URINARY SYSTEM

URINARY SYSTEM

NATURAL AGING CHANGES WITH THE ELDERLY

• Decreased kidney size-- less ability to get rid of waste

• Loss of smooth muscle tone--incontinence • Decreased blood flow—less ability for kidneys to filter • Difficulty emptying bladder—prone to UTIs 

 • What implications do these changes have on the

elderly resident? What might you anticipate with the elderly?

1. Increase risk of infection2. Incontinence3. UTI

FUNCTIONS OF URINARY SYSTEM

• 1. Remove waste through urine

• 2. Maintain fluid & electrolyte balance

• 3. Manage and balance chemistry of blood

ORGANS OF THE URINARY SYSTEM

Ureters- Connect kidney to bladder; 10-12 inches long, carry urineBladder- Stores urineUrethra- Tube that carries urine from bladder to outside of body.

females: 1 ½ inchesmales: 6-8 inches

Urinary meatus- outside of body; where urine is excreted outKidneys- Filtering organs that produce urine

WHO IS MORE AT RISK FOR INFECTION?

Think about this in terms of UTI for elderly…who is more at risk??? Male or Female???

KIDNEYS

• Kidneys: Bean shaped organs located in RETROPERITONEAL cavity. Filtering organs that produce urine.

 

INSIDE THE KIDNEY…

 Nephron-Functional unit of kidney, more than a million in each kidney, filters blood and removes waste. Located in cortex of kidney

Glomerulus-Coil of capillaries w/in nephron. Lies w/in Bowman’s capsule  Bowman’s Capsule-Encloses glomerulus; site of filtration

FORMATION OF URINE

Urine is secreted by the kidneys, stored in the bladder, and excreted through the urethra. Urine formation is the complex process that cleans the blood of unnecessary substances while selectively reabsorbing other essential material.

What are the essential materials?

FACTS ABOUT URINE

Normal urine is acidic and pale to

deep yellowDilute urine has more water and fewer

dissolved substances, so it is colorless to pale yellow

Concentrated urine has less water and more dissolved substances, so it is darker in color and has a stronger odor

SPEAKING ABOUT URINE….

Let’s learn the medical word for urinating….

VOIDVOIDEDVOIDING

HOMEOSTASIS

Body’s attempt to keep its internal environment (temp, BP, fluid balance) stable or in balance. The urinary system determines the content of tissue fluid (watery environment around the cell).

Specifically, waste products are removed, and fluids, electrolytes, blood pressure and pH (acid balance) are regulated to help the body maintain its normal state. The urinary system is responsible to maintain the fluid homeostasis of the body.

WHAT COLOR URINE WOULD YOU EXPECT TO SEE WITH……

•DEHYDRATION?

•EDEMA???

FLUID BALANCE AND FLUID IMBALANCE

Fluid Balance- same amount of fluid is taken in by the body that is excreted by the body

Fluid Imbalance- occurs when the bodyKeeps or retains too much fluid ORWhen the body loses too much fluid.

DEHYDRATION/EDEMA

DEHYDRATION

A decrease in the amount of water in the tissues. Occurs when fluid output exceeds input or intake.Fluid can be lost by:Vomiting, bleeding, diarrhea, too much urination (polyuria)

EDEMA

Abnormal swelling of a body part caused by fluid collecting in that area; usually extremities

FLUID IMBALANCE

DEHYDRATIONCauses:Fever, decreased fluid intake, abnormal loss of fluid/blood, diseaseS&S: dry membranes, coated tongue, low BP, low UO, wt. loss

EDEMACauses:Heart disease, CHF, kidney disease, infections, immobility, burns, increased saltS&S: edema, SOB, wt. gain, low UO

NURSING INTERVENTIONS

DEHYDRATIONWater @ bedsideAccurate I&OOffer fluidsCheck weightCheck VS

EDEMAAvoid tight shoesElevate legsCheck extremitiesAccurate I&OCheck weightCheck VS

3 STEPS OF URINE FORMATION

Step 1: Glomerular Filtration:• Urine formation starts. Filtering of blood. The filtrate

contains essential and nonessential materials. These waste products, helpful products, and water are filtered through the capillary walls of the glomerulus into Bowman’s capsule, forming a liquid called FILTRATE.

Step 2: Tubular Reabsorption:• Taking back water and essential materials that the body

needs. Moves it out of the filtrate and into the blood. 99% is reabsorbed back into the blood.

Step 3: Tubular Secretion:• Moves non essential material out of blood and into filtrate

for excretion out of the kidneys. The urine, containing wastes, is now passed out of the kidney and into the ureter.

URINE FORMATION