Health & Physical Assessment in Nursing First Edition

1. Health & Physical Assessment in NursingFirst Edition Donita D’AmicoandColleen Barbarito Chapter 20 Urinary System

2. LEARNING OBJECTIVE ONE

3. LEARNING OBJECTIVE ONE • Urinary System • Kidneys • Ureters • Bladder • Urethra

4. Figure 20.1 The urinary system. A. Anterior view of the urinary organs of a female. A

5. Figure 20.1 (continued)The urinary system. B. Relationship of the kidneys to the vertebrae. B

6. LEARNING OBJECTIVE ONE • Kidneys

7. Figure 20.2 Internal anatomy of the kidney.

8. LEARNING OBJECTIVE ONE • Kidneys • Location • Renal arteries • Renal capsule • Hilus • Medulla • Pyramids • Calyces • Collecting tubules

9. LEARNING OBJECTIVE ONE • Kidneys • Renal pelvis • Cortex • Nephrons • Glomeruli • Functions • Removes wastes, toxins, and foreign matter from the blood • Promotes fluid and electrolyte balance • Assists in maintenance of blood pressure • Contributes to erythropoesis and the metabolism of vitamin D

10. LEARNING OBJECTIVE ONE • Ureters • Function

11. LEARNING OBJECTIVE ONE • Urinary Bladder • Detrusor muscle • Functions • Temporarily store urine • Contract for urine release

12. LEARNING OBJECTIVE ONE • Urethra • Female • Male

13. LEARNING OBJECTIVE TWO

14. LEARNING OBJECTIVE TWO • Landmarks for Physical Assessment of the Urinary System • Costovertebral angle

15. Figure 20.3A Landmarks for urinary assessment. A. The costovertebral angle. A

16. LEARNING OBJECTIVE TWO • Landmarks for Physical Assessment of the Urinary System • Symphysis pubis

17. Figure 20.3B Landmarks for urinary assessment. B. The rectus abdominis muscles and the symphysis pubis. B

18. LEARNING OBJECTIVE TWO • Costovertebral Angle - Area on the Lower Back Formed by the Vertebral Column and Downward Curve of the Last Posterior Rib • Anatomical location of the kidneys and ureters

19. LEARNING OBJECTIVE TWO • Rectus Abdominis Muscles - Longitudinal Muscles Extending from the Pubis to the Ribs on Either Side of the Midline • Guides the location kidney palpation

20. LEARNING OBJECTIVE TWO • Symphysis Pubis - Joint Formed by the Union of Two Pubic Bones at the Midline • Bladder is cradled under this structure

21. LEARNING OBJECTIVE THREE

22. LEARNING OBJECTIVE THREE • Focused Interview • General questions

23. LEARNING OBJECTIVE THREE • Specific Questions • Illness or infection • Symptoms • Pain • Behaviors • Infants and children • Pregnant female • Older adult • Environment

24. LEARNING OBJECTIVE FOUR

25. LEARNING OBJECTIVE FOUR • Equipment • Examination gown and drape • Examination gloves • Stethoscope • Specimen container

26. LEARNING OBJECTIVE FOUR • Other Considerations • Age • Gender • Culture

27. LEARNING OBJECTIVE FIVE

28. LEARNING OBJECTIVE FIVE • Physical Assessment of the Urinary System • Techniques • Inspection • Palpation • Percussion

29. LEARNING OBJECTIVE FIVE • Areas of the Urinary System Assessment • Assessment of hydration status and skin color • Inspection of the abdomen

30. Figure 20.5Inspecting the abdomen from the foot of the bed.

31. LEARNING OBJECTIVE FIVE • Areas of the Urinary System Assessment • Auscultation of the right and left renal arteries

32. Figure 20.6Auscultating the renal arteries.

33. LEARNING OBJECTIVE FIVE • Areas of the Urinary System Assessment • Inspection of the costovertebral angles • Inspection of the flanks • Palpation of the costovertebral angles

34. Figure 20.7Palpating the costovertebral angle.

35. LEARNING OBJECTIVE FIVE • Areas of the Urinary System Assessment • Percussion of the costovertebral angles

36. Figure 20.8Blunt percussion over the left costovertebral angle.

37. LEARNING OBJECTIVE FIVE • Areas of the Urinary System Assessment • Palpation of the kidneys

38. Figure 20.9Palpating the left kidney.

39. LEARNING OBJECTIVE FIVE • Areas of the Urinary System Assessment • Palpation of the bladder

40. Figure 20.10Palpating the bladder.

41. LEARNING OBJECTIVE FIVE • Areas of the Urinary System Assessment • Percussion of the bladder

42. LEARNING OBJECTIVE SIX

43. LEARNING OBJECTIVE SIX • Abnormal Findings in the Urinary System • Bladder cancer • Kidney and urinary tract infections • Renal calculi • Renal tumors • Renal failure • Changes in urinary elimination

44. LEARNING OBJECTIVE SIX • Bladder Cancer • More common in men than women • Linked to smoking

45. LEARNING OBJECTIVE SIX • Glomerulonephritits and Urinary Tract Infections

46. LEARNING OBJECTIVE SIX • Renal Calculi

47. LEARNING OBJECTIVE SIX • Renal Tumors • Benign • Malignant • Linked to smoking

48. LEARNING OBJECTIVE SIX • Renal Failure • Acute • Oliguria • Diuresis • Recovery • Chronic • Uremia

49. LEARNING OBJECTIVE SIX • Changes in Urinary Elimination • Dysreflexia • Incontinence • Functional • Reflex • Stress • Urge • Total • Urinary retention

50. LEARNING OBJECTIVE SEVEN