1. Robert Adams Biology 120 Urinary System Terms

2. Acute Renal FailureARF Sudden renal failure Kidneys have suddenly stopped working Wastes products, fluids, and electrolytes build in the body

3. 3 Main Causes Prerenal Intrinsic Post renal Acute Renal Failure

4. Prerenal Sudden serious drop in blood flow to the kidneys Heavy blood loss Infection or sepsis dehydration Adaptive response to severe volume depletion and hypertension with structurally intact nephrons. Acute Renal Failure

5. Intrinsic Response to cytotoxic, ischemic, or inflammatory injuries to the kidney with structural and functional damage Damage from medicine, poison, or infection People with serious long term health problems are likely to have kidney complications due to medications antibiotics, pain meds., blood pressure meds., and dyes used for X-ray Acute Renal Failure

6. Post renal The obstruction of the passage of urine A sudden blockage that stops urine from flowing out of the kidneys Kidney stones Tumor Injury Enlarged prostate Acute Renal Failure

7. Symptoms Little or no urine Bruising easily Hand tremors Swelling (especially of the legs and feet) Seizures Loss of appetite Nausea, vomiting Acute Renal Failure

8. Risk Factors Symptoms Older adults Long term health problems Kidney or liver disease Diabetes Heart failure Obesity Liver cirrhosis Anaphylaxis Severe burns Anxiety Confusion Restlessness Exhaustion Pain in the back below rib cage Acute Renal Failure

9. Diagnosis BUN blood urea nitrogen Creatine clearance Urinalysis Serum potassium Serum creatine Ultrasound Abdominal CT scan or MRI Acute Renal Failure

10. Treatment Treatment varies depending on the cause Treated by a nephrologist Dialysis Antibiotics Special diets Meds. to rid extra fluid Meds. to control blood potassium Meds. to restore blood calcium levels Kidney transplant Acute Renal Failure

11. Acute Renal Failure Potentially fatal May lay to chronic renal failure Develops over a few hours or a few days Occurs in 5% of hospitalized patients Infection accounts for 75% of deaths associated with ARF

12. Blood, Urea, NitrogenBUN Test is a measure of the amount of nitrogen in the blood in the form of urea Measures renal function The liver produces urea as a waste product during the breakdown of protein

13. Why is this test given? See if kidneys are working normally See the condition of kidney disease Test treatment of kidney disease Check for sever dehydration Blood, Urea, Nitrogen

14. Blood, Urea, Nitrogen Patients prepare for this test by abstaining from meat or protein 24 hours prior Normal results are 6-20 milligrams per deciliter

15. High BUN Results Kidney injury or disease Diabetes High blood pressure Blockage of the urinary tract Low blood flow to the kidney Acute renal failure Dehydration Heart failure Severe burns Addison’s disease High protein diet Some meds. Blood, Urea, Nitrogen

16. Low BUN Results Low protein diet Malnutrition Severe liver damage Over hydration Severe muscle injury Pregnancy Cirrhosis Blood, Urea, Nitrogen

17. Catheterizationcath Urinary catheterization Tubing that is inserted into the bladder via the urethra Allows urine to drain freely from the bladder for collection Permanent or intermittent Tubing can be latex, polyurethane, or silicone

18. Types of catheters Foley Catheter – retained by means of a balloon at the tip which is inflated with sterile water. Indwelling catheter Robinson Catheter – intermittent flexible catheter for short term usage. No balloon tip so it can’t stay in place unaided Caude catheter – designed with a curved tip that makes it easier to pass through the curvature of the prostatic urethra Hematuria catheter – type of Foley catheter Texas Condom catheter – used for incontinent males, and carries a lower risk for infection Catheterization

19. When is a patient catheterized? Acute or chronic urinary retention Orthopedic procedures that limit patient movement Need for accurate monitoring of input and output Benign prostatic hyperplasia Blockage Various surgeries involving the bladder and prostate Catheterization

20. Procedure for men Wash hand, put on gloves Clean urethra opening Lubricate catheter Gently insert and advance catheter When you reach external sphincter you will feel resistance, gently continue to advance When urine flow starts hold catheter in place while you inflate balloon Secure catheter and attach drainage bag Catheterization

21. Procedure for women Wash hands, put on gloves Clean labia and urethral meatus Lubricate catheter Spread labia and locate urethral meatus Slowly insert catheter into meatus Gently advance catheter When urine flows advance about 2 more inches hold catheter in place and inflate balloon Secure catheter and attach drainage bag Catheterization

22. Diagnostic Reasons Urinalysis Collect accurately timed volumes or urine for renal function study Monitor urine output Install contrast dye for radiography Catheterization

23. Therapeutic Relieve obstruction to urine flow Give meds. Directly to urinary bladder Facilitate surgical repair of urethra and surrounding tissues Catheterization

24. Risks Allergy or sensitivity to materials Bladder stones Blood infections Hematuria Urethral injury Urinary tract infections Kidney damage Bladder spasms paraphimosis Catheterization

25. Cystoscopycysto Allows doctor to look inside of the bladder and the urethra Used for visual diagnosis Can also be used for certain treatments Can see areas that can’t be seen through X-ray Also called cystourethroscopy

26. Cystoscope Lighted instrument that is inserted through the urethra and moved to the bladder Sterile water is injected through the scope to help expand bladder and create clear viewing Medicine can also be injected through scope Tiny instruments can be inserted to collect tissue Cystoscopy

27. Types Flexible Rigid Cystoscopy

28. Procedure Patient is given a sedation IV for meds. and fluids Patient lies on back with knees bent, legs apart Genitals are cleaned Anesthetic is given Well lubricated cystoscope is inserted into the urethra and slowly advanced to the bladder Instrument can be used to biopsy 45 min. procedure performed by urologist Cystoscopy

29. Risks Anesthetic risk Temporary swelling of the urethra Difficult urination Hematuria Infection Urethra and bladder puncture Cystoscopy

30. Not administered if… Pregnant Allergic Bleeding problems On blood thinners Cystoscopy

31. Why? Find cause of hematuria, dysuria Urinary frequency Urinary inconsistence Urinary hesitance Urine retention Urethra blockage Urinary tract infections Biopsy Remove foreign objects Check for stones or tumors Diagnose enlarged prostate Cystoscopy

32. Preparation Sometimes antibiotics Nothing by mouth after midnight the evening before Cystoscopy

33. Infection that begins in the urinary system Most infections involve the lower urinary tract: bladder and urethra Infection is more common in women Urinary Tract InfectionUTI

34. Types Kidney (acute pyelonephritis) Bladder (cystitis) Urethra (urethritis) Urinary Tract Infection

35. Symptoms Strong urge to urinate Burning sensation when urinating Cloudy urine Frequent small amounts of urine Pelvic and rectal pain Strong smelling urine Hematuria Nausea, vomiting Urinary Tract Infection

36. Causes When bacteria enters the urethra and begins to multiply Infection caused by E. coli Sexual intercourse, STD’s GI bacteria spread from anus to urethra Urinary Tract Infection

37. How is it diagnosed? Treatment Urinalysis Bacteria culture in lab Cystoscopy Diagnostic imaging Antibiotics Home urine tests Single doses of antibiotics after sex Vaginal estrogen therapy hospitalization Urinary Tract Infection

38. Higher Risk Factors Reduce Risks Female Sexually active Using certain birth control Undergoing menopause Urinary tract abnormalities Suppressed immune system Using a catheter Blockage of the urinary tract Drink plenty of liquids Wipe front to back Empty bladder after sex Avoid irritating feminine products Urinary Tract Infection