GU

• amount of renal filtrate formed by kidneys in 1 min
• range: 105 - 125 mL/min
• affected by hypo/hypervolemia, affects urine output

1000ml - 2000 ml

• specfic gravity: 1.002 - 1.035
• PH: 4.6 - 8.0

• similar to blood plasma; no rbc and little protein
• blood pressure forces plasma  and dissolved materials out of capillaries

the blood level of a substance is related to the amount shown in the urine

i.e. if blood glucose is normal, no glucose in urine

• renin secretion
• activationof vitamin D,
• erythropoietin production

• uric acid: metabolism of nucleic acids
• urea: created by liver cells when excess amino acids are deaminated for energy
• creatinine: metabolism of creatinine phosphate, energy for muscles

• GFR decreases
• number of nephrons decrease
• urinary bladder decreases in size, detrusor muscle tone decreases

• crystals on the skin, late sign of uremia
• kidneys cant filter waste so it's excreted through the skin

• orthostatic hypotension
• crackles and wheezing
• edema
• weight
• I&O

morning; specimens are usually concentrated and are more likely to contain abmormal constituents

metformin; 48 hrs before and after 

mucomyst if mild-moderate renal insufficiency is found after a GFR or creatinine level is done

• involuntary loss of urine (< 50 ml) related to increased abdominal pressure (sneezing, laughing, etc)
• kegels help

• involuntary loss of urine associated with an abrupt and strong desire to void
• "unable to make it to the bathroom in time"
• most common
• kegels can help

• no urincary problems
• environmental barriers, physical limitations, loss of memory, disorientation prevent use of toilet

• involuntary loss associated with overdistention of bladder
• associated with spinal cord injuries  or enlarged prostate

continuous and unpredictable loss of urine

• inablity to empty the bladder completely
• bladder usually holds less than 50 ml after urination
• 150 - 200 ml residual volume indicates need for intervention

anesthesia from surgery or local trauma to the urinary structure

enlarged prostate, diabetes, pregnancy, medication, strictures, obstruction of the urinary tract

• no
• shock, heart failure and urinary obstruction are

• normal daily genital hygiene with soap and water
• dont clamp the tubing
• encourage fluids unless contraindicated
• keep it taped or fastened to the pt leg
• collect specimens and irrigate through the specimen port

• wash hands
• wear clean gloves

• best for a pt who is unable to void, post op or with neurologic disorder
• inserted into bladder every 3 hrs

• inflammation of kidney
• usually starts with infection of lower urinary tract

• inflammation of bladder
• symptoms: dysuria, frequency, urgency and cloudy urine

urethritis, prostatitis, cystitis

• stasis of urine in bladder
• contamination in the perineal and urethral areas (sex, fecal soiling, infection in the area)
• instruments in the urinary meatus i.e. catheter
• previous uti
• age
• faulty valves

• dysuria, urgency, frequency, incontinence, nocturia, hematuria, back pain, cloudy urine, foul-smelling urine
• elderly may experience cognitive changes

• inflammation of the urethra
• commonly associated with bladder or prostatic infections
• S&S: frequency, urgency and dysuria

orange urine

bubble bath and bath salts

• sulfa meds i.e. bactrim or septra
• ciprofloxacin (cipro)

• fatigue, urgency, dysuria, flank pain, fever, chills
• costovertebral tenderness
• cloudy urine, increased wbc, bacteria, casts, RBC, postivie nitrites
• usually shows signs of systemic disease

• microscopic particles formed in the kidney from abnormal constituents in the urine such as wbc, rbc or pus
• always indicates a kidney problem

when septicemia results from a urinary cause 

• fluids at 2 - 3 L/day
• antispasmodics
• encouraging voiding every 3 hours
• cranberry juice or capsules
• apply heat to suprapubic area
• empty bladder when urge is felt and after sex
• avoid bubble baths and scented toilet paper
• avoid cola, coffee, tea and alcohol

• lumen of urethra is narrowed by scar tissue
• acquired from injury or infection
• pts prone to UTI and have diminshed stream
• mostly seen in elderly men
• treated with mechanical dilation, pt needs pain meds

• kidney stones
• created from concentrated urinary salts (calcium oxalate, calcium phosphate, magnesium ammonia, uric acid, cystine)

stones in the kidney

• family history, chronic dehydration and infection
•  immobility which causes urinary stasis and increased blood calcium
• risk peaks between 30 and 50

• encourage pt to walk which promotes stone excretion and reduce bone calcium resorption
• diet modification

urine flow is obstructed which may cause uti or hydronephrosis

• use of sound, laser, dry shock wave energy to break up stones
• blood in urine is common after treatment

• urine backs up into and distends the kidney
• caused by stricture, kidney stone, tumor or enlarged prostate
• pt usually exhibits uti symptoms and flank or back pain

• most common cancer of the urinary tract
• common metastasis sites are liver, bones and lungs
• smokers 2x risk

• painless hematuria is the most common sign
• fistula, urine retention, dysuria, changes in bladder habits

• chemotherapeutic agents instilled into bladder 
• bacille calmette-guerin vaccine prevents recurring tumors
• photodynamic therapy

• urinary diversion; 6 - 8 in. section of ileum or colon used to drain urine
• contains mucus and pt must wear an ostomy bag at all times

dull pain the flank area, mass in the area, hematuria

• multiple cysts form in the kidney and replace normal kidney structures
• no treatment to stop it
• hereditary

• most common cause of chronic kidney disease
• complication of diabetes, damages blood vessels in kidneys

htn, genes, smoking, chronic hyperglycemia

• microalbuminuria advancing to proteinuria
• leads to chronic kidney disease

• excretion of 3.5g or more of protein in the urine per day
• low levels of protein cause ascites and widespread edema
• sodium intake is restricted and pt is on a low to moderate protein diet

• hypertension damages the kidneys
• damaged blood vessels cause necrosis
• treating the htn stops the damage

• glomerulus is inflammed and proteins, wbc and rbc leak into  urine
• associated with beta-hemolytic streptoccocal infection of throat or skin
• edema, oliguria and htn develop
• usually happens 6 - 10 days after infection