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Health & Physical Assessment in Nursing First Edition. Donita D’Amico and Colleen Barbarito. Chapter 20 Urinary System. LEARNING OBJECTIVE ONE. LEARNING OBJECTIVE ONE. Urinary System Kidneys Ureters Bladder Urethra.

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health physical assessment in nursing first edition
Health & Physical Assessment in NursingFirst Edition

Donita D’AmicoandColleen Barbarito

Chapter 20

Urinary System

learning objective one1
LEARNING OBJECTIVE ONE
  • Urinary System
    • Kidneys
    • Ureters
    • Bladder
    • Urethra
learning objective one3
LEARNING OBJECTIVE ONE
  • Kidneys
    • Location
    • Renal arteries
    • Renal capsule
    • Hilus
    • Medulla
    • Pyramids
    • Calyces
    • Collecting tubules
learning objective one4
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
learning objective one5
LEARNING OBJECTIVE ONE
  • Ureters
    • Function
learning objective one6
LEARNING OBJECTIVE ONE
  • Urinary Bladder
    • Detrusor muscle
    • Functions
      • Temporarily store urine
      • Contract for urine release
learning objective one7
LEARNING OBJECTIVE ONE
  • Urethra
    • Female
    • Male
learning objective two1
LEARNING OBJECTIVE TWO
  • Landmarks for Physical Assessment of the Urinary System
    • Costovertebral angle
learning objective two2
LEARNING OBJECTIVE TWO
  • Landmarks for Physical Assessment of the Urinary System
    • Symphysis pubis
slide17
Figure 20.3B Landmarks for urinary assessment. B. The rectus abdominis muscles and the symphysis pubis.

B

learning objective two3
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
learning objective two4
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
learning objective two5
LEARNING OBJECTIVE TWO
  • Symphysis Pubis - Joint Formed by the Union of Two Pubic Bones at the Midline
    • Bladder is cradled under this structure
learning objective three1
LEARNING OBJECTIVE THREE
  • Focused Interview
    • General questions
learning objective three2
LEARNING OBJECTIVE THREE
  • Specific Questions
    • Illness or infection
    • Symptoms
    • Pain
    • Behaviors
    • Infants and children
    • Pregnant female
    • Older adult
    • Environment
learning objective four1
LEARNING OBJECTIVE FOUR
  • Equipment
    • Examination gown and drape
    • Examination gloves
    • Stethoscope
    • Specimen container
learning objective four2
LEARNING OBJECTIVE FOUR
  • Other Considerations
    • Age
    • Gender
    • Culture
learning objective five1
LEARNING OBJECTIVE FIVE
  • Physical Assessment of the Urinary System
    • Techniques
      • Inspection
      • Palpation
      • Percussion
learning objective five2
LEARNING OBJECTIVE FIVE
  • Areas of the Urinary System Assessment
    • Assessment of hydration status and skin color
    • Inspection of the abdomen
learning objective five3
LEARNING OBJECTIVE FIVE
  • Areas of the Urinary System Assessment
    • Auscultation of the right and left renal arteries
learning objective five4
LEARNING OBJECTIVE FIVE
  • Areas of the Urinary System Assessment
    • Inspection of the costovertebral angles
    • Inspection of the flanks
    • Palpation of the costovertebral angles
learning objective five5
LEARNING OBJECTIVE FIVE
  • Areas of the Urinary System Assessment
    • Percussion of the costovertebral angles
learning objective five6
LEARNING OBJECTIVE FIVE
  • Areas of the Urinary System Assessment
    • Palpation of the kidneys
learning objective five7
LEARNING OBJECTIVE FIVE
  • Areas of the Urinary System Assessment
    • Palpation of the bladder
learning objective five8
LEARNING OBJECTIVE FIVE
  • Areas of the Urinary System Assessment
    • Percussion of the bladder
learning objective six1
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
learning objective six2
LEARNING OBJECTIVE SIX
  • Bladder Cancer
    • More common in men than women
    • Linked to smoking
learning objective six3
LEARNING OBJECTIVE SIX
  • Glomerulonephritits and Urinary Tract Infections
learning objective six5
LEARNING OBJECTIVE SIX
  • Renal Tumors
    • Benign
    • Malignant
    • Linked to smoking
learning objective six6
LEARNING OBJECTIVE SIX
  • Renal Failure
    • Acute
      • Oliguria
      • Diuresis
      • Recovery
    • Chronic
      • Uremia
learning objective six7
LEARNING OBJECTIVE SIX
  • Changes in Urinary Elimination
    • Dysreflexia
    • Incontinence
      • Functional
      • Reflex
      • Stress
      • Urge
      • Total
    • Urinary retention
learning objective seven1
LEARNING OBJECTIVE SEVEN
  • Special Considerations - Developmental, Psychosocial, Cultural, and Environmental
learning objective seven2
LEARNING OBJECTIVE SEVEN
  • Developmental Considerations - Pediatric
    • Renal blood flow and glomerular filtration rate increasing at birth
    • Infants and children having a fragile fluid and electrolyte balance
    • Illnesses involving dehydration leading to acidosis and fluid imbalance
    • Bed-wetting
learning objective seven3
LEARNING OBJECTIVE SEVEN
  • Developmental Considerations - Pregnant Female
    • Pressure of the enlarging uterus
    • Postpartum edema of the bladder
learning objective seven4
LEARNING OBJECTIVE SEVEN
  • Developmental Considerations - Geriatric
    • Decrease in renal blood flow and perfusion
    • Decrease in ability to concentrate and dilute urine
    • Reduction in ability to clear medications and acids
    • Reduction in ability to reabsorb bicarbonate and glucose
    • Effects of acidosis
    • Increased glycosuria
    • Fluid loss
    • Incontinence
learning objective seven5
LEARNING OBJECTIVE SEVEN
  • Developmental Considerations - Geriatric
    • Urinary retention
    • Nocturia
    • Benign prostatic hypertrophy
    • Postmenopausal women and decreased estrogen
learning objective seven6
LEARNING OBJECTIVE SEVEN
  • Psychosocial Considerations
    • Incontinence, altering self - image
    • Urinary tract infections may result from sexual trauma
    • Hesitation to discuss urinary system function
learning objective seven7
LEARNING OBJECTIVE SEVEN
  • Cultural and Environmental Considerations
    • Race
    • Ethnicity
    • Geography
    • Hypertension
    • Diabetes
    • Renal calculi
learning objective eight1
LEARNING OBJECTIVE EIGHT
  • Focus Areas Outlined in the Healthy People 2010
    • Chronic end - stage renal disease
    • Diabetes
learning objective eight2
LEARNING OBJECTIVE EIGHT
  • Key Objectives for Chronic End - stage Renal Disease
    • Decrease the rate of new cases of ESRD
    • Increase the number of dialysis patients on waiting lists for transplant
    • Decrease kidney failure due to diabetes
learning objective eight3
LEARNING OBJECTIVE EIGHT
  • Key Objectives for Diabetes
    • Prevent diabetes
    • Increase the number of diabetics who receive formal education
    • Increase the number of diabetics with annual testing for urinary microalbumin
    • Reduce death rates associated with diabetes
learning objective nine1
LEARNING OBJECTIVE NINE
  • Critical Thinking and the Nursing Process
learning objective nine2
LEARNING OBJECTIVE NINE
  • Learning Needs and Teaching Plans
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