxygen and has diffuse crackles on lung exam and bilateral infiltrates on chest x-ray. She deteriorates clinically and requires intubation and mechanical ventilation. Over the following days, her condition gradually improves with treatment but she initially fails attempts at breathing trials due to anxiety and high respiratory rate and volume. After diuresis to correct fluid balance and a subsequent successful breathing trial, she demonstrates readiness for extubation.
This document discusses the principles of documentation in the ICU. It outlines what should be documented, including assessments, clinical problems, communications, medications, plans of care, and special considerations. Documentation is important for communication among healthcare professionals, and has several uses like ensuring quality care, credentialing, addressing legal issues, and supporting research. The principles of documentation include producing high quality, accurate records in a timely manner according to policies and protecting patient privacy and confidentiality. Entries should be authenticated, dated, and use standard terminology. Documentation provides evidence for appropriate decision making and care.
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Dead body management of COVID-19 patients should follow standard infection prevention and control practices. The major steps are: 1) preparing the body in the patient room while preventing exposure to fluids, 2) transferring the body wrapped in cloth to the morgue, 3) cleaning and disinfecting surfaces, 4) burial following physical distancing with PPE-wearing burial teams, and 5) cleaning equipment and practicing hand hygiene before returning home. Proper cleaning, disinfection, PPE use, and minimizing contact with fluids are essential throughout the process.
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This document discusses various diseases of the liver including hepatic failure, cirrhosis, hepatitis, tumors, and inborn errors. It describes the clinical features and morphological alterations that can cause liver failure such as massive hepatic necrosis from viruses, drugs, or chronic liver disease. Cirrhosis is characterized by fibrosis and regeneration of hepatocytes into parenchymal nodules. Portal hypertension is a consequence of cirrhosis and can result in ascites, portosystemic shunts, splenomegaly, and hepatic encephalopathy. Viral hepatitis includes hepatitis A, B, C, D, and E which are transmitted through various routes and can cause acute or chronic disease. Alcoholic liver disease encompasses hepatic ste
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Disorder of fluid and electrolytes.pptxMesfinShifara
This document provides guidelines for initial electrolyte management in infants receiving intravenous fluids, with a focus on sodium, potassium, calcium, and disorders related to abnormalities in these electrolytes. It recommends:
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1. PREPARED BY: SHAMBEL DEBEBLE- IDNO-------------190/15
Submitted to: Mr. Tadele A. (MSc, Assistant professor)
Mr.Bikila T. (MSC ,Assistant professor )
June 13/06/ 2023
Fiche
21-06-2023 1
2. Outlines
Objectives
Introduction
Anatomy of Renal system
Physiology of Renal system
Assessment of Renal system
Physical Examination of Renal system
Diagnostic
Summary
Reference
21-06-2023 2
3. Objectives
At the end of this lesson students will be able to:
Describes the anatomy and physiology renal system.
Discuss information that will help you focus your renal and
urinary assessment.
Describe abnormal renal and urinary assessment findings as
they are associated with specific disease states.
Preformed physical examination after completed this courses.
Identify normal and abnormal lab values and their impact on
your renal and urinary assessment.
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4. INTRODUCTION
Kidneys are the organ that filter waste products from the
blood.
The kidneys serve three essential function:
They function as filter, removing metabolic product and toxins
from the blood and excreting them through the urine.
They regulate the body’s fluid status, electrolyte balance and
acid-base balance.
The kidney produce or activate hormones that are involved
erythrogenesis, Ca²˖ metabolism and the regulation of blood
pressure and blood flow.
21-06-2023 4
5. Introduction cont.…
Renal function may be assessed by measuring blood urea and
serum creatinine. Renal function decreases with age , which
must be taken into account when interpreting test values.
These tests primarily evaluate glomerular function by assessing
the glomerular filtration
In many renal diseases, urea and creatinine accumulate in the
blood because they are not excreted properly
These tests also aid in determining drug dosage for drugs
excreted through the kidneys
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6. Overview Urinary system anatomy
Main structures of the
urinary system:
Pair kidneys
Pair ureters
One bladder
One urethra
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8. Kidney functions
Urine formation
Excretion of waste products
Regulation of electrolytes
Regulation of acid-base balance
Control of water balance
Control BP
Regulation of RBC production
Synthesis of vitamin D to active form
Secretion of prostaglandins
Regulation of calcium and phosphorus balance
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9. Nephron
Each kidney has approximately 1
million nephrons
If the function is less than 20%
replacement therapy is usually
initiated
The nephron is responsible for the
initial formation of urine.
