The urinary system is a group of organs that produce and excrete urine from the body. http://www.tlcnursingceus.com/tlc-co...ary-system.php
Urine is a transparent yellow fluid containing unwanted waste products, mostly water, salts and nitrogen. Urine is slightly acidic and has a pH of 4.6 to 8.0. Abnormal findings would be keytone bodies, pus, blood, bacteria, glucose and certain crystals.
The major organs of the urinary system are the kidneys; a pair of bean-shaped organs that filter out substances that are contained in the blood. The entire bodies blood supply which is approximately 7-8% of the persons body weight; filters through these bean-shaped organs every thirty seconds, this produces what we call urine. Urine flows from the kidneys through two long, thin tubes called ureters. With a constant wave like action the urine moves itself along a provided path. The ureters transport the urine to the bladder, a very large vascular muscular organ. The bladder can store large amounts of urine, which excrete through a tube shaped urethra, to the outer meatus, (opening of the body); and is held inside the body by a elastic ring like muscle called the urinary sphincter muscle, which allows for spontaneous emptying.
An average adult produces approximately 1.5 liters of urine each day; the body needs this much at a minimum to avoid dehydration. The body needs to excrete approximately .5 liters daily to rid it self of unwanted waste.
Excessive or inadequate production of urine may indicate illness and a urinalysis or twenty-four urine may be ordered to determine the cause.
The presence of glucose, or blood sugar, in the urine may be a sign of diabetes; bacteria in the urine signal an infection of the urinary system; and red blood cells in the urine may indicate cancer or other disease processes in the urinary tract. DISORDERS OF THE URINARY SYSTEM
Renal failure is one of the most serious disorders found in this system. Renal failure can be total or partial either way it is very serious. Renal failure slows or stops the filtration of blood, causing toxic waste products to build up in the blood.
Acute renal failure is characterized by a sudden occurrence, decreased amount of urinary output, (less then 500cc qd)(oliguria) and rapid accumulation of nitrogenic wastes in the blood (azotemia). Acute type of failure can come from hemorrhage, trauma, burn, and toxic injury to the kidneys, severe infections or blockage to the lower urinary track. Many forms of acute renal failure are reversible when the cause is corrected.
Chronic renal failure is a progressive deterioration of kidney function over a long period of time. Chronic renal failure may result from many diseases such as diabetes, lupus, AIDS, and myeloma. If caught early enough the degenerative process can be slowed but not reversed. Early signs include sluggishness, fatigue, and mental dullness; later this disorder can progress to zero urine output, (anuria), convulsions, GI bleed, malnutrition, and various neuropathies, and the skin will becomes yellow. CHF and hypertension are complications that occur from the hypervolemia associated with increased volume from no urinary output. Treatment is restricted water and protein intake, diuretics. When all else fails the patient must begin long term hemodialysis and many times kidney transplant.
Urinary calculi, commonly known as kidney stones, results from a gradual build up of crystallized salts and minerals in the urine, (many times related to calcium, uric acid). They be found anywhere from the kidney to the bladder and vary in size, from fine grains of sand to the size of an orange. Certain factors add to the formation of these stones, including infection, urinary stasis and periods of immobility and hypercalciuria (to much calcium in the urine). This is a more common occurrence in men in their 50’s. If you have had one stone your chances of getting another is increased.
Urinary calculi (kidney stones) can be very painful, mostly if they obstruct a passageway that carries urine. Usually, the stones pass through and out of the urinary tract on their own, scratching there way along the interior line of whatever area they come into contact with. When a large stone finds it way down the urethra it can be extremely painful. If they fail to pass themselves through they can be broken up using an ultrasound method called lithotripsy.
Urinary tract infection, (UTI) is an infection of one or more of the structures in the urinary tract. Most UTI’s happen from bowel organisms, (E-coli). Women are more prone to UTI’s because of the shortness of their urethra.
