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Urinary System

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Chapter 39 Urinary System Anatomy and Physiology Review Anatomy and Physiology Review Anatomy and Physiology Review Common Diagnostic Tests Common Diagnostic Tests ... – PowerPoint PPT presentation

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Title: Urinary System


1
Chapter 39
  • Urinary System

2
Anatomy and Physiology Review
  • Urinary system consists of two kidneys, two
    ureters, bladder, and urethra
  • Functions
  • Manufacture urine
  • Expulse waste products

3
Anatomy and Physiology Review
4
Anatomy and Physiology Review
5
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6
Anatomy and Physiology Review
7
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8
Assessment
  • Pain on urination
  • Pattern of urination
  • Strength of urine stream
  • Urgency, frequency, incontinence, hematuria, and
    nocturia
  • Intake and output
  • Urine color, clarity, and odor

9
Urinary Terms
  • Anuria
  • Cessation of urine production
  • Dysuria
  • Difficult urination
  • Hematuria
  • Blood in urine

(continued)
10
Urinary Terms
  • Nocturia
  • Excessive urination at night
  • Oliguria
  • Decreased urine production

(continued)
11
Urinary Terms
  • Polyuria
  • Excess urination
  • Urgency
  • Need to urinate immediately

12
Changes with Aging
  • Nephrons decrease
  • Glomerular filtration rate decreases
  • Blood urea nitrogen increases
  • Sodium-conserving ability diminishes
  • Bladder capacity decreases
  • Renal function increases when lying down

(continued)
13
Changes with Aging
  • Bladder and perineal muscles weaken
  • Incidence of stress incontinence increases in
    females
  • Prostate may enlarge in males

14
Common Diagnostic Tests
  • Urine tests
  • Blood tests
  • Radiographic tests
  • Urodynamic tests
  • Endoscopic exam
  • Biopsy

15
Common Diagnostic Tests
16
Common Diagnostic Tests
17
Urinary Retention
  • Person unable to void when an urge
  • Stasis may lead to infection
  • May result in distended bladder
  • Urine overflow may cause incontinence
  • Caused by stress, calculus obstruction, stones,
    tumor, infection, medications, or trauma

(continued)
18
Urinary Retention
  • Symptoms
  • Frequency, voiding small amounts, and distended
    bladder
  • Treatment
  • Urinary analgesics, antispasmodics, catheter, and
    surgery

19
Urinary Incontinence
  • Involuntary loss of urine from bladder
  • Types
  • Stress
  • Leakage of urine on straining
  • Urge
  • Sudden need to urinate

(continued)
20
Urinary Incontinence
  • Types
  • Overflow
  • Full bladder leads to leakage
  • Total
  • No control of voiding
  • Nocturnal enuresis
  • Nighttime incontinence

(continued)
21
Urinary Incontinence
  • Goal of treatment
  • Keep perineum clean, dry, and intact

(continued)
22
Urinary Incontinence
  • Potential treatment
  • Medications
  • Pelvic floor exercises
  • Bladder retraining
  • Catheter insertion
  • Surgery

23
Cystitis
  • Inflammation of urinary bladder
  • Caused by escherichia coli, candida albicans,
    coitus, prostatitis, and diabetes mellitus
  • Treatment
  • Culture/sensitivity testing, antimicrobial
    medication, and urinary tract analgesic

(continued)
24
Cystitis
  • Increase fluid intake, acidic foods, and intake
    and output

25
Pyelonephritis
  • Bacterial infection of renal pelvis, tubules, and
    interstitial tissue of one or both kidneys
  • Also known as pyelitis or nephropyelitis
  • Treat to prevent from becoming chronic

(continued)
26
Pyelonephritis
  • Treatment
  • Urine culture/sensitivity testing,
    antimicrobials, antipyretics, analgesics,
    increase fluids, intake and output, and daily
    weight

27
Acute Glomerulonephritis
  • Glomerulus within nephron unit becomes inflamed
  • May be bacterial or viral
  • Treat to prevent renal complications, cardiac
    complications, and complications to cerebral
    functioning

(continued)
28
Acute Glomerulonephritis
  • Treatment
  • Drug therapy, fluid restriction, monitor labs,
    IO, bed rest, and VS

