To begin a subjective assessment, you should ask the patient about renal and urinary related symptoms such as pain, urinary incontinence, frequency, urgency, burning, or retention. Assess the flank area for discoloration and symmetry. Have you ever lost control of your urine? The assessment will attempt to determine the problem, onset, duration, predisposing factors and the severity of the problem. To begin, palpate over the left and right costovertebral area. Understanding the importance and function of the renal system is essential for performing a comprehensive nursing assessment and identifying renal issues. All content, including text, graphics, images, and information, contained is provided for educational purposes only. In the flank area? Was the onset of dysuria gradual or did it happen all of a sudden? INSPECTION – Abdominal contour, looking for asymmetry or distention (a sign of ascites) The nurse should also perform an abdominal assessment by inspecting the abdomen for any distention or swelling, which could indicate kidney enlargement or bladder distention. Some of the renal or urinary system-focused questions that you should ask the patient include: Do you urinate more than usual? The patient may leak small amounts of urine during the day and night. Have you noticed any clots in your urine? Serum chemistry interpretation, urinalysis, urinary tract endoscopy … Physical examination for signs of enlarged kidneys by bimanual palpation 8. This will cause a thud noise. This is below the umbilicus in the lower abdomen. You may use indirect or blunt percussion to assess the kidneys. Use deep palpation to locate the base of the bladder. The amount of urine output and its color can indicate renal issues. If the urine contains bacteria and sits for a long time, the odor can become unpleasant. Normal urine output is approximately 30-80ml per hour. Objective data includes data from physical examinations and medical tests. 1. 2. The nurse should then auscultate (listen using a stethoscope) the abdomen for any bruit. Physical examination for signs of enlarged kidneys by bimanual palpation 8. just create an account. 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Begin with light palpation in the lower abdominal area. In patients with renal disorders, symptoms and signs may be nonspecific, absent until the disorder is severe, or both. 4. The symphysis pubis is located at the midline where the two pubic bones form a joint. The urinary tract is the body's drainage system for the eventual removal of urine. Any unusual findings should be followed up with a focused assessment specific to the affected body system. credit by exam that is accepted by over 1,500 colleges and universities. Extend the midclavicular line on the right or left side to the epigastric area. Frequency is when the patient voids more frequently than what is usual for the patient. Assessment of the client at risk for or with actual problems of the renal system begins with a history and physical assess­ment. This pain is usually a steady, dull, aching visceral pain. Has the sudden involuntary passage of urine if yes, do you have pain before, during after! 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