ASSESSMENT OF RENAL AND URINARY TRACT INFECTION

Chapter 43

Assessment of Renal and
Urinary Tract Function

Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Renal and Urinary Systems
• Function to maintain the body’s state of homeostasis by
regulating fluid and electrolytes, removing wastes, and
providing hormones involved in red blood cell production,
bone metabolism, and control of blood pressure.
• Structures:
– Kidneys
– Ureters
– Bladder
– Urethra


Kidneys, Ureters, and Bladder


Internal Structure of the Kidney


Nephron


Formation of Urine


Renin Angiotensin System


Diagnostic Studies
• Urinalysis and urine culture
• Renal function tests
(See Table 43-5)
• Ultrasonography
• CT and MRI
• Nuclear scans
• Intravenous urography, retrograde pyelography, cystography,
renal angiography
(See Chart 43-2)
• Endoscopic procedures
• Biopsies


Cystoscopic Examination


Question
Is the following statement True or False?

Urea is an abnormal constituent of urine.


Answer
False

Urea is not an abnormal constituent of urine. Glucose is an
abnormal constituent of urine.


Nursing Care of the Patient Undergoing
Diagnostic Testing of the Renal-Urologic
System—Assessment
• Patient knowledge
• Psychosocial and emotional factors; fear, anxiety
• Urologic function, include voiding habits/pattern
• Fluid intake
• Hygiene
• Presence of pain or discomfort
• Allergies


Question
What is the normal adult bladder capacity?
A.50 – 100 mL
B.100 – 200 mL
C.300 – 500 mL
D.600 – 800 mL


Answer
C

The normal adult bladder capacity is 300 – 500 mL of
urine.


System—Diagnoses
• Knowledge deficient
• Pain
• Fear


System—Planning
• Patient goals may include understanding of procedures,
tests and expected behaviors; decreased pain or absence
of discomfort; and decreased apprehension and fear.


Interventions
• Patient teaching: providing a description of the tests and
procedures in language the patient can understand.
• Use appropriate, correct terminology.
• Encourage fluid intake unless contraindicated.
• Instruct in methods to reduce discomfort; sitz baths,
relaxation techniques.
• Administer analgesics and antispasmodics as prescribed.
• Assess voiding and provide instruction related to voiding
practices and hygiene.
• Provide privacy and respect.

Question
A 24-hour urine collection is scheduled to start at 1 am.
When should the nurse start the procedure?
A.At 1 am, with or without a specimen.
B.At the first specimen that was voided at 4 am.
C.2 hours after the urine was discarded.
D.After discarding the 1 am specimen.


Answer
D

A 24-hour urine collection that starts at 1 am begins after
discarding the 1 am specimen.


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