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•Identify the organs of the urinary system, from a
•Identify the parts of the nephron (the functional unit
•List the characteristics of a normal urine specimen.
•Give a list of abnormal findings, briefly explain the
•State normal and minimal urine outputs.
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2 drawing, and explain their functions.
of the kidney) and explain in brief their functions.
disease or disorder causing these.

• Define key words.
• Describe various procedures used in diagnosis of disease and disorders of the urinary system, giving the nursing responsibilities for each.
• Differentiate between normal and abnormal laboratory findings.
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• Two kidneys
• Retroperitoneal
• Adipose cushion
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• Maintenance of pH
• Regulation of water and electrolyte elimination
• Elimination of waste products and toxic substances
• Stimulation of red blood cell production
(erythropoieten)
• Contributes to control of blood pressure
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• Functioning part of the kidney
• 2 types: cortical (superficial) & juxtamedullary
• In both types the distal tubule empties into the collecting tubules
• Consists of
• glomerulus, water and solutes are filtered from the blood
• Tubules, reabsorb essential minerals from the filtrate and permit waste substances to be eliminated
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• Functional unit of the kidney
• 1 million nephrons per kidney
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• Glomerular filtration
• Tubular reabsorption
• Tubular secretion
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Filtration = The forcing of fluids and dissolved substances through a membrane by pressure
• Occurs in the glomerolus
• Composition of filtrate similar to plasma containing glucose, amino acids, salts urea and uric acid
• Blood and proteins only when damaged
• Approximately 600mls blood pass through glomerolus/minute – only 120mls becomes filtrate
• GFR= amount of filtrate formed/minute (about 100-
125ml)
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• 99% of filtrate is re-absorbed allowing body to retain essential nutrients and fluid
• All glucose should be reabsorbed
• Majority of sodium and potassium are actively reabsorbed from proximal convoluted tubule
• Na reabsorption depends on blood pressure
• ADH makes distal convoluted tubule more permeable therefore more water reabsorbed
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• Active transport
• Passive transport
• Osmosis
• Pinocytosis
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• From blood into filtrate
• Includes k, H, creatinine and certain drugs
• If Na is reabsorbed K is secreted
(controlled by aldosterone)
• HCO
3 is increase or decreased to regulate pH
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• Aldosterone
• Atrial natriuretic peptide (ANP)
• Antidiuretic hormone (ADH)
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• Adequate Blood Supply Pre Renal
• Normal Kidney Renal
• No obstruction to urine flow Post Renal
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• Normal urine output > 1ml/Kg/Hr
1– 2L/day
• Oliguria 400 ml/ Day
• Anuria
• Absolute Anuria
<100 ml/day nil
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• Amount: 1- 2 liters/24 hours
• Color: straw or amber, clear
• Specific gravity: 1.010- 1.025
• pH: 4.6- 8.0
• 95% water
• Nitrogenous wastes: Urea, creatinine, uric acid,
• Urobilinogen
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• Glucose
• Protein
• Blood
• Bacteria
• Ketones
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If you do Acute tubular necrosis may develop and this is very BAD
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• Renin secretion– maintain Cardiac output and
BP
• Secretion of erthropoeitin
• Activation of vitamin D
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• Kidney
• Ureter
• Bladder
• Urethra
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• Urination= micturation- voiding
• Reflex that can be voluntarily controlled
• Bladder volume: approx
800mL max
• Stimulation occurs with
200- 400mL
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• Number of nephrons decreases
• Lose ability to concentrate urine
• Bladder decreases in size
• Decreased detrusor muscle tone
• Creatinine clearance decreases
• Greater incidence of nocturia
• Incontinence is not normal at any age
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• Skin color, presence of crystals, turgor
• Respiratory rate and rhythm
• Edema
• Tenderness
• Urine characteristic
• Palpate bladder
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• Urinalysis
• Urine culture and sensitivity
• Creatinine clearance
• BUN
• Serum creatinine
• Serum electrolytes
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• KUB
• IVP
• Arteriogram
• Cystogram
• Renal Scan
• CT
• MRI
• Ultrasonography
• Renal Biopsy
• Cystoscopy
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• Urethral Catheterization
• Ureteral Catheterization
• Nephrostomy tube
• Urinary stent
• Nephrectomy
• Lithotripsy
• Cystectomy
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