The Big Picture
The urinary system has four major structures: the kidneys, ureters, bladder, and urethra. A disorder can affect one or more of these structures.
Common problems include urinary tract infections, kidney stones, and kidney failure. Some problems are temporary. Others develop over many years and require long-term treatment and support.
When supporting a client with a urinary system disorder, follow the care plan and stay aware of comfort, infection prevention, privacy, fluid-related directions, and changes that need to be reported.
Look for Nova Scotia CCA Notes throughout this page for current provincial guidance.
Quick tip: Tap, click, or press Enter on any term with a dotted underline and an ⓘ icon to see its plain-English definition.
Start Here If You’re Overwhelmed
Focus on these core ideas:
- A urinary tract infection (UTI) is an infection in the urinary system.
- Renal calculi are kidney stones.
- Renal failure happens when the kidneys do not function or are severely impaired.
- Acute renal failure develops suddenly and moves through different phases.
- Chronic renal failure develops over many years as nephrons are destroyed.
- When a client has a catheter during acute renal failure, urine output below 30 mL per hour should be reported immediately.
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Course Notes: Key Ideas You Need to Know
Major Structures of the Urinary System
The major structures are:
- kidneys
- ureters
- bladder
- urethra
Urinary system disorders can affect one or more of these structures.
Urinary Tract Infections
A urinary tract infection (UTI) is an infection in the urinary system. An infection that begins in one area can spread through the urinary system.
Normally, the urinary system contains no microbes or pathogens. A pathogen is a microbe that can cause illness, infection, or disease.
Pathogens can enter the urinary system through the urethra.
Common Causes of UTIs
Common causes include:
- catheterization
- urological examinations
- infections through sexual intercourse
- poor perineal hygiene
- incomplete bladder emptying
- poor fluid intake
UTIs are also frequently acquired in health care settings.
Who Has a Higher Risk?
Women have a high risk because pathogens can enter their short urethra more easily.
Prostate gland secretions help protect men from UTIs. An enlarged prostate increases the risk of a UTI. Older men are therefore more likely than younger men to develop one.
Benign prostatic hypertrophy (BPH) means an enlarged prostate gland.
Cystitis and Pyelonephritis
Cystitis affects the bladder.
Pyelonephritis is inflammation of the kidney and renal pelvis caused by bacterial infection.
Signs and Symptoms of a UTI
Signs and symptoms include:
- urinary frequency and urgency
- oliguria, meaning a scant amount of urine
- dysuria, meaning difficult or painful urination
- pain or burning during urination
- foul-smelling urine
- hematuria, meaning blood in the urine
- pyuria, meaning pus in the urine
- fever and chills
- pain in the lower abdomen or back
In an older person, sudden confusion can indicate a possible urinary infection.
Treatment
Treatment includes antibiotics and increased fluid intake, usually 2 000 mL per day.
Renal Calculi
Renal calculi are kidney stones.
Risk factors include:
- prolonged bed rest
- immobility
- poor fluid intake
Kidney stones differ in size and mineral content.
Signs and Symptoms of Renal Calculi
Signs and symptoms include:
- severe, cramping pain in the back and side just below the ribs
- pain in the abdomen, thigh, and urethra
- nausea and vomiting
- fever and chills
- urinary frequency and urgency
- oliguria
- dysuria
- hematuria
- foul-smelling urine
Treatment and Care
Treatment includes medication for pain relief and increased fluid intake of about 2 000 to 3 000 mL per day.
The increased fluid intake increases urine excretion and helps stones leave the body.
All urine must be strained so any stones passed during urination can be caught.
Sometimes stones need surgical removal. Dietary changes can help prevent more stones from forming, so dietitians are usually part of the health care team.
Renal Failure
Renal failure, or kidney failure, occurs when the kidneys do not function or are severely impaired.
When the kidneys fail:
- waste products remain in the blood
- the body retains fluid
- the face, hands, and feet can become puffy and swollen
- hypertension can develop
- congestive heart failure can develop
Congestive heart failure (CHF) occurs when the heart cannot pump blood normally. Blood backs up and causes an abnormal amount of fluid in the tissues.
Renal failure can be acute or persistent.
Acute Renal Failure
Acute renal failure begins suddenly after blood flow to the kidneys becomes severely decreased.
Causes include:
- severe bleeding
- heart attack
- CHF
- burns
- infections
- severe allergic reactions
Acute renal failure is usually temporary. Treatment can reverse the condition, but it is serious and can result in death.
