Fall 2007TITLE: Nursing Strategies: Alterations of Renal/Urinary FunctionALTERATIONS OF RENAL/URINARY FUNCTION STUDY GUIDELincoln Memorial UniversityCaylor School of NursingNursing 241Fall 2007TITLE: Nursing Strategies: Alterations of Renal/Urinary Function DATES: See SyllabusTIMES: See SyllabusOBJECTIVES: Upon completion of this unit, the student should be able to demonstrate, in the clinical/campus laboratory setting, in individual and group conferences, and on written material, the ability to: 1. Review the anatomy and physiology of the renal and urinary systems.2. Define and use the glossary terms as listed in the assigned readings.3. Using the four adaptive modes of Roy’s Adaptation Model (RAM), recognize human adaptive responses to behavior or stimuli that affect Renal/Urinary function.4. Identify common signs and symptoms of compromised body fluids that pose potential problems for adults with renal disease.5. Utilize the RAM nursing process to provide care for the adult who is experiencing any of the following common disorders of the Renal/Urinary system:- Inflammatory disorders- Vascular/obstructive disorders- Genitourinary trauma- Genitourinary cancer- Renal failure 6. Discuss the psychosocial impact of bladder cancer and adaptation to a urinary diversion system. 7. Define both acute and chronic renal failure and state the most common causes, clinical manifestations and nursing management. 8. Differentiate between the oliguric and diuretic phases of acute renal failure. 9. Identify appropriate community agencies and resources available for patients/families in renal failure.10. Discuss the treatment options for the adult in chronic renal failure (CRF).11. Discuss the psychosocial problems encountered by the dialysis patient and family.12. Recognize indications for use, including advantages and disadvantages, for peritoneal dialysis, continuous ambulatory peritoneal dialysis, continuous cycle peritoneal dialysis and hemodialysis. 13. Utilize the RAM nursing process to provide care for adults undergoing peritoneal dialysis, continuous ambulatory peritoneal dialysis, continuous cycle peritoneal dialysis and hemodialysis. 14. Recognize and identify different dialysis access devices; i. e. shunt, fistulas.15. Discuss dietary restrictions imposed on the patient in chronic renal failure and develop a teaching plan for a patient on a "renal diet".16. Discuss preoperative and postoperative goals and nursing care for adults undergoing kidney surgery. 17. Describe the role of the nurse in the pre- and postoperative management of a patient undergoing kidney transplantation.118. Discuss the role of the nurse in organ procurement.19. Identify different types and treatment of erectile dysfunctions.20. Utilize the nursing process to plan care for the patient undergoing prostatectomy. 21. List the advantages and disadvantages of the four types of prostatectomy: transurethral, suprapubic, retropubic, perineal. 22. Identify and discuss clinical manifestations of testicular cancer and identify nursing care. 23. Define and explain the terms on the vocabulary list.24. Identify the medications on the drug list by generic name, classification, mechanism of action, clinically significant side effects, normal dosage and nursing implications and be able to correctly calculate IV, IM and oral dosages.CLINICAL OBJECTIVES:Upon completion of this unit, the student should be able to: 1. Use assessment parameters to determine the status of renal and urinary function. 2. Discuss the procedure for the various types of urine collection. 3. Adequately prepare and assess the patient for radiologic tests and endourologic procedures of renal and urinary function. 4. Adequately prepare, maintain and assess patients with catheters and closed urinary drainage systems. 5. Assess patients for risk factors related to the development of urinary tract infections.TOPICAL OUTLINE:I. Nursing care of adults with common disorders of the urinary tract and kidneysA. Inflammatory Disorders1. Acute pyelonephritis2. Chronic pyelonephritis3. Interstitial cystitisB. Vascular/Obstructive Disorders1. Nephrosclerosis2. Renal cysts (Polycystic Disease) C. Genitourinary Trauma1. Renal trauma2. Ureteral trauma3. Bladder trauma4. Urethral trauma D. Genitourinary Cancer1. Renal cancer2. Bladder cancer E. Renal Failure 1. Acute renal failure2. Chronic renal failureII. Nursing process and management of adults with urinary and renal dysfunction2A. Dialysis1. Hemodialysis2. Peritoneal dialysis B. Kidney SurgeryC. Kidney Transplantation1. Preoperative management2. Postoperative management III. Nursing care of adults with common disorders of the male genitourinary systemA. Assessment and Diagnostic Evaluation B. Erectile dysfunctionsC. Conditions of the Prostate 1. Prostatitis2. Benign prostatic hyperplasia (BPH) 3. Cancer of the prostate D. Testicular Cancer E. Penile CancerREQUIRED READINGS:Smeltzer, S. and Bare, B. (2008). Brunner & Suddarth’s Medical surgical nursing. (11th ed.). Philadelphia: Lippincott. Ch. 43 (pp. 1492-1513), 44 (pp. 1514-1517, 1521-1568), 45 (pp. 1577-1578, 1596-1609), 49 (pp. 1739-1779).CLINICAL SKILLS: 1. Provide suprapubic catheter care. 2. Care for a patient with a urinary diversion device. 3. Manage nursing care of patient on peritoneal dialysis. 4. Prepare patient for hemodialysis. 5. Care for a patient with continuous bladder irrigation (CBI). 6. Care for a patient undergoing renal or prostatic surgery. 7. Utilize the nursing process to develop a plan of care for a patient with an alteration in fluid volume. 8. Administer medications related to urinary and renal systems. 9. Monitor the circulatory accesses utilized for hemodialysis.10. Monitor and appropriately initiate intake and output, urinary output and specific gravity.DRUG LIST3Antibiotics: Immunosuppressants:4(trimethoprim-sulfamethoxazole) TMP-SMZ, (corticosteroids) Prednisone Bactrim, Septra (cyclosporine) Sandimmune, Neoral(ciorofloxacin) Cipro (tacrolimus) Prograf(gentamicin) Garamycin (mycophenolate