The renal function helps maintain the body’s state of homeostasis by?
- regulating fluid and electrolytes (done through excretion/re-absorption)
- providing hormones.
How much does just 1 nephron filter a day?
180L/day is filtrate by just one nephron.
What subjective data should we be asking?
- past medical hx and pre-existing conditions = diabetes,hypertension,childbirth, STDs
- medications (allergies)
- past surgical hx/treatments - that are related to this system
- functional health pattern questions = changes in voiding/haematuria/pain(dysuria)
- family hx = genetics
What objective data should be performed?
Physical assessment.
- presence of oedema
- bladder scan
- prostatic exam
- abdominal and kidney palpation
- abnormal anatomy
- inspection of genitalia
What is Benign prostatic hyperplasia (BPH)?
Gradual increase in gland size of the prostate.Depending on the lobe affected can gradually compress (and obstruct) urethra.
-is not always cancerous
What are the clinical manifestations of Benign prostatic hyperplasia (BPH)? Name 4.
- mild weakness of urinary stream
- frequency
- hesitancy
- dribbling
- incomplete bladder emptying
- retention
- nocturnal
- urgency
- dysuria
- incontinence
List 3 complication that could arise from urinary catheterisation.
- UTI’s (during insertion/while inserted)
- bladder spasms
- urethral rupture
- pressure necrosis
- urethral strictures
- allergy
List the nursing management for IDC (Indwelling Urethral Catheter).
Always depends on the type/indication.
- monitor drainage =amount/colour/odour, fluid balance chart
- secure catheter
- monitor for infection = temp, confusion,urgency, redness, smell, dicoloured urine
- infection prevention = sterile, keep it clean, tubes are free flowing, no occlusions
- bladder training post removal = lax detrusor muscle gets lazy.
When gathering a health hx during a renal and urinary tract assessment what should the nurse be inquiring about?
- pt’s reason for seeking help
- hx of UTI’s
- any fever or chills
- nocturia and date of onset
- haematuria or change in urine colour
- urinary incontinence
- any STD’s
habits: use of alcohol, drugs or tobacco - what meds they are on
- family hx
For a renal and urinary tract assessment what would you be doing for a physical assessment?
Several body systems can be affected which leads to either the increase or decrease of the urinary tract.
- so a full head to toe assessment is needed
- ausculatate all abdomen quadrants
- bladder should be scanned
Why is a urinalysis so important?
this provides important clinical info such as kidney function, diagnose other diseases such as diabetes, can detect if bacteria is present…
A urine exam should include?
- colour
- odour
- clarity
- sedements
- pH
There are 3 categories of ARF (acute renal failure). List them and what it means?
- Prerenal =hypoperfusion of the kidney
- Intrarenal = actual damage to kidney tissue
- postrenal = obstruction to urine flow
what is the nursing management for ARF (acute renal failure)?
- monitor for complications
- participate in emergency treatment of fluid and electrolyte imbalances
- assess progress and response to treatment
- provide physical and emotional support
