Incontinence Retention

Loss of voluntary control of bladder Inability to empty bladder

Stress incontinence May accompany with overflow incontinence
-Increase in intra-abdominal pressure /occur after anesthesia
-Forces urine through the sphincter Spinal cord injury at the sacral level
Laughing, Coughing, Females weakened -Catheter: tube inserted in urethra
Spinal cord injuries, brain damage --Drains urine from bladder to collecting bag
Common source of UTI
Urinalysis
Constituents, characteristics of urine vary with dietary intake, drugs, care of specimen
Normally clear, straw-colored; pH 4.5-8.0
Abnormal Cloudy large amounts protein, blood cells, bacteria, pus
appearance Dark color Hematuria (blood), excessive bilirubin, high
concentration of urine
Unpleasant, unusual odor infection
Abnormal Blood (hematuria) Small, microscopic amounts: Infection, inflammation,
constituents tumors of UT
(high in Large no. of RBC: Increased glomerular permeability or
numbers) hemorrhage in tract
Protein (Proteinuria) Leakage of albumin into the filtrate
Inflammation, increased glomerular permeability
Bacteria (Bacteriuria) Indicates UTI
Pus (Pyuria)
Urinary casts Microscopic mold of tubules: 1+ cells, bacteria, protein
Inflammation of tubules
Specific gravity Ability of tubules to concentrate urine
Low = renal failure
Blood tests
High serum urea (BUN) & Indicate failure to excrete nitrogen wastes due to low GFR
creatinine
Metabolic acidosis Indicates low GFR, failure of tubules to control acid/base balance
Anemia Indicates low erythropoietin secretion and/or bone marrow depression
Due to accumulating wastes
Antibody level Antistreptolysin O (ASO) or antistreptokinase (ASK)
-Use to diagnose the poststreptococcal glomerulonephritis
Renin level Indicates a cause of hypertension
Other test
Culture and sensitivity tests Urine specimens: identify organism and select drug treatment
Clearance tests used to asses GFR
creatinine, insulin clearance
Radiologic tests used to visualize structures and abnormalities
 Intravenous pyelography (IVP)
 Angiography
 Ultrasound
 CT, MRI
Cytoscopy visualize lower UT
Can be used to perform biopsy or remove kidney stones
Biopsy Acquire tissue specimen for microscopic analysis
Dialysis Provides “artificial kidney”
-Sustains life after kidney fails
For acute renal failure or end-stage renal failure (those waiting for a transplant)
Two forms: Hemodialysis & Peritoneal dialysis
Urinary Tract Infections (UTI)
Urine: excellent medium for microorganismal growth (e.g. Escherichia coli)
-ascending: Perineal cavity  mucosa  bladder  ureters  kidneys
etiology female Proximity to anus
 Short urethra
Frequent irritation to tissues: bubble bath, sexual activity
Older male with prostatic hypertrophy and retention of urine prone to UTI
-Male reproductive tract shares some of the structures of the urinary tract
Children Congenital abnormalities
Elderly Incomplete emptying
Reduced fluid intake
Impaired blood supply to bladder
Immobility