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Understanding the Urinary System: Anatomy and Functions

The urinary system plays a vital role in maintaining homeostasis in the body. It comprises the kidneys, ureters, urinary bladder, and urethra, functioning to regulate blood and water volume, blood pressure, electrolyte levels, and acid-base balance. Key components include nephrons, which are responsible for filtering blood and forming urine. Aging affects the urinary system's efficiency, leading to various conditions such as incontinence and urinary tract infections. This overview covers normal urine composition, diagnostic tests, and common urinary disorders, emphasizing the importance of urinary health.

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Understanding the Urinary System: Anatomy and Functions

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  1. The Urinary System Anatomy and Physiology 2014

  2. Structure • Kidneys • Ureters • Urinary bladder • urethra

  3. Function • Maintains homeostasis • Controls blood and water volume • Maintains blood pressure • Regulates electrolyte levels

  4. Eliminates protein wastes, excess salts and toxic materials from blood • Balances acid/base (PH) • Secretes renin and erythropoietin

  5. Kidney Structure • 2 reddish brown, bean-shaped organs • Located in small of the back at lower edge of ribs on either side of spine • “Retroperitoneal”

  6. How the kidneys Regulate BP • ADH • RENIN • ALDOSTERONE

  7. 3 Parts • Cortex • Medulla • Pelvis

  8.     BecomeHealthyNow.com Home

  9. Nephron • Functional units of the kidney • Cells that form urine • Over 1 million nephrons in each kidney

  10. Glomerular Filtration • Tubular Reabsorption • Tubular Secretion

  11. WORD WALL • Oliguria • Anuria • Dysuria • Polyuria • hematuria

  12. Urine • Body excretes 1000-2000 ml of urine/day • Is normally sterile • Color varies with hydration

  13. Characteristics of Normal Urine • CLARITY • ODOR • SPECIFIC GRAVITY

  14. THINK…. • A STRONG, OFFENSIVE ODOR FROM FRESHLYVOIDED URINE IS SUGGESTIVE OF…….. Urinary Tract Infection

  15. Composition of Normal Urine • Water • Protein wastes products (urea, uric acid & creatinine) • Excessive minerals from diet (Na+,K+, Ca,sulfates & phosphates

  16. Toxins • Hormones • Bile compounds • Pigments from food/drugs

  17. WORD WALL • Frequency • Urgency • Nocturia • Enuresis • retention

  18. Effects of Aging on the Urinary System • Ability to filter blood, reabsorb electrolytes & secrete wastes decreases • Less ability to return to normal after changes in blood volume

  19. Decrease in number & size of nephrons • Decrease in GFR • Smaller capacity of bladder • Weaker bladder muscles

  20. Incontinence • Not a normal consequence of age • Common due to many reasons • See Chpter 23 for more information on incontinence

  21. Critical Thinking Challenge COMPARE & CONTRAST COMPARE & CONTRAST URGE vs. OVERFLOW • STRESS vs. FUNCTIONAL

  22. Nursing Assessmentof The Urinary System

  23. HEALTH HISTORY • Chief complaint • History of Present Illness • Past Medical History • Family History • Review of Systems

  24. Diagnostic & Laboratory Tests Urinary System

  25. URINE TESTS • UA ( urinalysis ) • C & S ( Culture & Sensitivity ) • Creatinine Clearance (24 hr)

  26. BLOOD TESTS • BUN ( blood urea nitrogen ) • Serum Creatinine • Serum Electrolytes

  27. Radiographic Studies • KUB ( flat plate ) • IVP • Arteriogram • Renal Scan • US

  28. Invasive Procedures • Renal Biopsy • Cystoscopy

  29. What are Urodynamic Studies ??

  30. What are common Therapeutic measures Related to “Catheterization”

  31. Catheter Types Foley Ureteral Suprapubic Nephrostomy

  32. Common Tubes and Catheters • Ureteral Catheter • Nephrostomy Tube • Urinary Stent

  33. Pre-Op Care  Urologic Surgery • Evaluate fluid status • Bowel cleansing • Enterostomal Therapist/Nurse • Counseling/Teaching

  34. Post-Op Care Urologic Surgery • Report to MD U/O < 30 ml/hr • Pain Management • Mon. lung sounds • Assess for Paralytic ileus

  35. Urinary Tract Inflammation and Infections

  36. Cystitis • Inflammation of the urinary bladder • Bacteria enters from the urethra, lymph nodes, infected kidneys • Women more suseptible

  37. Causes • E-coli • Candida Albicans • Coitus • Diabetes mellitus • See Box 40-2 Risk Factors for UTI’s

  38. Signs & Symptoms • Dysuria, hematuria • Frequency, urgency • Low grade fever • Pelvic or abd. discomfort • Bladder spasms

  39. Med. Dx & Tx • C&S and UA obtained • Increase fluids 3-4 L / day • Antibiotics (Cipro,Bactrim,Septra • Analgesics(Pyridium) • See Pt. Teaching pg. 898

  40. Gerontologic Considerations • Watch for signs of mental confusion • Fever may be masked • Sepsis develops quickly

  41. Pyelonephritis • Bacterial infection of renal pelvis and kidney • Most common form of kidney disease • Often the result of reflux

  42. Signs & Symptoms • Flank pain • Chills, fever,N & V • Dysuria, fatique • Bladder irritation

  43. Med & Nursing Considerations • Bedrest • Increase fluids (8 8oz. Glasses water/day) • IV • Monitor I + O • Protein & Na+ restrictions • Mon. for circulatory overload

  44. Pharmacological TX • Antibiotics (Bactrim) or Cipro • Antipyretics • Analgesics • Antispasmotics • Antihypertensives

  45. Glomerulonephritis • Autoimmune disease • Glomerulus becomes inflammed • Symptoms dev. 1-3 wks after respiratory infection cau by group A- hemolytic strep

  46. Signs & Symptoms • Tea colored urine • Decrease in u/o • Periobital edema • HTN • Hypervolemia

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