Urinary System

CNA2-Core & AcuteOSBN Curriculum

http://www.medcomrn.com/dev/flash/flvplayer/movie.php?movie=http://ss1.medcomrn.com/flv/78722r_sec01_300k.flv&title=&detectflash=false&detectflash=false=false

Rid the Body of Liquid Waste: Urine Regulate

◦Body’s Fluid Balance◦Blood Pressure◦Filter Waste Products

System◦Kidneys◦Ureters◦Bladder◦Urethra

Anatomy & Physiology

Normal: Light Yellow/Clear Straw

◦ Dilute Amber

◦ Low Fluid Intake Cloudy

◦ Infection Orange-Red to Brownish

◦ Jaundice Green-Brown

◦ Bile Obstruction Dark Brown

◦ Acute Renal Failure

Urine

Ureterostomy Small Intestine Stoma Created Suprapubic Catheter Pt. no Longer has Voluntary Control

Bladder Diversions

Elevated TempLeaking of PouchStoma should be Pink Irritation

◦Skin/StomaUrine Cloudy

Observation & Reporting

Report Abnormals to NurseUrine Drainage Bag below Bladder

Accurate I&OEncourage PO Fluids

CNA2 Actions

Kidney StonesTreatment

◦Pass Stone◦Lithotripsy◦High-Energy Shock◦Ureteroscopy◦Stent◦Open Surgical Procedure

Renal Calculi

Sudden/Severe Flank Pain Bloody Urine Nausea Urination

◦ Burning◦ Difficulty

Fever

Observation & Reporting

Report Abnormals to Nurse Strain ALL Urine Pain Observations & Rating Accurate I&O General Post-Op Care

CNA2 Actions

Severely Impaired Renal Function Waste Products not Removed Fluids Retained HTN and HF Acute or Chronic Can be Life Threatening

Renal Failure

Acute: ARF◦Occurs Suddenly◦Decreased Bld Flow to Kidneys

Chronic: CRF or Chronic Kidney Disease: CKD

◦ Kidneys Cannot Meet Bodies Needs◦ Kidneys Slowly Destroyed

Treatment◦ Dialysis

Hemodialysis Peritoneal

Acute vs. Chronic

Decreased UOPEdema: Ankle/Feet/LegsDecreased AppetiteNauseaMental Status ChangesFlank Pain Jaundice

Observation & Reporting

Report Abnormals to Nurse Frequent Oral Hygiene Accurate I&O Daily Weights Low Protein/Potassium Diet No BPs on Fistula Arm

CNA2 Actions

Urinary Tract Infection: UTI Bladder Infection Bacterial Cause Women > Men

Pyelonephritis Kidney Infection Can be Serious Ureters Carry Bacteria between Kidneys & Bladder

Infections

UTI◦Burning/Frequency/Urgency◦Cloudy/bloody Urine

Pyelonephritis◦ Elevated Temp◦ Flank Pain

Elderly◦ No Fever/Symptoms◦ Acute Onset Confusion

Observation & Reporting

Report Abnormals to NurseEncourage PO FluidsAccurate I&O If Foley Disconnects

◦Call Nurse STAT

CNA 2 Actions

Infection/Inflammation ProstateNarrow UrethraBlock Bladder NeckTreated w/Antibiotics

Prostatitis

Burning/Pain on UrinationDifficulty UrinatingPain

◦Low Back◦Abd

FeverChills

Observation & Reporting

Report Abnormals to NurseObserve PainAccurate I&OEncourage PO Fluids

CNA 2 Actions

Benign Prostatic Hyperplasia

B P H

Transurethral Resection of the Prostrate

TURP

Surgical Removal of the ProstateRobotic Transurethral

Prostatectomy

Urine Reddish-Pink 1st 24HrsFever/ChillsPain Incision

◦Draining◦Painful◦Red

Excessive BleedingAbnormal VS

Observation & Reporting

Continuous Bladder Irrigation

Report Abnormals to NurseMonitor VSReport PainPeri-Care/Cath CareFoley Cath PrecautionsEmotional SupportGeneral Post-Op Care

CNA 2 Actions

CNA 2 Actions3-Way Foley Catheter

◦W/continuous bladder irrigation (CBI)Accurate I&OPain: Bladder spasmReport signs of infectionAvoid Straining

I&O w/CBI1400: 3000ml1600: 850 UOP from f/c1830: 1100 UOP from f/c2100: 750 UOP from f/c2100: 1500 LTC for next shiftWhat is the 8hr UOP?

http://www.youtube.com/watch?v=PIctPwk-FFU

BioCon-500 Scanner

Siemens Multistix 10 SG /www.youtube.com/watch?v=ubFsVU1EIis

Urine Dipstick

How to remove fc◦https://www.youtube.com/watch?v=8mXj

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  fc tape & urometer

◦https://www.youtube.com/watch?v=Fs3eHmTpTXU

fc specimen collection◦https://www.youtube.com/watch?v=ya3E

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Foley Catheter Skills

This project was funded $3,000,000 (100% of its total cost) from a grant awarded under the Trade Adjustment Assistance Community College and Career Training Grants, as implemented by the U.S. Department of Labor’s Employment and Training Administration. Rogue Community College is an equal opportunity employer/program. Auxiliary aids and services, alternate form and language services are available to individuals with disabilities and limited English proficiency free of cost upon request.

This work is licensed under a Creative Commons Attribution 4.0 International License.