Urinary System Handout
I.
Urinary System
a. Essential to _________________
b. Every head to toe assessment must include ___________________
II.
Anatomy
a. Kidney:
i. Characteristics
1. ______________________
2. Shape: ______________________
3. Color: _______________________
4. #: __________________________
ii. Cortex
1. Contains: __________________________
a. __________________ unit of the kidney
b. _________________ blood
c. Creates ____________________
iii. Medulla
1. Function: Drain _______________ from the _____________ to
the renal ______________________
iv. Renal pelvis
1. Contains
a. __________________
b. Renal _____________
c. Renal _____________
b. Ureters
i. Long narrow _________________ tube
ii. Moves urine via _________________________________
iii. Extends from ______________ - __________________
iv. #: _____________
c. BLADDER
i. Description ______________________________________________
ii. Location: Behind _______________________________
iii. Function: _________________ for urine
iv. Normal Capacity: ______________________________
d. Urethra
i. Carries urine from _______________ & ___________ its from the body
III.
Function of the Urinary System
a. ___________________ formation
i. The ____________________ form urine through a __________ process
ii. Nephron: __________________________________
1. Glomerulus
2. Bowman’s capsule
3. Proximal convoluted tubule
4. Loops of Henle
5. Distal convoluted tubule
b. Excretion of ___________________ products
i. The amt. of __________ formed is r/t the amt. of
fluid _____________
1.  fluid intake  __________volume urine
a. Characteristic: _________________
2.  fluid intake  ___________volume of urine
a. Characteristic: _____________________
ii. ___________________ (waste product)
1.  Blood Urea Nitrogen (BUN) = ________________________
iii. Creatinine
1. Creatinine clearance compares the levels of Creatinine in the
_______________ with the levels in the ________________
2. ______ Creatinine Clearance = renal dysfunction
iv. Primary means of ridding the body of _____________________
Small Group Questions
1. Describe the flow of urine from formation to excretion
2. What is the functional unit of the urinary system? What does it do?
3. Increased or decreased fluid intake has what effect on volume of urine and its
characteristics
4. What two main waist products do the kidneys rid the body of?
IV.
Assessment
a. Nursing Assessment
i. Urine: ____________________________________
ii. ________________ urinating
iii. ____________ intake
iv. Painful urination: _________________
v. Urinating at night: ______________________
vi. Blood in the urine: ______________________
vii. Cloudy urine: ____________________
viii. Discharge?
ix. Pain:
_________________________________________________________
x. Symptoms
xi. Associated symptoms
xii. Hx of _______________
xiii. Meds
xiv. Smoking or _______________________
xv. Females: _______________
b. Physical Assessment
i. Urine sample: _____________________
ii. V/S
iii. Skin: _____________________________________________________
iv. Palpate ____________________________
v. ________________________ kidney for tenderness
c. Urinalysis
i. Color: _________________________
ii. Specific gravity: ______________________________
1. ____________________ of urine
2. Related to the level of ________________________________
3.  fluid intake  ______ H20 excretion  _____ specific gravity
4.  fluid intake  ______ H20 excretion  _____ specific gravity
5.
iii. pH: __________________________________
iv. Protein: ________________________________
1. Negative for __________________________________________
2. Trace only: ___________________________________________
d. Culture & Sensitivity
i. ID __________________________________________
ii. Time: _______________________________________
e. Clean-voided : uncontaminated by skin__________________.
i. Female : Cleanse: _____________to ________________
ii. Male: Cleanse: tip of the penis _____________________________
f. Collect a "clean-catch"
i. _______________to void  _______________________ catch 
Collect __________ oz of urine
g. Safety
i. ______________________ precautions
ii. ______________________ bag for transport
h. Sterile urine specime
i. Collection Indwelling Foley Catheter
1. ___________________ from the drainage bag
a. ____________________________ port
ii. Catheter –___________________ cath
1. A small amt of urine is allowed to run out of the catheter into a
basin, then the urine is collect in a sterile specimen bottle.
V.
I&O
a. Intake
i. Oral ___________________________
1. 1 oz = __________ mL
ii. Liquids a ______________________________
iii. ________________________________
iv. ________________________________
b. Output
i. _______________________
ii. __________ suction
iii. _________________________
iv. _________________________ (chest / wound)
c. Health person fluid ___________________ = fluid ___________________
d. If the client takes in more fluid than they excrete  ____________________
i. S&S
1. Weight: ______________
2. Swelling: ______________
3. Urine output: _______________
4. Fluid ______________
a. Lungs
b. Abd: ______________________
ii. Nursing Diagnosis: __________________________
e. If a client excretes more fluid than they take in  ___________________
i. S&S
1. ___________
2.
3. Urine output___________
4. BP_____________________________________
5. Pulse___________________________________
6. Mentation: ____________________________
7. Skin; ___________________________________
8. Mucus membranes:_____________________________
9. Weight: _______________________
Small Group Questions
1. Describe the nursing assessment of a client who is complaining of voiding issues?
2. What dx test do you expect the doctor to order for a client with renal failure
3. What does a UA measure & what should not be found in the blood.
4. Increased & decreased fluid intake have what effect on specific gravity
5. Describe how to get a clean catch and a sterile urine specimen?
6. Calculate the intake of a person who ate, 5 oz of jello, 10 oz chicken broth, and a 24 oz
soda.
VI.
