Upper tract Filters
by-products of metabolism, adjusts body's fluid and electrolyte balance, delivers urine to lower tract
Filters by-products of metabolism, adjusts body's fluid and electrolyte balance, delivers urine to lower tract
Indicates Whether disease is interfering with function of different kidney parts Whether pathogens are at
work in kidney or bladder Whether food materials that should go to body cells are escaping into urine( protein , sugar don't supuse to be on urine.)
Routine UA tests for
pH, specific gravity, glucose, ketones, albumin, blood, bilirubin
4.6 to 8.0
Urine specific gravity
1.010 to 1.025
No glucose, ketones, bacteria, albumin, bilirubin No or very few red blood cells or white blood cells
Checks for urine
color, appearance, odor, foam content, casts
Urine calcium Helps detect
bone disease High amounts of calcium indicate degeneration of bone tissue
Urine Culture Small amounts of a urine sample placed on a culture medium, allowed to incubate Reveals any organisms present
Obtain a clean-catch midstream urine sample from client for a culture and sensitivity (C&S) test Wear gloves while handling urine. Take care not to contaminate specimen with any outside organisms.Send sample to laboratory immediately
Renal Failure: Dialysis
Process that assumes work of a damaged, nonfunctioning kidneyLong-term procedure for
for chronic disorders, eg, kidney
disease secondary to shock, diabetes mellitus, chronic hypertension
Purposes of dialysis are
to Remove waste products, excess water; remove poisons or toxins from blood Establish proper levels of electrolytes
Maintain acid-base balance;
Renal Failure: Dialysis Two types
Peritoneal dialysis and hemodialysis
Peritoneum serves as semipermeable membrane Short-term use
Peritoneal dialysis Possible complications
Peritonitis, pain, shortness of breath, protein loss, fluid overload or loss, electrolyte imbalance, constipation, infection, bleeding .
Nursing assessment and data gathering in peritoneal dialysis includes
observation for signs of drug reactions, abdominal distention or pain, bleeding or shock, respiratory problems, infection, and leakage around the catheter leading into the peritoneum.
Continuous ambulatory peritoneal dialysis (CAPD)
Used in home Dialysate remains intraperitoneally Client exchanges dialysate four to five times per day
Continuous ambulatory peritoneal dialysis (CAPD)Advantages
Steady blood chemistry levels easily obtained Process is shorter, less expensive Training is less complicated
Hemodialysis (aka extracorporeal hemodialysis)
Performed by circulating client's blood through a machine outside body External shunt or arteriovenous fistula inserted into client's blood veBruit and thrill detected at shunt sitessel
Cannula separation is a life-threatening emergency.
The client can exsanguinate (lose all their blood) in a matter of minutes. Whenever a client has a cannula placement, he or she should be taught to always have two clamps attached to the dressing, to quickly clamp the ends of separated cannula until they can be reattached.
Blood tests to detect renal function include
BUN, creatinine clearance, and uric acid.
Incontinence can be
temporary, iatrogenic, total, stress, reflux, or paradoxical.
Kidney disease can start as an acute infection
and reoccur as chronic conditions.
Nursing care of the client with a urinary disorder focuses on
maintaining and preserving renal function, decreasing discomfort, preventing infection, promoting skin integrity, maintaining fluid balance, and restoring and maintaining the client's self-esteem.
Early symptoms of renal disease are subtle.
The nurse's ability to detect small changes in the client is crucial to early treatment.
Nephrolithiasis can be treated by
ESWL and percutaneous nephrolithotomy.
Common urinary diversions include
the ileal conduit and the Kock pouch.
Kidney and bladder tumors are often
metastatic before they are discovered.Dialysis is a life-saving
Kidney from well human
being recentcadaverTransplanted into body of another person to replace a diseased kidney
Kidney Transplant Kidney donor:
client's living relative with compatible tissue matches Kidney Transplant Donor: must have two well-functioning kidneys, no underlying disease
Kidney Transplant Major advantage:
live donor can sacrifice one kidney and continue to live without difficulty.
Kidney Transplant Potential cure for client with renal failure
Proper matching of recipient and donor is crucial Rejection of transplanted organs
Kidney Transplant Difficulty with all transplants is body's natural reaction:
to reject foreign substance Medications available to suppress rejection
Kidney Transplant Rejection syndrome
in kidney transplantation usually easier to manage than that in other organ transplants
Inability to achieve or maintain an erection sufficient to complete sexual intercourse
Caused by disease, medication, or environmental factors ,Psychogenic
Medical and surgical treatment
Oral medication,Intraurethral suppositories ,Intracorporeal pharmacotherapy,Mechanical devices ,Penile implants ,Penile revascularization
A consistent problem in which the client ejaculates before, during, or immediately after penetration
Premature Ejaculation treatment may include
Wearing condoms, Performing a special squeeze technique, Application of lidocaine gel, Medications such as serotonin reuptake inhibitors
Many medications used to treat ED ( Ejaculation dx.)
(tadalafil or sildenafil) are contraindicated for clients who use nitroglycerin products. Life-threatening hypotension may result.
The client who receives vasodilating medications
Viagra, Cialis, MUSE, Caverject, or Edex may have a side effect known as priapism (a prolonged, uncomfortable erection for 2 to 3 hours or longer). Medical intervention may be necessary.
Abnormal and persistent penile erection
without sexual stimulation. It is extremely painful and may last several hours, or even days.
Causes Penile or spinal cord injury, tumor,
cerebrospinal syphilis, pelvic vascular thrombosis Prolonged sexual activity, leukemia, sickle cell anemia, or other blood disorders ,Infections such as prostatitis, urethritis, and cystitis, particularly if renal calculi are also present.