1. Urinary system

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

3. 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

4. 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)

5. 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

6. Bladder Hollow muscular sac Lining folds called rugae – disappears as muscles of bladder allow it to expand and 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

7. 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 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 Urine

8. 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

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

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

11. 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

12. 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

13. 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

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

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

16. 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

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

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

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

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