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ASSESSMENT OF RENAL AND URINARY TRACT INFECTION
1.
Chapter 43 Assessment of
Renal and Urinary Tract Function Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
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.
Kidneys, Ureters, and
Bladder Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
4.
Internal Structure of
the Kidney Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
5.
Nephron
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
6.
Formation of Urine
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
7.
Renin Angiotensin System
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
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.
Cystoscopic Examination
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
10.
Question Is the following
statement True or False? Urea is an abnormal constituent of urine. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
11.
Answer False Urea is not
an abnormal constituent of urine. Glucose is an abnormal constituent of urine. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
12.
Nursing Care of
the Patient Undergoing Diagnostic Testing of the Renal-Urologic System—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.
Question What is the
normal adult bladder capacity? A.50 – 100 mL B.100 – 200 mL C.300 – 500 mL D.600 – 800 mL Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
14.
Answer C The normal adult
bladder capacity is 300 – 500 mL of urine. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
15.
Nursing Care of
the Patient Undergoing Diagnostic Testing of the Renal-Urologic System—Diagnoses • Knowledge deficient • Pain • Fear Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
16.
Nursing Care of
the Patient Undergoing Diagnostic Testing of the Renal-Urologic System—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.
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.
Question A 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.
Answer D A 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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