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10. ASSESSMENT
History taking
Subjective data:- include all characterization of symptoms,
history of present illness, past medical and surgical history,
demographic data, and lifestyle factors.
Signs and symptoms involving the urinary tract may be due
to disorders of the kidneys, ureters, or bladder, surrounding
structures, or disorders of other body systems.
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11. Past Health History.
The patient should be questioned about the presence or history
of diseases that are related to renal or other urologic problems.
Some of these diseases are hypertension, diabetes mellitus,
metabolic problems, tuberculosis, viral hepatitis, congenital
disorders, neurologic conditions trauma.
Specific urinary problems such as any cancer, infections,
benign prostatic hyperplasia, and calculi should be noted.
21-06-2023 11
12. Medications.
An assessment of the patient's current and past use of
medications is important.
This should include over-the-counter drugs, as well as
prescription medications and herbs.
Drugs affect the urinary tract in several ways.
Many drugs are known to be nephrotoxic.
Certain drugs may alter the quantity and character of urine
output.
e.g., diuretics may increase the urine output.
Anticoagulants may cause hematuria.
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13. Past surgical history
The patient should also be questioned about any previous
hospitalizations related to renal or urologic diseases and all
urinary problems during past pregnancies.
The duration, severity, and patient's perception of any problem
and its treatment should be elicited.
Past surgeries, particularly pelvic surgeries, or urinary tract
instrumentation should be documented.
Information should be obtained from the patient about any
radiation or chemotherapy treatment for cancer
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14. Functional Health Patterns
• Health Perception–Health Management Pattern.
Ask about the patient's general health, particularly when disease
affecting the kidneys is suspected.
Sometimes responses such as “feeling tired all of the time,”
changes in weight or appetite, excess thirst, fluid retention, and
complaints of headache, pruritus, or blurred vision may be related
to abnormal kidney function.
21-06-2023 14
15. Similarly, the elderly patient may report malaise and nonlocal
zed abdominal discomfort as the only symptoms of a urinary
tract infection.
An occupational history should be taken.
Exposure to certain chemicals can affect the kidneys and
urinary tract system.
Aromatic amines and certain organic chemicals may increase
the risk of bladder cancers.
21-06-2023 15
16. A smoking history should be obtained.
Cigarette smoking is a major factor in the risk for bladder
cancer.
Tumors occur 4 times more frequently in cigarette smokers
than in nonsmokers.
The presence of certain renal or urologic problems in a family
history increases the likelihood of similar problems occurring in
the patient.
21-06-2023 16
17. Nutritional-Metabolic Pattern.
The usual quantity and types of fluid a patient drinks are
important information related to urinary tract disease.
Dehydration may contribute to urinary infections, calculi
formation, and renal failure.
Large intake of particular foods, such as dairy products or
foods high in proteins, may also lead to calculi formation.
21-06-2023 17
18. Nutritional-Metabolic Pattern.Cont.….
Caffeine, alcohol, carbonated beverages, or spicy foods
often aggravate urinary inflammatory diseases.
Many herbal teas also cause diuresis( increased production
of urine).
An unexplained weight gain may be the result of fluid
retention secondary to a renal problem.
21-06-2023 18
19. Elimination Pattern.
Ask about urine elimination patterns are the cornerstone of the
health history in the patient with a lower urinary tract disorder.
This line of inquiry begins with a question of how the patient
manages urine elimination.
The majority of patients eliminate urine by spontaneous voiding,
and they should be asked about daytime (diurnal) voiding
frequency and the frequency of night time or nocturia.
21-06-2023 19
20. Activity-Exercise Pattern.
The patient's level of activity should be assessed.
A sedentary person is more likely to have stasis of urine than
an active individual, which can predispose to infection and
calculi.
Demineralization(loss of minerals) of bones in a person with
limited physical activity can cause increased urine calcium
precipitation.
