female urinary system nurs.230 dr essmat gemaey king saud university

Female urinary system

Nurs 230

Dr essmat gemaey

King Saud University

Objectives

Upon completion of this session the students will be able to

bull Describe the anatomy and physiology of the urinary system

bull Identify landmarks that guide assessment of the urinary system

bull Perform assessment of the urinary system bull Differentiate normal from abnormal findings in

physical assessment of the urinary system

Overview of the urinary system

bull The urinary system is composed ofbull the kidneys ureters bladder and urethra bull The glomeruli are the filtering units of the kidney

and are responsible for removing wastes toxins and foreign matter from the blood

bull The normal function of the kidneys are bull prevents the accumulation of nitrogenous waste promotes fluid and electrolyte balance assists in maintenance of blood pressure and

contributes to erythropoiesis

Equipment

Includes

An examination gown

Clean nonsterile examination gloves

A stethoscope and a specimen container

Landmarks

bull The costovertebral angle is the area on the lower back formed by the vertebral column and downward curve of the last posterior rib

bull The rectus abdominis muscles are longitudinal muscles extending from the pubis to the ribs on either side of the midline

bull The symphysis pubis is the joint formed by the union of two pubic bones at the midline

Gathering the data

bull The general questions in the focused interview concern voiding patterns family history of renal disease and information about diagnostic testing

bull Questions in the focused interview include those related to illness infection symptoms behaviors and pain

bull The subjective data will include hygiene practices use of medications (especially analgesics) sexual practices risk factors including smoking and history of hypertension or diabetes

Some of the renal or urinary system-focused questions

bull Ask patients include

1048633 Do you urinate more than usual (frequency urgency nocturia)

1048633 Any pain or burning upon urination

1048633 Any difficulty starting or maintaining the stream of urine

1048633 Any blood in your urine

1048633 Any difficulty controlling your urine

Inspection

bull clientrsquos general appearance and assessment of mental status

bull The clientrsquos hydration status and skin color provide data about the function of the urinary system

bull The renal arteries are auscultated for bruits bull The costovertebral angles and flanks are

inspected for color symmetry and masses

bull Assess skin turgor for

bull dehydration which may

bull accompany diabetes or

bull diuretic use

bull Palpate abdomen for

bull bladder distention

bull Inspect urine specimen for

bull color and odor

Posterior Exam

bullTo assess the kidney assess costovertebral angle tenderness Using indirect percussion place one hand over the 12th rib at the costovertebral angle on the personrsquos back

bullThump that hand with the ulnar edge of the other fist Normally a thud is felt but no pain

bullSharp pain occurs with an inflamed kidney

Palpation for the kidneys

bull It should be noted that a kidney does not move discernibly on inspiration and if significantly enlarged may be bimanually palpable ie it can be ldquobouncedrdquo between your hands

bull To examine for the kidneys one hand should be placed on the abdomen and should remain fixed the other hand is then placed posteriorly and is used to flick the kidney between your hands

bullSearch for R kidney as L normally not palpablebullPlace hand under patientrsquos R kidney feel with

opposite hand on abdomen (hands in ldquoduck-billrdquo position) Press 2 hands together firmly ask pt to take deep breath you feel no change

bullCosto-Vertebral Angle- tendernessndashPlace ball of hand at CVA strike it with ulnar surface

of right (Sharp pain occurs with inflammation

Palpation technique of kidney

bull Palpation of the costovertebral angle and flanks reveals tenderness or masses

bull Blunt percussion at the costovertebral angle produces pain or discomfort in the presence of kidney disease

bull The kidneys are not easily palpated except in the presence of enlargement or disease

bull The bladder is assessed for distention and surface characteristics

bull Percussion above the symphysis pubis is carried out to determine the location and degree of fullness

Costovertebral angle tenderness

Abnormal findings

ndashAbnormal findings in the urinary system include bladder cancer glomerulonephritis renal calculi renal tumor renal failure and

urinary tract infection ndashChanges in urinary elimination include

dysreflexia incontinence and urinary retention

Some terms definitions

ndashcaculi ndash Stones that block the urinary track usually

composed of calcium struvite or a combination of magnesium ammonium phosphate and uric acid content in water

ndashglomerulus ndash Tufts of capillaries of the kidneys that filter

more than one liter (1L) of fluid each minute

hematuria Blood in the urine nocturia Nighttime urinationoliguria Diminished volume of urine

less than 400mlday

ANNURIA urine output less than 50mlday Pyuria presence of pus in urineUrgency strong desire to urinate

Noctoria excessive urination at nightIncontinence involuntary loss of urine

Urine - dipstick tests

A dipstick test is a test when a special chemically treated stick is dipped into urine to check for levels of sugar blood and ketene

1A sample of your urine is taken

2The nurse will stick a small plastic stick with special chemicals at one end into

urine

3 The stick will change colour at one end which will check how much sugar

ketone or blood if any is present

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Objectives

Upon completion of this session the students will be able to

bull Describe the anatomy and physiology of the urinary system

bull Identify landmarks that guide assessment of the urinary system

bull Perform assessment of the urinary system bull Differentiate normal from abnormal findings in

physical assessment of the urinary system






Equipment

Includes

An examination gown



Landmarks




Gathering the data











Inspection








bull diuretic use




bull color and odor

Posterior Exam


















Abnormal findings










less than 400mlday







urine



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Equipment

Includes

An examination gown



Landmarks




Gathering the data











Inspection








bull diuretic use




bull color and odor

Posterior Exam


















Abnormal findings










less than 400mlday







urine



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Landmarks




Gathering the data











Inspection








bull diuretic use




bull color and odor

Posterior Exam


















Abnormal findings










less than 400mlday







urine



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Gathering the data











Inspection








bull diuretic use




bull color and odor

Posterior Exam


















Abnormal findings










less than 400mlday







urine



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Inspection








bull diuretic use




bull color and odor

Posterior Exam


















Abnormal findings










less than 400mlday







urine



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bull diuretic use




bull color and odor

Posterior Exam


















Abnormal findings










less than 400mlday







urine



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Posterior Exam


















Abnormal findings










less than 400mlday







urine



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Abnormal findings










less than 400mlday







urine



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less than 400mlday







urine



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urine



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female urinary system nurs.230 dr essmat gemaey king saud university

Documents

diabetes slide

erythropoiesis slide

female urinary system

urine specimen

general questions

physical assessment

skin color

inflamed kidney