Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 43 Assessment of Renal and Urinary Tract Function
May 22, 2015
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
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
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
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Kidneys, Ureters, and Bladder Kidneys, Ureters, and Bladder
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Internal Structure of the Kidney Internal Structure of the Kidney
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NephronNephron
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Formation of UrineFormation of Urine
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Renin Angiotensin SystemRenin Angiotensin System
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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
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Cystoscopic Examination Cystoscopic Examination
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QuestionQuestion
Is the following statement True or False?
Urea is an abnormal constituent of urine.
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AnswerAnswer
False
Urea is not an abnormal constituent of urine. Glucose is an abnormal constituent of urine.
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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
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QuestionQuestion
What is the normal adult bladder capacity?
A.50 – 100 mL
B.100 – 200 mL
C.300 – 500 mL
D.600 – 800 mL
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AnswerAnswer
C
The normal adult bladder capacity is 300 – 500 mL of urine.
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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
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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.
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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.
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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.
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AnswerAnswer
D
A 24-hour urine collection that starts at 1 am begins after discarding the 1 am specimen.