21-06-2023 20
21. Sleep-Rest Pattern
Nocturia is a common and a particularly both some lower
urinary tract symptom that often leads to sleep deprivation,
daytime sleepiness, and fatigue.
multiple disorders affecting the lower urinary tract, including
urinary incontinence, urinary retention, and interstitial cystitis.
Nocturia also may be attributable to polyuria owing to renal
disease, poorly controlled diabetes mellitus, alcoholism,
excessive fluid intake, or obstructive sleep apnea.
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22. Cognitive-Perceptual Pattern.
Pain is a frequent symptom of urinary tract disease.
Types of pain associated with renal and urologic problems
include dysuria, groin pain, costovertebral pain and suprapubic
pain.
pain in the abdominal region just below the umbilicus.
Complaints of pain should be assessed and the location,
character, and duration documented.
Many urinary tract tumors are painless in the early stages.
21-06-2023 22
23. Self-Perception–Self-Concept Pattern.
Problems associated with the urinary system, such as
incontinence, urinary diversion procedures, and chronic fatigue
may indicate anemia, can result in loss of self-esteem and a
negative body image.
Sensitive questioning may elicit cues to problems in this area.
21-06-2023 23
24. Role-Relationship Pattern
Urinary problems can affect many aspects of a person's life,
including the ability to work and relationships with others.
These factors will have important implications for future
treatment and management of the patient's condition.
The nurse must be alert for indications from the patient.
21-06-2023 24
25. Sexuality-Reproductive Pattern.
The patient should be questioned about the effect of a renal or
urologic problem on her or his sexual patterns and satisfaction.
Problems related to personal hygiene and fatigue can seriously
affect a sexual relationship.
Although urinary incontinence is not directly associated with
sexual dysfunction, it often has a devastating effect on self-
esteem and social and intimate relationships.
Counseling of both the patient and partner may be indicated
21-06-2023 25
26. Urinary Tract Infections
UTI means infection of any part of urinary tract Kidney, Ureter,
Bladder and Urethra.
Defined by the presence of more than a hundred thousand
organisms per ml in midstream sample of urine.
Infections of the urethra and bladder are often considered
superficial or mucosal infections.
while prostatitis, pyelonephritis, and renal suppuration signify
tissue invasion.
21-06-2023 26
27. Urinary Tract Infections
Classification
Anatomic categories
- lower tract infection (urethritis, bladder cystitis)
- upper tract infection (acute pyelonephritis, and intrarenal and
perinephric abscesses).
Complicated UTI - there are underlying factors that predispose
to ascending bacterial infection catheterization, instrumentation,
anatomic or functional urologic abnormalities.
Uncomplicated UTI - Occurs without underlying abnormality or
impairment of urine flow.
21-06-2023 27
28. Infecting organisms
Common agents are the gram-negative bacilli
Escherichia coli causes ~80% of acute infections in patients
without catheters, urologic abnormalities, or calculi
Proteus Enterococci
Klebsiella Staphylococci
Pseudomonas Candida
Enterobacter
21-06-2023 28
29. Clinical Presentation
Asymptomatic bacteriuria
Common in females & elderly.
25% develop symptomatic UTI .
25% clear spontaneously.
Spontaneous cure & reinfection are common.
21-06-2023 29
30. Clinical Presentation
Bladder Cystitis
• Symptoms: dysuria, frequency, urgency, and supra pubic pain
• Physical examination generally reveals only tenderness of the
supra pubic area
Acute Pyelonephritis:- is a bacterial infection causing
inflammation of the kidneys and is one most common diseases of
kidney.
• Symptoms generally develop rapidly over a few hours or a day
• fever, shaking chills, nausea, vomiting, abdominal pain, and
diarrhea
21-06-2023 30
31. Urinary Tract Pain
Genitourinary pain:-is not always present in renal disease, but
is generally seen in the more acute conditions of the urinary
tract
Kidney pain: may be felt as a dull ache in costovertebral
angle; or may be a sharp, colicky pain felt in the flank area that
radiates to the groin or testicle. Due to distention of the renal
capsule; severity related to how quickly it develops.
21-06-2023 31
32. Involuntary Voiding
Urinary incontinence: involuntary loss of urine; may be due to
pathologic, anatomical, or physiologic factors affecting the
urinary tract.
