Name of the teacher : Mrs. M.

Hindu Bai
Programme : III Semester
Subject : ADULT HEALTH NURSING – II
Unit : III
Topic : Nursing Management of Patients with Kidney and Urinary System Disorders
Duration : 15 hrs.
Venue : III SEME batch class room
Previous knowledge : students have knowledge on Anatomy & Physiology of G.U. System
Method of teaching : Power point presentation
Discussion
MCQs
Class room discussion
GENERAL OBJECTIVES: At the end of the topic students will be able to gain indepth knowledge about Kidney and Urinary
System Disorders and will develop desirable skills and attitude in maintaining and monitoring of G.U System disorders in clinical and
community settings.

Specific objectives: The students will be able to

 Discuss regarding Review of Anatomy and physiology of the genitourinary system
 Describe about History, physical assessment, diagnostic tests
 Explain Urinary tract infections: acute, chronic, lower, upper
 Explain Nephritis, nephrotic syndrome
 Identify Renal calculi
 Discuss about Acute and chronic renal failure
 Enumerate about disorders of ureter, urinary bladder and Urethra
 Disorders of prostate: inflammation, infection, stricture, obstruction, and Benign Prostate Hypertrophy
S.No. Time Objectives Content Teaching & Learning Evaluation
Activity
1 30 mints Students will be able Introduction
to tell the Discuss regarding Review of Anatomy and physiology of the genitourinary
system Lecture cum discussion
What are all the
⁎ Anatomy arteries to be supplied
⁎ Relationship of organs blood to the kidney?
⁎ Blood supply
⁎ Physiology of genitourinary system
⁎ Applied anatomy

History, physical assessment, diagnostic tests:

⁎ Inquire about other family members with renal and/or urinary tract
malformations.
2 2 hrs. Describe about ⁎ Ask about family history of kidney disease with onset in third to fifth Lecture and videos Define cystography?
History, physical decade (polycystic kidney, autosomal dominant gene).
assessment, ⁎ Identify family history of male infertility and cystic fibrosis (congenital
diagnostic tests absence of vas deferens).
⁎ Be alert for family members with history of early-onset renal (Wilms’
tumor) or other cancers.
⁎ The patient’s chief concern or reason for seeking health care, the onset
of the problem, and its effect on the patient’s quality of life
⁎ The location, character, and duration of pain, if present, and its
relationship to voiding; factors that precipitate pain, and those that
relieve it
⁎ History of urinary tract infections, including past treatment or
hospitalization for urinary tract infection, Fever or chills
⁎ Previous renal or urinary diagnostic tests or use of indwelling urinary
catheter
⁎ Physical examination: pain, changes in voiding, frequency Urgency
Dysuria Hesitancy Nocturia Incontinence Enuresis Polyuria Oliguria
Anuria Hematuria Proteinuria, gastrointestinal system symptoms.

⁎ Special diagnostic findings: Renal Function Tests, X-Ray Films and Demonstration
Other Imaging Modalities Kidney, Ureter, and Bladder Studies,
General Ultrasonography, Bladder Ultrasonography, Computed
Tomography and Magnetic Resonance Imaging, Nuclear Scans,
 Intravenous Urography, Retrograde Pyelography, Cystography, Voiding Videos
Cystourethrography, renal angiography, urologic endoscopic
procedures, BIOPSY Renal and Ureteral Brush Biopsy, Kidney Biopsy,
Urodynamic Tests, Uroflowmetry & Cystometrography.

Urinary tract infections: acute, chronic, lower, upper: Patients with

disorders of the upper or lower urinary tract often exhibit similar problems,
regardless of the underlying disorder. This chapter provides an overview of
common problems that these patients experience, such as fluid and
3 1 hr. electrolyte imbalances and dysfunctional voiding patterns. Discussion and videos List out any 3 upper
Explain urinary tract ⁎ Introduction urinary tract
infections ⁎ Definitions infections?
⁎ Incidence
⁎ Types
⁎ Etiological factors
⁎ Risk factors
⁎ Pathophysiology
⁎ Clinical features
⁎ Diagnostic findings
⁎ Medical Management
⁎ Nursing management
⁎ complications

Nephritis
⁎ Introduction

⁎ Definitions
4. 2 hrs. Lecture cum discussion Define nephritis?
Explain in detail ⁎ Incidence
about nephritis,
nephrotic syndrome.
⁎ Types

