ASSESSMENT OF RENAL AND URINARY TRACT INFECTION

Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Chapter 43

Assessment of Renal and Urinary Tract Function

Chapter 43

Assessment of Renal and Urinary Tract Function


Renal and Urinary SystemsRenal 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


Kidneys, Ureters, and Bladder Kidneys, Ureters, and Bladder


Internal Structure of the Kidney Internal Structure of the Kidney


NephronNephron


Formation of UrineFormation of Urine


Renin Angiotensin SystemRenin Angiotensin System


Diagnostic StudiesDiagnostic 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


Cystoscopic Examination Cystoscopic Examination


QuestionQuestion

Is the following statement True or False?

Urea is an abnormal constituent of urine.


AnswerAnswer

False

Urea is not an abnormal constituent of urine. Glucose is an abnormal constituent of urine.


Nursing Care of the Patient Undergoing Diagnostic Testing of the Renal-Urologic System—Assessment

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


QuestionQuestion

What is the normal adult bladder capacity?

A.50 – 100 mL

B.100 – 200 mL

C.300 – 500 mL

D.600 – 800 mL


AnswerAnswer

C

The normal adult bladder capacity is 300 – 500 mL of urine.


Nursing Care of the Patient Undergoing Diagnostic Testing of the Renal-Urologic System—Diagnoses

Nursing Care of the Patient Undergoing Diagnostic Testing of the Renal-Urologic System—Diagnoses• Knowledge deficient

• Pain

• Fear


Nursing Care of the Patient Undergoing Diagnostic Testing of the Renal-Urologic System—Planning

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.


InterventionsInterventions

• 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.


Question 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.


AnswerAnswer

D

A 24-hour urine collection that starts at 1 am begins after discarding the 1 am specimen.

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ASSESSMENT OF RENAL AND URINARY TRACT INFECTION

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