Ureteral pain: felt in the back and radiates to the groin or scrotum if
the upper ureter is the source, to the suprapubic area, penis, and
urethra if the lower ureter is the source.
21-06-2023 32
33. • Bladder pain (lower abdominal pain or pain over suprapubic area):
may be due to bladder infection or over distended bladder
• Urethral pain: from irritation of bladder neck, from foreign body in
canal, or from urethritis due to infection or trauma; pain increases
when voiding.
• Back and leg pain: due to cancer of prostate with metastases to bone.
21-06-2023 33
34. Physical Examination
Inspection.
The nurse should assess for changes in the following:
Skin: pallor, yellow-gray cast, excoriations, changes in turgor, bruises,
texture e.g., rough, dry skin.
Mouth: stomatitis, ammonia breath odor
Face and extremities: generalized edema, peripheral edema, bladder
distention, masses, enlarged kidneys
21-06-2023 34
35. Abdomen: skin changes described earlier, as well as striae,
abdominal contour for midline mass in lower abdomen may
indicate urinary retention or unilateral mass occasionally seen in
adult, indicating enlargement of one or both kidneys from large
tumor or polycystic kidney)
Weight: weight gain secondary to edema; weight loss and
muscle wasting in renal failure
General state of health: fatigue, lethargy, and diminished
alertness
21-06-2023 35
36. Palpation.
The kidneys are posterior organs protected by the abdominal
organs, the ribs, and the heavy back muscles.
A landmark useful in locating the kidneys is the costovertebral
angle or CVA formed by the rib cage and the vertebral column.
The normal-sized left kidney is rarely palpable because the
spleen lies directly on top of it.
Occasionally the lower pole of the right kidney is palpable.
21-06-2023 36
37. Palpation cont.
To palpate the right kidney, the examiner's left anterior hand is
placed behind and supports the patient's right side between the
rib cage and the iliac crest .
The right flank is elevated with the left hand, and the right hand
is used to palpate deeply for the right kidney.
The lower pole of the right kidney may be felt as a smooth,
rounded mass that descends on inspiration.
21-06-2023 37
39. Percussion.
Tenderness in the flank area may be detected by fist percussion kidney
punch.
This technique is performed by striking the fist of one hand against
the dorsal surface of the other hand, which is placed flat along the
posterior CVA margin.
Normally a firm blow in the flank area should not elicit pain.
21-06-2023 39
41. If CVA tenderness and pain are present, it may indicate a
kidney infection or polycystic kidney disease.
Normally a bladder is not percussible until it contains 150
ml of urine.
If the bladder is full, dullness is heard above the symphysis
pubis.
A distended bladder may be percussed as high as the
umbilicus
21-06-2023 41
42. Auscultation.
The bell of the stethoscope may be used to auscultate over
both CVAs and in the upper abdominal quadrants.
With this technique, the abdominal aorta and renal arteries are
auscultated for a bruit (an abnormal murmur), which indicates
impaired blood flow to the kidneys.
21-06-2023 42
43. Diagnostic studies of the urinary system
Urinalysis
Urinalysis is a general examination of urine to establish
baseline information or provide data to establish a tentative
diagnosis and determine whether further studies are to be
ordered.
Try to obtain first urinated morning specimen.
Ensure that specimen is examined within 1 hr of urinating.
21-06-2023 43
44. Creatinine clearance
Creatinine is a waste product of protein breakdown (primarily
body muscle mass).
• Rate at which creatinine is removed from the blood.
• Useful measure of
- glomerular filtration rate
• - excreting capacity of the kidney.
Normal values
men : 90-140 ml/sec/m²
women: 72-110 ml/sec/m²
21-06-2023 44
45. Urine culture
Urine culture is done to confirm suspected urinary tract infection and
identify causative organisms.
Use sterile container for collection of urine.
Concentration test
Study evaluates renal concentration ability.
Concentration is measured by specific gravity of urines.
Normal values 1.020-1.035
21-06-2023 45
46. Blood Chemistries
BUN( blood urea nitrogen)
BUN is most commonly used to identify presence of renal
problems.
Concentration of urea in blood is regulated by rate at which
kidney excretes urea.
Be aware that, when interpreting BUN, non renal factors
may cause increase.
