Intermediate Content Teaching-Learning Activities

Competencies Classroom RLE

Given an adult client ELIMINATION PATTERNS

(young, middle, old, old- Responses to Altered Urinary Elimination
old adult) with altered
urinary elimination I. REVIEW OF ANATOMY, PHYSIOLOGY
patterns, the students will AND FUNCTIONS OF THE URINARY
be able to: SYSTEM
Cultural and Ethic Disparities:
A. apply knowledge of II. NURSING PROCESS - Urologic Disorders
normal urinary - Chronic Kidney Disease
elimination A. ASSESSMENT
patterns and 1. Nursing History Evidence-Based Practice:
assessment a. Subjective Data - Are prophylactic antibiotics
techniques in • General manifestations: effective for recurrent UTI?
caring for clients fatigue, headaches, blurred vision,
elevated BP, anorexia, nausea and
B. assess the health vomiting, chills, itching, excessive thirst,
status of the client: change in body weight, cognitive Gender Difference:
changes - Urinary Calculi
1. conduct a health • Edema - Urinary Incontinence
history and • Pain
functional health • Change in the patterns of urination,
status of clients urine output and urine composition Ethical Dilemmas:
having or at risk for - Payment for Organs
altered urinary 2. Functional Health Patterns - Allocation of Resources
elimination a. Objective Data - Withdrawing Treatments
patterns a.1. Physical Assessment
• Percussion of the kidneys
2. perform systematic
• Palpation of the kidneys
and
comprehensive
a.2. Urinary Assessment
physical
assessment to • Skin assessment
validate assessed • Abdominal assessment
• Urinary meatus assessment
 data • Kidney assessment
• Bladder assessment

a.3. Diagnostic and Laboratory Tests

• Non-invasive tests
- KUB
3. interpret deviations - IVP
from normal - Renal Ultrasound
findings in the - Computerized Tomography
physical - Magnetic Resonance Imaging
assessment, • Invasive Tests
diagnostic and - Transurethral Biopsy
laboratory - Transrectal Biopsy
examinations - Endoscopy

a.4. Laboratory Tests

• Urine Studies
• Blood Studies
• Serum Creatinine
• Creatinine Clearance

B. ANALYSIS/NURSING DIAGNOSIS

1. Impaired Urinary Elimination as

4. utilize the evidenced by frequency, urgency,
assessed data in hesitancy, dysuria and nocturia
order to: 2. Urge Urinary Incontinence as evidenced
by frequency, urgency, loss of urine
4.1. prioritize before reaching toilet, and voiding in
nursing diagnosis small or large amounts
3. Urinary Retention as evidenced by
4.2. discuss the sensation of bladder fullness, dribbling
patho-physiologic urine, dysuria and bladder retention
processes 4. Stress Urinary Incontinence as
evidenced by dribbling urine with
increased abdominal pressure, urinary
 urgency, and urinary frequency
5. Acute Pain (Cognitive-Perceptual)
6. Ineffective Health Maintenance (Health-
Perception – Health-Management)

C. PLANNING
1. Planning for Health Promotion
a. Promoting urinary elimination
b. Preventing urinary tract infections
c. Managing risks such as renal calculi
and hypertension

2. Planning for Health Maintenance and

Restoration
a. Catheters
1. Types – urethral, nephrostomy,
ureteral, suprapubic
2. System – intermittent and
intermittent self-catheterization,
exdwelling drainage systems
b. Urologic Surgery
• Nephrotomy
• Nephrectomy
• Pyelotomy
• Ureterotomy
• Cystotomy
• Cystectomy
• Lithoytipsy
• Extracorporeal renal surgery
• Percutaneous nephrostomy
• Urinary diversion
• Renal transplantation
• Dialysis
 Nursing Care of Clients with Urinary Elimination
Disorders

A. Urinary Tract Disorders

1. Urinary Tract Infection
2. Urinary Calculi
3. Urinary Tract Tumor
4. Urinary Retention
5. Neurogenic Bladder
6. Urinary Incontinence

B. Kidney Disorders
1. Glomerular Disorders
a. Glomerulonephritis
b. Nephrotic Syndrome
2. Vascular Kidney Disorder
3. Kidney Trauma
4. Renal Failure
5. implement
individualized D. IMPLEMENTATION
nursing care: 1. Pharmacological Therapies
a. Diuretics
5.1. safely and b. Medications for Gout
knowledgeably c. Antispasmodics
administers d. Cholinergics
prescribed e. Analgesics
medications and f. Alpha-Blockers
treatments, 2. Complementary Alternative Medications
a. Biofeedback for Urinary incontinence
5.2. actively b. Halamang Gamot
participating in 3. Nutrition and Diet Therapy
planning and a. Protein-, Mineral-, and Fluid-Modified
coordinating Diets
culturally sensitive
interdisciplinary
 care,

5.3. providing
client education
and health
maintenance and
community based
care,

5.4. efficiently and

effectively utilize
available
resources in the
care of clients to
achieve outcomes

6. evaluate the
effectiveness of
nursing care,
revising the
nursing care plan
as needed to
promote, maintain,
or restore
functional health
status of clients