urinary elimination

• It is the last step in the removal and elimination of excess water and byproducts of body metabolism

  urinary elimination
• Filter waste product of metabolism from the blood

  kidney
• kidney is a size of a fist
• The functional unit of the kidneys

  nephron
• Where urine is formed

  nephron
• The normal range of urine production is 1 to 2 L per day and 30 mL of urine per hour
• • Each nephron contains a cluster of capillaries called the glomerulus.
• filters water, glucose, amino acids, urea, uric acid, creatinine, and major electrolytes

  glomerulus
• produced by the kidneys, stimulates red blood cell production and maturation in bone marrow

  erythropoietin
• is attached to each kidney pelvis and carries urinary waste to the bladder

  ureter
• • is a hollow, distensible, muscular organ
  • Holds urine until the volume in the bladder triggers a sensation of urge indicating the need to pass urine 

  bladder
• In males the bladder rests against the rectum, and in females it rests against the anterior wall of the uterus and vagina.
• two parts of the bladder

  • Trigone – a fixed base
  • Detrusor –  a distensible body 
• Urine travels from the bladder through the urethra and passes to the outside of the body through the urethral meatus
• urethra passes through a thick layer of skeletal muscles called the pelvic floor muscles.
• stabilize the urethra and contribute to urinary continence

  pelvic floor muscles
• Urination, micturition, and voiding are all terms that describe the process of bladder emptying
• ccurs when the brain gives the bladder permission to empty, the bladder contracts, the urinary sphincter relaxes and urine leaves the body through the Urethra

  micturation
• Children cannot voluntarily control voiding until age 18 to 24 months
• If sugar combined with blood and it pass through nephron, then it can be destroyed
• is the inability to empty the bladder partially or completely

  urinary retention
• • Involuntary leakage of urine
  • defined as the “complaint of any involuntary loss of urine”

  urinary incontinence
• two types of urinary diversion

  continent urinary reservoir

  orthotopic neobladder
• • which is created from a distal part of the ileum and proximal part of the colon. The ureters are embedded into the reservoir.

  continent urinary reservoir
• • which uses an ilea pouch to replace the bladder.

  orthotopic bladder
• is the amount of urine left in the bladder after voiding and is measured with either ultrasonography or straight catheterization

  postvoid residual (PVR)
• is a permanent incontinent urinary diversion created by transplanting the ureters into a closed-off part of the intestinal ileum and bringing the other end out onto the abdominal wall, forming a stoma

  Ureterostomy or ileal conduit
• • small tubes that are tunneled through the skin into the renal pelvis.
  • These tubes are placed to drain the renal pelvis when the ureter is obstructed.

  Nephrostomy tubes
• Immediate and strong desire to urinate

  urgency
• • Pain or discomfort in voiding

  dysuria
• • Voiding more than 8 times during walking hours or less than every 2 hours


  frequency
• • Delay in start of voiding


  hesitancy
• voiding excessive amount of urine

  polyuria
• diminished urinary output


  oliguria
• Awakened from being sleep due to the urge

  nocturia
• Leakage of small amount of urine

  dribbling
• Blood in urine


  hematuria
• • Unable to void 
  • Acute or chronic

  retention
• Children who wet the bed at night without waking from sleep have what is called nocturnal enuresis
• placement of a tube through the urethra into the bladder to drain urine

  urinary catheterization