Surgical Nursing Care in Urinary Disorder

Medical-Surgical
Nursing: An Integrated
Approach, 2E
Chapter 29
NURSING CARE OF
THE CLIENT:
URINARY SYSTEM
Urology
 The study of disorders of the
urinary system.
Warning Signs of Kidney
Disease
 Burning or difficulty during urination.
 Increase in the frequency of urination,
especially at night.
 Passage of bloody appearing urine.
 Puffiness around the eyes, or swelling
of the hands and feet, especially in
children.
 Pain in the small of the back just
below the ribs (not aggravated by
movement).
 High blood pressure.
Anatomy of the Urinary
System
 Consists of two kidneys, two
ureters (upper urinary tract), a
urinary bladder, and a urethra
(lower urinary tract).
Changes in the Urinary
System Related to Aging
 Nephrons decrease, resulting in decreased filtration
and gradual decrease in excretory and reabsorptive
functions of renal tubules.
 Glomerular filtration rate decreases, resulting in
decreased renal clearance of drugs.
 Blood urea nitrogen increases 20% by age 70.
 Sodium-conserving ability is diminished.
 Bladder capacity decreases.
 Renal function increases when client is lying down.
 Bladder and perineal muscles weaken, resulting in
ability to empty bladder.
 Incidence of stress incontinence increases in females.
 Prostate may enlarge, causing frequency or dribbling.
Altered Urinary Elimination
Patterns:
Urinary Retention
 A person who is unable to void
when there is an urge to void has
urinary retention.
 This creates urinary stasis and
increases the possibility of
infection.
Altered Urinary Elimination
Patterns:
Urinary Incontinence
 The involuntary loss of urine from
the bladder.
 May be a complication of urinary
tract problems or neurologic
disorders and may be permanent
or temporary.
Classifications of
Incontinence
 Stress incontinence: leakage of urine from
coughing, laughing, jogging, dancing, etc.
 Urge incontinence: occurs when a person is
unable to suppress the sudden urge to urinate.
 Overflow incontinence: when the bladder
becomes so full and distended that urine leaks
out.
 Total incontinence: when no urine can be
retained in the bladder, usually due to
neurologic problem.
 Nocturnal Enuresis: incontinence that occurs
during sleep.
Infectious Disorders:
Cytitis
 An inflammation of the urinary
bladder.
 More common in females.
 Common causes are coitus,
prostatitis, and diabetes mellitus.
Pyelonephritis
 A bacterial infection of the renal
pelvis, tubules, and interstitial
tissue of one or both kidneys.
Acute Glomerulonephritis
 A condition that can affect one or
both kidneys.
 In both acute and chronic disease,
the glomerulus within the nephron
unit becomes inflamed.
 Predominantly a disease of
children and young adults when
cause is bacterial.
 Viral form can affect all ages.
Chronic
Glomerulonephritis
 The prognosis for acute
Glomerulonepthritis is often good
when treatment is begun early;
however, chronic
Glomerulonephritis generally
leads to permanent kidney
damage.
Obstructive Disorders:
Urolithiasis
 A calculus, or stone, formed in
the urinary tract.
 The size and location of the stone
within the urinary system greatly
affects the degree of pain.
Obstructive Disorders:
Urinary Bladder Tumors
 Bladder cancer occurs most
frequently after the age of 50.
 The only early warning signs are
increased urinary frequency and
painless, intermittent hematuria.
 Main risk factor is cigarette
smoking.
Renal Tumors
 Risk factors include smoking,
familial incidence, and
preexisting renal disorders.
 Symptoms include weight loss,
dull flank pain, gross hematuria,
and a mass that may be palpable
in the flank area.
Polycystic Kidney
 Polycystic kidney disease (PKD)
may be inherited or acquired.
 Multiple grape-like cluster of
fluid-filled cysts develop in and
greatly enlarge both kidneys.
Acute Renal Failure
 The rapid deterioration of renal
function with rising blood levels of
urea and other nitrogenous wastes
is called acute renal failure.
 Term used when some kidney
function remains (total and
permanent kidney failure is called
end-stage renal disease).
Chronic Renal Failure
(End-Stage Renal
Disease)
 A slow, progressive condition in
which the kidney’s ability to
function ultimately deteriorates.
The condition is not reversible.
 Lifetime dialysis becomes
inevitable unless kidney
transplantation is performed
successfully.
Dialysis
 A mechanical means of removing
nitrogenous waste from the blood
by imitating the function of the
nephrons.
 Two types of dialysis: hemodialysis
and peritoneal dialysis.
 Strict aseptic care is mandatory
for dialysis clients.
Kidney Transplantation
 Organ rejection is a risk. Signs of
rejection include generalized
edema, tenderness over the graft
site, decreased urine output,
hematuria, weight gain, and
fatigue.

Surgical Nursing Care in Urinary Disorder

Uploaded by

Copyright:

Available Formats

Surgical Nursing Care in Urinary Disorder

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Surgical Nursing Care in Urinary Disorder

Uploaded by

Copyright:

Available Formats

Medical-Surgical

You might also like