Infections of the lower urinary tract are called cystitis. This is an inflammation of the urinary bladder, most often caused by ascending infection from the urethra; it can also be caused by sexual intercourse. Signs and symptoms of a lower UTI are; frequency of urination, urgency of urination, burning upon urination. The urinalysis may show bacteria, pus and red blood cells. Treatment of antibiotics, fluids, and educating the patient on possible causes helps to avoid future episodes. Some people are more prone to reoccurring UTI’s.
Infections of the upper urinary tract are called pyelonephritis. This is an infection of renal pelvis, tubules, (tubes), in the kidneys. The bacteria may enter through the bladder via the ureters or through blood stream.
Many times this upper UTI is caused by reflux of urine up through the ureters from a faulty valve, that is suppose to prevent this from happening. Sign and symptoms are chills and fever; flank pain. A urinalysis will show bacteria, pus. The s/s are pretty much the same as for the lower UTI except the bacteria in the urine found on the urinalysis are coated with antibodies that happens only in the renal pelvis. An upper UTI is more serious due to the fact it can cause damage and death to tissues in the kidneys if not treated,
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Kidney and bladder cancer has been on rise for the past thirty years. These cancers have been linked to various causative agents, primarily cigarette smoking, abuse analgesics, obesity and certain industrial chemicals. Treatment typically includes removal of cancer tissue, followed by radiation therapy. INHERITED AND CONGENITAL DISORDERS
Polycystic renal disease is a disease of many cysts that formed in the kidneys, reducing the amount of functioning that the renal tissue can do. Kidney dialysis or transplant is most often needed to prevent kidney failure or even death.
Hypospadias is a birth defect in which the male urinary opening is misplaced on the penis; it may be under the head of the penis or as far away as the scrotum. Surgery before the child reaches twenty-four months old can correct the defect, permitting normal urination and, later, sexual intercourse. AGE RELATED CHANGES
There are a number of age-related changes that effect the urinary system. As an individual age, the kidneys function less efficiently. A person eighty years old will have half the nephrons as that of a newborn baby. If only half the nephrons are there then the kidneys decrease at least that much in their ability to filter and function. For this reason, an elderly person is much more likely to have a drug reaction then a middle aged or young person would. The kidney is less efficient in removing the drug from the bloodstream.
Arteriosclerosis, (thickening & loss of elasticity to arterial wall, decreasing blood flow) can affect the blood vessels that supply the urinary system. When circulation is poor, there is a greater chance of developing infection as well as decreased ability to recover from illness or injury.
There are age-related changes that decrease the elasticity of the ureters, bladder, and urethra. As muscle tone decreases, the amount of urine the bladder can hold is reduced. Many times the elderly person will not be aware of the need to void until their bladder is almost full or full. This leads to:
* Frequency-- the need to urinate often
* Urgency-- an immediate need to urinate
* Nocturia-- waking at night to urinate
* Incontinence-- inability to hold urine
The first three of the above definitions lead to the fourth; incontinence. Incontinence can also come from certain medications, but whatever the reason it is a serious problem. It is a physical problem with the potential of the skin to breakdown from the exposure to acidic urine on the skin. Many rashes and pressure sores, (decubitis ulcers), come from a patient being incontinent.
Incontinence also as a large effect on the psychological aspect of the patient health. Incontinence is very distressing and embarrassing; if you can remember ever wetting your pants as a child you know what I am talking about. Patients with neurological disorders (related to the nervous system), frequently have no control of their bladder functions because the brain is unable to receive signals to control urination. Many times this leads a person with a neurological disorder to have a urinary catheter inserted (a tube that is inserted into the bladder to drain urine into a collection bag).
Urinary tract infections, (reviewed previously), are a common thing in many people in different age groups, however, the elderly when confined to bed, or when they have a catheter, or when they are incontinent of bowel, have an increased chance of getting a UTI.
Immobility has serious effects on the urinary system primarily because of the incomplete emptying of the urine from the bladder and kidneys. When urine is retained too long as with any fluid standing still, it begins to grow bacteria, resulting in infection and development of kidney stones (calculi). http://quizlet.com/7593567/chap37-nu...m-flash-cards/ http://quizlet.com/subject/the-urinary-system-nursing/ http://www.slideshare.net/NurzPogz/u...disorderspptx1