Cystitis
a. Inflammation of the __________________________
b. Etiology: _____________________________
c. S&S
i. __________uria
ii. ____________________
iii. ____________________
iv. ___________uria
v. ___________uria
vi. ___________uria
vii. Lower _________________discomfort
d. Gerontologic Considerations
i. _________________ S&S
ii. _______________________
iii. Altered ___________________________ function
iv. ____________________ temp
VII.
Pyelonephritis
a. Inflammation of the renal ____________& parenchyma
b. Etiology: _______________________/ __________________
c. S&S
i. Cystitis +
ii. _________________pain
iii. __________________/ diarrhea
iv. __________________/ chills
v. __________________
d. Dx: _____________________________
e. Rx:________________________ & Urinary ____________________
f. Nursing Assessment
i. S&S
ii. ________________patterns
iii. ________________intercourse
g. Health promotion
i. Fluids: ___________________
ii. Void when :_____________________
iii. Female - Clean _____________ to __________________
iv. __________________ after intercourse
v. Avoid : ____________________________________________________
vi. _____________________ underwear
vii. ____________________ not bath
h. Nrs. Dx: Pain
i. Assess
ii. Admin
iii. Teach
iv. Diet
Small Group Questions
1. What are the S&S of cystitis?
2. Differentiate with cystitis & Pyelonephritis
3. What are the gerontological considerations for a client with a UTI?
4. What would you teach a client about preventing further UTI’s
VIII.
Glomerulonephritis
a. Inflammation of the _________________________
i. Damage 
1. _________________ & _______________ escapes into tubule
b. Etiology
i. Acute: _________________________________________
ii. Chronic: _________________________________________________
c. Nephrotic Syndrome:
i. Group of ______________________________________
1. ___________________________ in the urine
2. _______ serum ________________________
3. ____________________________
4. _____ serum __________________________
ii. S&S
1. #1 _______________________________
2. ______________________________
3. _____________________
4. Irritability
5. Fatigue
iii. Dx finding
1. ______________________
2. ______________________uria
3. ______________________emia
4. ______________________emia
5. Azotemia: Increased ________________ products in the blood
iv. Complications
1. Renal ___________________________
2. ________________________________
d. Medical management
i. Edema: ___________________________
ii. Inflammation: ________________________________________________
iii. Infection: ___________________________________
iv. Diet
1. Sodium: _____________________________
2. Protein: _____________________ azotemia _________________
3. Fat: __________________________
e. Nursing Management
i. Edema:
1. Qday _____________________
2. __________________________
3. Measure _____________________ girth
4. Skin ___________________________
5. Diet ____________________________
IX.
Kidney Stones AKA: Renal _____________________
a. Risk factors
i. __________________________________
ii. Urinary ___________________________
iii. __________________________________
iv. __________________________________
b. S&S
i. __________________:
1. ___________________
2. ___________________
3. ___________________
ii. __________________ uria
c. DX
i. _______________
ii. _______________
iii. CT scan / MRI
iv. Cystoscopy: _________________ scope to inspect _________________
1. ____________________ anesthesia
d. Medical management
i. #1 goal :_______________________:
1. _________________ analgesic
2. _________________
ii. ___________________________
iii. ___________________________
iv. Diet
1. Fluids
2. Protein
3. Sodium
e. Surgical Management
f. Nursing Dx: Acute pain / deficit knowledge
i. Administer: _________________________
ii. Positision
iii. _______________________
iv. __________________ to flank
v. Fluids
vi. Assess _____________________
vii. ____________________
viii. _____________________ the urine with gauze
ix. Avoid _____________________________
Small Group Questions
1. What are the classic clinical manifestations fro a client with Glomerulonephritis
2. What causes Glomerulonephritis
3. What are the medical interventions for a client with Glomerulonephritis
4. What are the specific nursing interventions of this client
5. What are the S&S of renal calculi
6. How is a renal calculi treated?
X.
Cancer
a. Pathophysiology
i. Most common site: _____________________
ii. Carcinogen: __________________________
iii. Metastasize ______________________
b. S&S
i. Initial: _______________________________________________
ii. Late: ________________________ & _________________ uria
c. Med Treatment
i. Goal Eradicate before ________________________________
1. ________________________________
a. Cystectomy / Nephrorectomy
ii. Radiation
iii. Chemotherapy
XI.
Renal Failure
a. Unable to remove accumulated ______________ products from the ________
b. Acute
i. ____________ onset
ii. Often ____________________
iii. Etiology: ______________________ - ________________________
iv. S&S
1. _______________uria: urine < _______________mL/day
2. BUN ___________________
3. GFR ___________________
4. ________________________
a. Confusion
b. _______________ & ______________ retention
i. ____________________ & ___________________
c. _______________kalemia
c. End-stage
i. ____________________ kidney distruction
ii. S&S
1. _____________________
a. ______________
b. Weakness
c. ______________________
d. ______________________
iii. Medical treatment
1. No _____________________drugs: _________________
2. Antihypertensives
3. Diuretics
4. Fluid: _________________________
5. Sodium: __________________________
XII.
Dialysis
a. Purpose
i. Remove _______________ and ______________products from the body
b. Definition
i. __________________________means of removing waste from the blood
c. Types:
i. _______________ dialysis & _____________________dialysis
d. Process
i. _______________________ and ____________________across a semi
permeable membrane into a ____________________________solution
ii. Toxins and wastes are removed by _______________________________
iii. Excess water is removed by _________________________________
e. Hemodialysis
i. A ____________________with an artificial semi-permeable membrane
ii. Frequency: ___________________________________________
f. Peritoneal
i. Uses the ________________________ lining of the abd cavity
ii. Complication: __________________________________
iii. Frequency: ____________________________________