The Renal System

Question 1

What is the urinary system?

Answer 1

Consists of the kidneys, ureters, bladder, and the urethra. The purpose of the urinary system is to eliminate waste from the body, regulate blood volume and blood pressure, control levels of electrolytes and metabolites, and regulate blood pH.

Question 2

What adaptations occur during pregnancy to the renal system?

Answer 2

The extra blood flow makes her kidneys produce up to 25% more urine soon after conception.
Peaks by about 9 to 16 weeks of the pregnancy.
Passing urine frequently can also be influenced by pressure on the woman’s bladder from her growing uterus.

Question 3

What do you need to note down as midwives about a women’s renal system?

Answer 3

Pre-existing renal conditions
Frequency of micturition
Urinary tract infections
Nocturia

Question 4

What adaptations occur during labour to the renal system?

Answer 4

• Monitor urine output → should not decrease 30mls an hour
• Palpate for bladder before vaginal examination. Making sure they do not have a palpulate bladder → lost the urge of passing urine
• Retention of urine: as the bladder rises above the symphysis pubis leading to retention of the urethra
• Urinalysis- Ketonuria: energy is needed during labour. The body uses up glucose and if not restored the body burns fat and a by-product of fat is ketone.

Question 5

What adaptations occur during postnatal to the renal system?

Answer 5

Increase in urine output as the woman is trying to try reverse and go back to normal for 7 days
• Retention of urine 
• Stress incontinence
• Instrumental birth 
• Urinary tract infections 
• Acute renal failure 
• Eclampsia

Question 6

Urinanalysis and its findings

Answer 6

Acidity (pH). The pH level indicates the amount of acid in urine. Abnormal pH levels may indicate a kidney or urinary tract disorder.
Concentration. A measure of concentration, or specific gravity, shows how concentrated particles are in your urine. A higher than normal concentration often is a result of not drinking enough fluids.
Protein. Low levels of protein in urine are normal. Small increases in protein in urine usually aren’t a cause for concern, but larger amounts may indicate a kidney problem.
Sugar. Normally the amount of sugar (glucose) in urine is too low to be detected. Any detection of sugar on this test usually calls for follow-up testing for diabetes.
Ketones. As with sugar, any amount of ketones detected in your urine could be a sign of diabetes and requires follow-up testing.
Bilirubin. Bilirubin is a product of red blood cell breakdown. Normally, bilirubin is carried in the blood and passes into your liver, where it’s removed and becomes part of bile. Bilirubin in your urine may indicate liver damage or disease.
Evidence of infection. If either nitrites or leukocyte esterase — a product of white blood cells — is detected in your urine, it may be a sign of a urinary tract infection.
Blood. Blood in your urine requires additional testing — it may be a sign of kidney damage, infection, kidney or bladder stones, kidney or bladder cancer, or blood disorders.

Question 7

What is a urinary tract infection

Answer 7

Cystitis: caused by ascending infection, results in inflammation of the bladder causing voiding to be painful and frequent but with small quantities.
Urinary tract infections: an infection of kidneys and pelvis