Urinary system Functions of Urinary System Removes waste

Urinary system

Functions of Urinary System • Removes waste • Maintains acid-base balance of body • Parts include: – – 2 KIDNEYS 2 URETERS BLADDER URETHRA

Kidneys • 2 bean shaped organs • Protected by ribs and fat • Each kidney is found in mass of fatty tissue (adipose capsule) • 2 main sections: – Cortex: outer layer, contains most of the neurons that aid in production of urine – Medulla: inner layer, contains most of tubes that carry urine from the nephrons through the kidneys

Nephrons • Microscopic filtering units • Over 1 million/kidney • Contains glomerulus – Cluster of capillaries that filter waste • Bowman’s capsule – Surround glomerulus picks up filtered materials and passes it to the convoluted tubule – Substances needed by the body are reabsorbed and returned to the capillaries • At the end, most of the water, sugar, vitamins and salts have been reabsorbed • Excess salts, water, wastes remain in the tubule and become urine • Urine enters collecting ducts (tubes) in the medulla • Collecting tubes empty into the renal pelvis (first section of the ureter)

Ureters • 2 muscular tubes 10 -12 inches long • One extends from the renal pelvis to the bladder • Peristalsis: a wavelike motion of the involuntary muscle that moves urine through the ureter from the kidney to the bladder

Bladder • Hollow muscular sac • Lining folds called rugae – disappears as muscles of bladder allow it to expand fill with urine • 3 layers of visceral muscle • Urge to void occurs with bladder contains 1 cup • Circular sphincter muscle – Control bladder opening – Can’t be controlled by infants • FUNCTIONS: – Receives urine from ureters – Stores urine until eliminated from body

Urethra • Tube carries urine from bladder to outside • External opening called meatus • Different in male/females – Females shorter – Opens in front of vagina or passes through the penis – Male: carries both urine from urinary system and semen from the reproductive system Urine • Liquid waste • 95% water • Excess useful products like sugar can be found, but usually indicates disease • 1 ½ - 2 quarts produced daily • 150 quarts filtered through kidneys

Key Terms • • Polyuria: excess urination Oliguria: below normal urination Anuria: absence of urination Hematuria: blood in urine Nocturia: urination at night Dysuria: painful urination Retention: inability to empty bladder Incontinence: involuntary urination

Diseases • Symptoms: • Frequent urination • Inflammation of the bladder • More common in females due to shortness of urethra • Dysuria and burning • Bladder spasm • Hematuria • ? Fever ? • Treatment: • Antibiotics and increased fluid intake

Nursing Care Cystitis • Emphasize prevention • Showers instead of baths through drinking may help plenty of fluids, juices • Report dark, cloudy, or rich in vitamin C such foul-smelling urine to as cranberry help the nurse acidify the urine, • Report complaints of • Teach to wipe from burning with urination, from front to back frequency or urgency

Renal Calculi • Kidney stone formed when salts in urine settle • Small stones can be eliminated in urine • Large stones may become lodged • Symptoms: sudden pain, hematuria and retention • Treatment: increase fluids, pain meds, strain urine w/ gauze, lithotripsy, possible surgery

Renal Failure • Kidneys stop functioning • Acute – Caused by injury, poisoning, dehydration – Prompt treatment leads to good prognosis • Chronic – Progressive loss of kidney function caused by glomerulonephritis, hypertension, toxins and endocrine disease. – Waste accumulates and affects body systems

Chronic Renal Failure Signs and Symptoms • • N/V diarrhea decreased mental ability convulsions muscle irritability ammonia odor to the breath and perspiration later: coma and death

Chronic Renal Failure Nursing Care • Residents will be on • Dialysis- an artificial fluid restriction means of filtering waste products from the body, • Important to only give may be necessaryfluids as instructed by • Can prolong and improve nurse life • Also must be on a special diet-make sure • Unless a person receives items given are a kidney, must receive allowed dialysis a few days each week

Chronic Renal Failure Nursing Care • Residents often have • These residents may problems with dry skin urinate on rare and c/o mouth dryness, occasions depending if so report to nurse on severity of renal and find out what can failure be done to make them more comfortable

Uremia • Toxic condition where urinary waste is in bloodstream • Caused from any condition that affects proper function of kidneys • Symptoms: n/v, ammonia breath, anuria, headache and confusion, coma/death • Treatment: restrictive diet, dialysis, transplant

Urine Retention • Inability to empty the • Signs and Symptoms bladder adequately include pain in the lower abdomen, strong, • Can be short or long painful, and frequent term urge to urinate but • May be caused by cannot blockage , disorders such • Distended bladder as MS or Diabetes, • Weak urine flow or • Most common cause in dribbling at the end of men –enlarged prostate urination and between urinations

Nursing Care Urinary Retention • Report symptoms to • Surgery may be done the nurse depending on the cause • Usually treated with medications • May require catheterization to drain the bladder

Urinary Incontinence • Inability of resident to • NA should monitor control urination resident frequently, keep skin clean and • May be cause by many dry, change disease, or other incontinence briefs problems according to facility • Risk of skin require breakdown increased • Report changes in odor • Resident may require and color an external catheter if • Try bowel and bladder a male or indwelling training if requested catheter if female

Urinary System Specimen Collection • Routine Urine • Clean Catch Urine • Urine Sample from Indwelling Catheter • 24 hour urine collection