29
Chronic Glomerulonephritis
  • Slowly progressive, destructive process affecting
    glomeruli
  • Causes loss of kidney function
  • Treat to prevent further renal damage and cardiac
    or cerebral complications

(continued)
30
Chronic Glomerulonephritis
  • Treatment
  • Medications, protein and fluid restriction, bed
    rest, intake and output, VS, and monitor labs,
    daily weight, and lung sounds

31
Urinary Calculi
  • Calculus, or stone, formed in urinary tract
  • Very small calculi may be flushed out by
    peristalsis and fluids
  • All urine must be strained, stones collected, and
    sent to lab for composition

(continued)
32
Urinary Calculi
33
Urinary Calculi
34
Urinary Calculi
  • Treatment
  • Lithotripsy, surgery, analgesics, medications,
    and dietary changes

35
Urinary Bladder Tumors
  • May be cancerous or benign papillomas
  • Surgery may remove tumor, part of bladder, or
    entire bladder
  • Makes urinary diversion necessary
  • Other treatment
  • Chemotherapy, analgesics, and sometimes
    low-residue diet

36
Urinary Bladder Tumors
37
Urinary Bladder Tumors
38
Renal Tumors
  • Cancer in kidneys
  • Radical nephrectomy may be performed if other
    kidney healthy and disease localized
  • Treatment
  • Immunotherapy, targeted therapy, analgesics,
    antiemetics, chemotherapy, and radiation
  • Chemotherapy and radiation provide minimal benefit

39
Polycystic Kidney
  • Multiple grape-like clusters of fluid-filled
    cysts develop in and greatly enlarge both kidneys
  • Treat to preserve kidney function, prevent
    infections, and relieve pain

(continued)
40
Polycystic Kidney
  • Control hypertension
  • Eventually, may need dialysis or renal
    transplantation

41
Renal Failure
  • Any acute or chronic loss of kidney function when
    some kidney function remains
  • End-stage renal disease (ESRD)
  • Total, or nearly total, permanent kidney failure

42
Acute Renal Failure (ARF)
  • Postrenal
  • Disrupted urine flow
  • Prerenal
  • Disrupted blood flow to kidney
  • Intrarenal
  • Renal tissue damage
  • Often reversible if diagnosed early

(continued)
43
ARF
  • Treat to stabilize kidney function, return to
    normal using surgery, medications, and dietary
    restrictions
  • Treatment
  • Medication, dietary changes, fluid restrictions,
    and dialysis (peritoneal or hemodialysis)

44
Chronic Renal Failure/ESRD
  • Slow, progressive condition
  • Kidneys ability to function ultimately
    deteriorates
  • Not reversible
  • Multisystem disease process

(continued)
45
Chronic Renal Failure/ESRD
  • Goal
  • Preserve remaining kidney function and prevent
    complications

46
Dialysis
  • Mechanical means of removing waste from blood
  • Hemodialysis
  • Machine with artificial membrane used to filter
    blood
  • Peritoneal dialysis
  • Uses peritoneal lining of abdominal cavity as
    membrane through which diffusion and osmosis occur

47
Dialysis
48
Kidney Transplantation
  • Client must be tissue- and blood-typed to
    determine compatible donor
  • After transplant surgery, immunosuppressive drug
    therapy to decrease chance of organ rejection
  • Greatest complication
  • Infection

49
  • Kidney Patient Guide

50
Chapter 60
  • Infants with Special Needs Birth to 12 Months

51
Hypospadias
  • Urethral opening on ventral surface of penis
  • Surgically corrected during first year of life

52
Vesicoureteral Reflux
  • Backflow of urine from bladder into ureters and
    possibly kidneys
  • Primary symptom
  • Recurrent urinary tract infections
  • Treatment
  • Preventing urinary tract infections and surgery

53
Wilms Tumor
  • Nephroblastoma
  • One of the most common early childhood cancers
  • Symptoms
  • Abdominal mass to side of midline, abdominal
    pain, malaise, anemia, and fever

(continued)
54
Wilms Tumor
  • Avoid palpating tumor
  • Surgery is treatment of choice
  • Also use chemotherapy and radiation

55
Chapter 61
  • Common Problems 118 Years

56
Urinary System
  • Acute poststreptococcal glomerulonephritis
  • Nephrotic syndrome
  • Enuresis
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