Urinary
system
Functions of Urinary System
• Removes waste
• Maintains acid-base
balance of body
• Parts include:
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2 KIDNEYS
2 URETERS
BLADDER
URETHRA
Kidneys
• 2 bean shaped organs
• Protected by ribs and fat
• Each kidney is found in mass of fatty tissue
(adipose capsule)
• 2 main sections:
– Cortex: outer layer, contains most of the neurons that
aid in production of urine
– Medulla: inner layer, contains most of tubes that carry
urine from the nephrons through the kidneys
Nephrons
• Microscopic filtering units
• Over 1 million/kidney
• Contains glomerulus
– Cluster of capillaries that
filter waste
• Bowman’s capsule
– Surround glomerulus picks
up filtered materials and
passes it to the convoluted
tubule
– Substances needed by the
body are reabsorbed and
returned to the capillaries
• At the end, most of the
water, sugar, vitamins and
salts have been reabsorbed
• Excess salts, water, wastes
remain in the tubule and
become urine
• Urine enters collecting
ducts (tubes) in the
medulla
• Collecting tubes empty
into the renal pelvis (first
section of the ureter)
Ureters
• 2 muscular tubes 10-12
inches long
• One extends from the
renal pelvis to the bladder
• Peristalsis: a wavelike
motion of the involuntary
muscle that moves urine
through the ureter from
the kidney to the bladder
Bladder
• Hollow muscular sac
• Lining folds called rugae –
disappears as muscles of
bladder allow it to expand
and fill with urine
• 3 layers of visceral muscle
• Urge to void occurs with
bladder contains 1 cup
• Circular sphincter muscle
– Control bladder opening
– Can’t be controlled by
infants
• FUNCTIONS:
– Receives urine from
ureters
– Stores urine until
eliminated from body
Urethra
• Tube carries urine from
bladder to outside
• External opening called
meatus
• Different in male/females
– Females shorter
– Opens in front of vagina or
passes through the penis
– Male: carries both urine
from urinary system and
semen from the
reproductive system
Urine
• Liquid waste
• 95% water
• Excess useful products
like sugar can be found,
but usually indicates
disease
• 1 ½ - 2 quarts produced
daily
• 150 quarts filtered through
kidneys
Key Terms
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Polyuria: excess urination
Oliguria: below normal urination
Anuria: absence of urination
Hematuria: blood in urine
Nocturia: urination at night
Dysuria: painful urination
Retention: inability to empty bladder
Incontinence: involuntary urination
Diseases
•Symptoms:
•Frequent urination
• Inflammation of the
bladder
• More common in
females due to
shortness of urethra
•Dysuria and burning
•Bladder spasm
•Hematuria
•? Fever ?
•Treatment:
•Antibiotics and increased fluid
intake
Nursing Care Cystitis
• Emphasize prevention • Showers instead of
through drinking
baths may help
plenty of fluids, juices • Report dark, cloudy, or
rich in vitamin C such
foul-smelling urine to
as cranberry help
the nurse
acidify the urine,
• Report complaints of
• Teach to wipe from
burning with urination,
from front to back
frequency or urgency
Renal Calculi
• Kidney stone formed when salts in urine
settle
• Small stones can be eliminated in urine
• Large stones may become lodged
• Symptoms: sudden pain, hematuria and
retention
• Treatment: increase fluids, pain meds, strain
urine w/ gauze, lithotripsy, possible surgery
Renal Failure
• Kidneys stop functioning
• Acute
– Caused by injury, poisoning, dehydration
– Prompt treatment leads to good prognosis
• Chronic
– Progressive loss of kidney function caused by
glomerulonephritis, hypertension, toxins and endocrine
disease.
– Waste accumulates and affects body systems
Chronic Renal Failure Signs and
Symptoms
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N/V
diarrhea
decreased mental ability
convulsions
muscle irritability
ammonia odor to the breath and perspiration
later: coma and death
Chronic Renal Failure Nursing Care
• Residents will be on
• Dialysis- an artificial
fluid restriction
means of filtering waste
products from the body, • Important to only give
may be necessaryfluids as instructed by
• Can prolong and improve nurse
life
• Also must be on a
special diet-make sure
• Unless a person receives
items given are
a kidney, must receive
allowed
dialysis a few days each
week
Chronic Renal Failure Nursing Care
• Residents often have
problems with dry
skin and c/o mouth
dryness, if so report to
nurse and find out
what can be done to
make them more
comfortable
• These residents may
urinate on rare
occasions depending
on severity of renal
failure
Uremia
• Toxic condition where urinary waste is in
bloodstream
• Caused from any condition that affects
proper function of kidneys
• Symptoms: n/v, ammonia breath, anuria,
headache and confusion, coma/death
• Treatment: restrictive diet,
dialysis, transplant
Urine Retention
• Inability to empty the
bladder adequately
• Can be short or long
term
• May be caused by
blockage , disorders
such as MS or Diabetes,
• Most common cause in
men –enlarged prostate
• Signs and Symptoms
include pain in the
lower abdomen, strong,
painful, and frequent
urge to urinate but
cannot
• Distended bladder
• Weak urine flow or
dribbling at the end of
urination and between
urinations
Nursing Care Urinary Retention
• Report symptoms to
• Surgery may be done
the nurse
depending on the
cause
• Usually treated with
medications
• May require
catheterization to drain
the bladder
Urinary Incontinence
• Inability of resident to • NA should monitor
control urination
resident frequently,
keep skin clean and
• May be cause by many
dry, change
disease, or other
incontinence briefs
problems
according to facility
• Risk of skin
require
breakdown increased
• Report changes in
• Resident may require
odor and color
an external catheter if
• Try bowel and bladder
a male or indwelling
training if requested
catheter if female
Urinary System Specimen
Collection
• Routine Urine
• Clean Catch Urine
• Urine Sample from
Indwelling Catheter
• 24 hour urine
collection