PENGKAJIAN SYSTEM

PERKEMIHAN

Irsanty collein

DEMOGRAFI
umur
Gender
Ras dan etnik
Tanya masalah urologi sebelumnya termasuk tumor, infeksi,batu
atau operasi urologi
Riwayat penyakit DM, hipertensi
Paparan bahan kimia di tempat kerja (hidrokarbon: gasoline,
minyak, bahan metal: mercury, gas: klorin, toluene).

Adakah albumin atau protein di urine

Punya masalah dalam kehamilan (proteinuria, peningkatan TD,
diabetes gestasional, ISK)
Status social ekonomi
Kepercayaan terkait sakit
Bahasa yang berbeda dengan petugas kesehatan

RIWAYAT NUTRISI
Tanya diet yang mempengaruhi
Perubahan diet
Intake cairan yang berlebihan atau kurang
Pola minum pasien setiap hari: tinggi kalori, cafein
Makanan tinggi protein masalah pada ginjal

RIWAYAT PENGOBATAN

PEMERIKSAAN FISIK
Ginjal
Ureter
Bladder

..\internet\Urinary System.ppt

PENGKAJIAN PSIKOSOSIAL
Ketakutan
Marah
Cemas
Perasaan bersalah
kesedihan

PEMERIKSAAN
LABORATORIUM
Serum kreatinin
BUN
Rasio BUN
Osmolalitas darah

TES URINE
Urinalisis
Warna urine
pH
Glukosa
Keton
Bersihan kreatinin
elektolit

OTHERS DIAGNOSTIC TESTS

Bedside sonography/bladder scanners
Computed tomography
Kidney, ureter, and bladder x-rays
Intravenous urography
Bowel preparation
Allergy information
Fluids

CYSTOGRAPHY AND
CYSTOURETHROGRAPHY
Instilling dye into bladder via urethral catheter
Voiding cystourethrogram
Monitoring for infection
Encouraging fluid intake
Monitoring for changes in urine output and for development
of infection from catheter placement

RENAL ARTERIOGRAPHY
(ANGIOGRAPHY)
Possible bowel preparation

Light meal evening before, then

nothing by mouth
Injection of radiopaque dye into renal
arteries
Assessment for bleeding
Monitoring of vital signs
Absolute bedrest for 4 to 6 hours
Serum creatinine measured for
several days to assess effects of test

RENAL BIOPSY
Percutaneous kidney biopsy
Clotting studies
Preprocedure care
Follow-up care
Assessment for bleeding for 24 hours
Strict bedrest
Monitoring for hematuria
Comfort measures

RENOGRAPHY
Small amount of radioactive material, a
radionuclide, used
Procedure via intravenous infection
Follow-up care:
Small amount of radioactive material may be
excreted.
Maintain standard precautions.
Client should avoid changing posture rapidly and
avoid falling.

OTHER DIAGNOSTIC TESTS

Ultrasonography
Cystoscopy and cystourethroscopy
Procedure is invasive.
Consent is required.
Postprocedure care includes monitoring for airway patency, vital signs,
and urine output.
Monitor for bleeding and infection.
Encourage client to take oral fluids.

RETROGRADE PROCEDURES
Retrograde procedures go against the normal
flow of urine.
Procedure identifies obstruction or structural
abnormalities with the instillation of dye into
lower urinary tract.
Monitor for infection.
Follow-up care is the same as for a cystoscopic
examination.

URODYNAMIC STUDIES
Studies that examine the process of voiding include:
Cystometrography
Urethral pressure profile
Electromyography
Urine stream test

Bladder scanner
Kydney, ureter dan bladder x rays
IV urograf
CT scan
Cystograf
Renograf
USG
Angiograf renal
Retrograf prosedur

Biopsi renal

TUGAS
Kumpul minggu depan
Diagnosa keperawatan apa saja yang mungkin muncul (minimal 3)
Perencanaan

TUGAS DISKUSI
Trauma ginjal/bladder
Tumor ginjal/bladder
Ginjal polikistik
Sindrom nefrotik