urinary system assessment, an evaluation of the condition and functioning of the kidneys, ureters, bladder, and urethra and an investigation of concurrent and previous disorders that may be factors in abnormalities in these structures. The assessment aids the urologist in diagnosing the abnormalities. ▪ METHOD: In an interview the patient is asked whether painful urination, frequency or burning on urination, dribbling, a decreased urinary stream, nocturia, stress incontinence, headache, back pain, or increased thirst has occurred. The color, odor, and amount of urine voided and obtained via catheter are determined. The patient’s vital signs; any bladder distension; skin condition; neurological changes; the location, duration, and character of pain; and the presence of bladder spasms are recorded. It is determined whether the patient has hypertension, diabetes, a venereal disease, vaginal or urethral drainage or discharge, or a history that includes cystitis, pyelonephritis, kidney stones, prostatectomy, renal surgery, a kidney transplant, or a venereal infection. The patient’s sexual activity; use of coffee, tea, cola beverages, alcohol, perfumed soaps, feminine hygiene sprays, and prescribed and over-the-counter medication; and habit of bathing in a tub or shower are ascertained. A family history of polycystic kidney disease, hypertension, diabetes, or cancer is noted in the assessment, together with laboratory studies of the specific gravity of the patient’s urine, casts, protein, red and white blood cells in the urine, and serum creatinine level. Diagnostic procedures may include cystoscopy, ultrasonic imaging, nuclear imaging, urethroscopy, excretory and IV urography, renal angiography, retrograde studies, and x-ray imaging of the kidneys, ureters, and bladder.