21-06-2023 46
47. Normal finding: 10-30 mg/dl (1.8-7.1 mmol/L)
Creatinine
Creatinine is more reliable than BUN as a determinant of renal
function.
Creatinine is end product of muscle and protein metabolism
and is liberated at a constant rate.
Normal finding: 0.5-1.5 mg/dl (44-133 μmol/L).
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48. Uric acid
Uric acid study is used as a screening test primarily for
disorders of purine metabolism but can indicate kidney disease
as well.
Normal finding: 2.5-5.5 mg/dl (149-327 mol/L) for women; 4.5-
6.5 mg/dl (268-387 mol/L) for men
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49. Sodium (Na+)
Sodium is main extracellular electrolyte determining blood
volume.
Usually, values stay within normal range until late stages of
renal failure.
Normal finding: 135-145 mEq/L (135-145 mmol/L)
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50. Potassium (K+)
Kidneys are responsible for excreting majority of body's
potassium.
In renal disease, K+ determinations are critical because K+ is
one of the first electrolytes to become abnormal.
Elevated K+ levels of >6 mEq/L can lead to muscle weakness
and cardiac dysrhythmias.
Normal finding: 3.5-5.0 mEq/L (3.5-5.0 mmol/L)
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51. Calcium (Ca2+)
Calcium is main mineral in bone and aids in muscle contraction,
neurotransmission, and clotting.
In renal disease, decreased reabsorption of Ca2+ leads to renal
osteodystrophy.
Normal finding: 9-11 mg/dl (4.5-5.5 mEq/L, 2.25-2.74 mmol/L)
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52. Phosphorus
In renal disease, phosphorus levels are elevated because the
kidney is the primary excretory organ.
Normal finding: 2.8-4.5 mg/dl (0.95-1.45 mmol/L)
Bicarbonate (HCO3
−)
Most patients in renal failure have metabolic acidosis( when the
body produce more acid or kidneys are not removing enough
acid from body) and low serum HCO3
− levels.
Normal finding: 22-26 mEq/L (22-26 mmol/L)
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53. Renal disorders
Acute renal failure:-is a rapid loss of renal function due to
damage to the kidneys.
Depending on the duration and severity of ARF, a wide range of
potentially
• life-threatening metabolic complications can occur, including
metabolic acidosis as well as fluid and electrolyte imbalances.
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54. Chronic renal failure
Chronic, irreversible loss of kidney function attributable to loss of
functional nephron mass – pathophysiologic processes for more
than 3 months.
Nephrotic syndrome:-is a kidney disorder that causes your
body to pass too much protein in your urine.
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55. RFT (Renal Function Test)
•is used to evaluate the severity of kidney disease and to follow
the patient's clinical progress.
Tests involved in RFT
• Urea Uric acid
• Ammonia Calcium
• Parathyroid Potassium
• Hormone
• Creatinine clearance and Glomerular filtration rate
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56. Summary
An assessment of the urinary system is used to gather information
about the urinary structures and urinary elimination.
The nursing student is assessing factors that may affect a patient’s
ability to urinate normally.
An assessment of the patient’s elimination history, possible
symptoms of a urinary problem, and complaints are important
Understanding the importance and function of the renal system is
essential for performing a comprehensive nursing assessment and
identifying renal issues.
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57. Summary cont.…
The renal system includes the kidney, ureters, bladder, and urethra.
The kidneys filter the blood and create urine from waste products and
excess water, which then travels through the ureters into the bladder.
The bladder collects the urine and then excretes it by contracting
and pushing it out through the urethra.
Although the renal system is sometimes referred to as the urinary
system, the kidneys are the vital organs that drive system processes.
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58. Reference
1. Nursing Health Assessment A Critical Thinking, Case Studies
Approach Patricia M. Dillon, DNSC, R N
2. Brunner And Suddarth’s Texbook Of Medical-surgical Nursing 10th
Edition By Suzanne C.O’connell;bare Brenda G Smeltzer(2003-07).
3. Essentials Of Human Anatomy And Physiology 11th Edition
4. Barbara Bates: a Guide To Physical Examination And History Taking
,A guide To Clinical Thinking.
5. Cox’sclinical Applications Of Nursingdiagnosis 5th Editionadult, Child,
Women’s, Mental Health,gerontic, And Home Health Considerations
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