⁎ Etiological factors

⁎ Risk factors
 ⁎ Pathophysiology

⁎ Clinical features Lecture cum discussion

⁎ Diagnostic findings

⁎ Medical Management

⁎ Nursing management

⁎ Complications

Nephrotic Syndrome

⁎ Introduction
Videos and discussion List the types of renal
5. 1hr. ⁎ Definitions calculi?
Identify about renal
calculi ⁎ Incidence

⁎ Etiological factors

⁎ Risk factors

⁎ Pathophysiology

⁎ Clinical features

⁎ Diagnostic findings

six. 2 hrs. ⁎ Medical Management Lecture cum discussion Enlist the indications
Discuss about Acute of hemodialysis?
and Chronic renal ⁎ Nursing management
failure
⁎ Complications
 ⁎ Nursing diagnosis

Renal Calculi

⁎ Introduction

7. 3 hrs. ⁎ Definitions
Enumerate about Lecture cum Discussion List any 4 disorders of
disorders of ureter, ⁎ Incidence ureter, urinary bladder
urinary bladder and videos and urethra?
Urethra ⁎ Etiological factors

⁎ Risk factors

⁎ Pathophysiology

⁎ Clinical features

⁎ Diagnostic findings

⁎ Medical Management

8. 3 hrs. ⁎ Nursing management

Discuss regarding Lecture cum discussion Differentiate between
Disorders of Hydrocele and
⁎ Complications
prostate: varicocele?
inflammation,
infection, stricture, ⁎ Nursing diagnosis
obstruction, and
Benign Prostate Acute and chronic renal failure
Hypertrophy: ⁎ Introduction

⁎ Definitions

⁎ Incidence
 ⁎ Etiological factors

⁎ Risk factors

⁎ Pathophysiology

⁎ Clinical features

⁎ Diagnostic findings

⁎ Medical Management

⁎ Nursing management

⁎ Complications

⁎ Nursing diagnosis

Disorders of ureter, urinary bladder and Urethra

⁎ UTI
⁎ Cystitis
⁎ Urinary incontinence
⁎ Urinary retention
⁎ Urinary reflux
⁎ Bladder neoplasm
⁎ Urinary bladder calculi
⁎ Urethritis
⁎ Urethral tumors
⁎ Urethritis’
⁎ Ureteral calculi
⁎ Trauma of Ureters, bladder, urethra
⁎ Neoplasm of ureters, bladder and urethra
⁎ Congenital disorders of ureters, bladder and urethra

Disorders of prostate: inflammation, infection, stricture, obstruction,

and Benign Prostate Hypertrophy:
Acute uncomplicated cystitis in adult men is uncommon but occasionally
 occurs in men whose sexual partners have vaginal infections with
Escherichia coli. Asymptomatic bacteriuria may also occur from
genitourinary manipulation, catheterization, or instrumentation. The
incidence of sexually transmitted diseases (STDs) is increasing in men and
women. STDs are most common in young, sexually active people, with the
incidence higher in men than women.
⁎ Prostatitis
⁎ Benign Prostatic Hyperplasia (Enlarged Prostate)
⁎ Cancer of the prostate
⁎ Conditions Affecting the Testes and Adjacent Structures:
Undescended Testis (Cryptorchidism), orchitis, epididymitis,
testicular cancer, hydrocele, vasectomy, varicocele,
⁎ Conditions Affecting the Penis: Phimosis, Cancer of The Penis,
Priapism, Peyronie’s Disease, Urethral Stricture & Circumcision

ESSAY QUESTIONS: (15 Marks)

1. a. Define Glomerulonephritis
b. Explain the causes and pathophysiology of glomerulonephritis
c. Discuss in detail about nursing management of patient with glomerulonephritis
2. a. Define Renal Failure
b. causes, pathophysiology and clinical manifestations of patient with acute renal failure
c. Explain in detail about nursing management patient with acute renal failure
3. a. Define Nephrotic syndrome
b. Causes and clinical manifestations of nephrotic syndrome
c. Pathophysiology and complications of nephrotic syndrome
d. Nursing care of patient with nephrotic syndrome
4. a. define Renal calculi
b. list the types and clinical manifestations of renal calculi
 c. Discuss regarding surgical management of renal calculi
d. nursing care of patient with renal calculi
5. a. Define Chronic Renal Failure
b. causes, pathophysiology and clinical manifestations of patient with chronic renal failure
c. Explain in detail about medical & nursing management patient with acute renal failure

