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NCLEX Review of the Urinary System

 ♠  Show Notes:

An NCLEX Review of the Urinary System: We will go over the major diseases that you most likely encounter in the NCLEX Exam.

The Urinary System

– is a vital system in the body that enables us to produce, store and eliminate urine.

MAINLY COMPOSED OF:
– the Kidneys
– the Prostate
– the Ureters
– the Bladder
– the Urethra

Although it is not necessary to have the physiology of each anatomy committed to your memory, it is very important to understand the concept and function of each.

DIAGNOSTIC TESTS WITH THE URINARY SYSTEM:

URINANALYSIS  

Very important to remember these values for the NCLEX.

BUN Level            10-20 mg/dl
Creatinine Level            0.5- 1.5 mg/dl
Calcium                 9- 11 mg/ dl
Urine Specific Gravity        1.003- 1.030

ELECTROLYTE IMBALANCE

Hyponatremia (decreased sodium)
Muscle weaknes, Headaches
Fatigue, confusion, vomiting, coma

Hpernatremia (increased sodium)
Tachycardia, dry mucus membrane
decreased urinary output

Hypokalemia (decreased pottasium)
Anorexia, nausea, vomiting
abdominal distention

Hyperkalemia (increased pottasium)
Irritability, nausea and vomiting
diarrhea

Hypokalcemia (decreased calcium)
osteoporosis, fractures, muscle spasms
tetany, n & v, vomiting.

Hypercalcemia (increased calcium)
Renal calculi, coma, arrythmias, decreased reflex

POLYCYSTIC KIDNEY DISEASE

NEPHROTIC SYNDROME

GLOMERULONEPHRITIS/ PYELONEPHRITIS

Urinary Calculi/ Ur0lithiasis

♣

CHRONIC RENAL FAILURE

STAGES OF CHRONIC RENAL FAILURE

Stage 1 Diminished Renal Reserve

• – renal function is reduced, but no accumulation of metablic wastes occurs.
  – the healthier kidney compensates for the diseased kidney
  – The ability to concentrate urine is decreased
•   ♦ Results in nocturia and polyuria

– Stage 2 Renal Insufficiency

• – metabolic waste begin to accumulate in the blood, because affected nephrons can no
  longer compensate.
  – responsiveness to diuretics is decreased, resulting in Oliguria and edema

Stage 3 End Stage Renal Disease.

• – excessive amount of metabolic wastes such as
  urea and creatinine accumulate in the blood.
  – kidney is unable to maintain homeostasis
  – treatment is by dialysis

Metabolic Changes
– Urea and Creatinine
– Sodium
– Pottasium
– Acid Base Balance
– Calcium and Phosporus

Cardiac Changes
– Hypertension
– Hyperlipidemia
– Heart Failure
– Uremic Pericarditis

INTERVENTIONS
– It is important to monitor renal, respiratory and cardiovascular status and the fluid balance.

REMEMBER FOR NCLEX
– Patient with Chronic Renal Failure would have

• ♣ UREMIA, ANEMIA AND ACIDOSIS

DIALYSIS:

Peritoneal Dialysis:

♣ Complication: can include Peritonitis

Hemodialysis:

♠ Pt. may use external shunt or surgically constructed internal arterivnous fistula (long-term)

Most common cause of renal failure is *poorly controlled diabetes & Hypertension.

Dopamine= can enhance renal perfusion and elevate blood pressure.

♠ Ways to control monitor kidney function:

• Monitor I and O
• Monitor Lab Values
• Specific Gravity
• BUN and Serum

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