SHORT QUESTIONS: (2Marks)

1. Dialysis
2. Hemodialysis
3. Nephrotic syndrome.
4. Renal calculi.
5. UTI
6. Cystitis
7. Hydrocele
8. Prostatitis
9. Benign Prostatic Hyperplasia (Enlarged Prostate)
10. Cancer of the prostate
11. Renal transplantation
12. Principles of dialysis

BRIEF QUESTIONS: (5marks)

1. List out any 4 causes of Acute Renal failure.
2. define Urinary incontinence.
3. enumerate differentiation between hemo and peritoneal Dialysis.
4. Enlist any 5 clinical manifestations of Nephrotic syndrome.
5. What is Priapism
6. what is Peyronie’s Disease
7. Define Urethral Stricture
8. Define Circumcision
9. Enlist the differentiation between Urinary incontinence and Urinary retention

10. what is Urethritis

11. Describe any 3 conditions which is Affecting the Testes

STUDENTS ASSIGNMENTS:

1. Describe the physiology of genitourinary system

2. Write about positive and negative feedback mechanism of filtration of urine
3. Write about diagnostic findings of G.U. System disorders: Intravenous Urography, Retrograde Pyelography, Cystography,
Voiding Cystourethrography, renal angiography, Uroflowmetry & Cystometrography
4. draw the picture of hemodialysis
5. write in detail about eligible criteria for renal transplantation donor and recipient
 6. procedure of Renal Biopsy

MCQs

1. The last part of a nephron is the _____.

A) Collecting Duct
B) Renal papilla
C) Distal convoluted tubule
D) Glomerulus

2. Which area actually secretes renin into the blood?

A) Macula densa
B) Juxtaglomerular apparatus
C) Juxtaglomerular cells
D) Cortical nephron

3. Which blood vessel conveys blood out of the nephron?

A) Efferent arteriole
B) Vasa recta
C) Peritubular capillary
D) Interlobular vein
4. Which blood vessels surround the loops of Henle?

A) Vasa recta
B) Peritubular capillaries
C) Interlobular arteries
D) Efferent arterioles

5. Which of the following are not found in the glomerular filtrate?

A) Glucose
B) Protein
C) Uric acid
D) Creatinine

6. Which muscle metabolism waste product is eliminated by the kidneys?

A) Urea
B) Uric acid
C) Creatine
D) Creatinine

7. Which of these has the highest concentration in the urine?

A) Glucose
B) Sodium
C) Uric acid
D) Phosphate

8. Which ion is reabsorbed in exchange for sodium?

A) Chloride
B) Potassium
C) Calcium
D) Magnesium

9. What is the average glomerular filtration rate?

A) 10 L per day
B) 180 L per day
C) 1,500 ml per day
D) 1 ml per minute

10. Which of the following is usually not found in the urine?

A) Magnesium
B) Urea
C) Uric acid
D) Glucose

11. How much urine is formed in 24 hours?

A) 12 liters
B) 100 ml
C) 1.5 L
D) 3,000 cc

12. Renin acts on _____ to convert it to angiotensin I.

A) Angiotensin II
B) Angiotensinogen
C) ACE
D) Aldosterone

13. in which one of the following types of glomerulonephritis is the serum C3 level characteristically normal?

a. early acute- streptococcal nephritis

b. active systemic lupus erythematous nephritis

c. minimal change nephropathy.

d. membranoproliferative glomerulonephritis type II

14. which one of the following is the commonest cause of the nephrotic syndrome in children?

a. Henoch – Schonlein nephritis

b. minimal-change nephropathy

c. membranoproliferative glomerulonephritis

d. acute post streptococcal glomerulonephritis

15. which one of the following conditions does not typically lead to rapidly progressive glomerulonephritis (RPGN)

a. good pasture’s syndrome

b. membranous glomerulonephritis

c. nephritis of granulomatosis with polyangiitis (formerly Wegener’s granulomatosis)

d. SLE
16. following cadaveric renal transplantation, which one of the following condition is most likely to be associated with recurrence of
glomerulonephritis in the allograft

a. Minimal-change nephropathy
b. membranoproliferative glomerulonephritis type II
c. Henoch-Schonlein nephritis
d. Polycystic kidney disease