Phases of Acute Renal Failure
Acute renal failure occurs in phases.
| Phase | What Happens |
|---|---|
| Oliguria | Urine output falls below 400 mL in 24 hours. This phase lasts from a few days to 2 weeks. |
| Diuresis | Large amounts of urine are produced, about 1 000 to 5 000 mL per day. |
| Recovery | Kidney function improves and returns to normal. |
The full disease process can take from 1 month to 1 year.
Some people do not recover and develop chronic renal failure.
Treatment
The physician orders medications, restricted fluids, and diet therapy.
Care-Plan Measures
The care plan will likely include:
- measuring and recording urine output every hour when the client has a catheter
- measuring and recording fluid intake and output
- restricting fluid intake
- taking daily weight measurements with the same scale
- providing frequent oral hygiene
- following measures required when the client is confined to bed
- following measures to prevent infection
Report: If a client with a catheter produces less than 30 mL of urine per hour, report it immediately.
Chronic Renal Failure
In chronic renal failure, the kidneys cannot meet the body’s needs.
The nephrons in the kidneys are destroyed over many years.
Common causes include:
- hypertension
- diabetes
- infections
- urinary tract obstruction
- tumours
Signs and symptoms appear after 80 to 90% of kidney function has been lost.
Some signs and symptoms include:
- yellow skin
- dry, itchy, or brittle skin
- inflammation of the mouth
- bruises and bleeding
- hypertension
- a burning sensation in the legs and feet
Waste products build up in the blood, affecting each body system.
There is no cure. During the early stages, diet therapy, fluid restriction, and medications may slow kidney damage.
Dialysis and Kidney Transplantation
When considerable kidney function has been lost, dialysis becomes necessary.
Dialysis removes wastes and excess water from the blood.
Role limit: Sorrentino’s Canadian Textbook for the Support Worker, 5th Edition states that only specially trained nurses perform dialysis.
Dialysis first takes place in a dialysis unit. Some clients eventually have home dialysis. If you are providing care for a client receiving home dialysis, your supervisor will make sure you understand your responsibilities and scope of practice.
When dialysis does not provide adequate treatment, a client may require a kidney transplant.
Nova Scotia CCA Note
Sorrentino states that only specially trained nurses perform dialysis. In Nova Scotia, Nova Scotia Health currently provides home dialysis training and management for people who perform their own peritoneal dialysis or hemodialysis at home. (nshealth.ca)
Why this matters in Nova Scotia: For study purposes, keep Sorrentino’s statement as the textbook teaching, but know that current Nova Scotia home-dialysis services also support trained patients who perform their own dialysis at home.
Official source: Home Dialysis Unit
Last checked: October 3, 2026
Care of a Client With Chronic Renal Failure
Care can include:
- limiting fluids
- measuring the client’s blood pressure in the supine, sitting, and standing positions
- measuring weight every day with the same scale and at the same time
- measuring and recording fluid intake and output
- using bath oils, lotions, and creams to help prevent itching, according to the care plan
- providing frequent oral hygiene because the mouth is often dry
- encouraging rest
- preventing complications of bed rest when the client is confined to bed
Nova Scotia CCA Note
Nova Scotia’s current CCA Occupational Standards of Practice says a CCA measures vital signs, collects data, documents, and follows specific escalation and reporting indicators identified by a regulated healthcare professional. A CCA’s point-of-care assessment is observational. It does not include the comprehensive evaluation used to make clinical or care-planning decisions. (novascotiacca.ca)
For tasks outside the regular CCA occupational standards, Nova Scotia places specific limits on extended practice and delegation. These include employer requirements, training, competency verification , and appropriate supervision or clinical oversight. A CCA must not work outside the occupational standards or the employer’s policies and procedures. (novascotiacca.ca)
Why this matters in Nova Scotia: The chronic renal failure care measures on this page must stay within the care plan, your training, and your workplace role. Measuring, observing, and recording information does not give a CCA authority to make independent clinical decisions.
Official source: Continuing Care Assistant Occupational Standards of Practice (CCA OSoP)
Last checked: October 3, 2026
Supporting a Client With a Urinary System Disorder
A client may feel fear or apprehension when a diagnosis comes as a shock or when unexpected surgery is needed.
Communicate With Respect
Listen to the client and use empathy when speaking. This shows respect.
Support Comfort
Use pain-reducing comfort measures.
Make sure the client is sitting or lying on a clean, dry, wrinkle-free base at all times.
Report and document: Report and record any pain the client experiences so the client can remain comfortable and receive medication according to the care plan.
Protect the Client From Infection
Wear the proper PPE recommended in the care plan.
Follow Standard Practices at all times.
Change out of your uniform before leaving the agency or the client’s home to reduce the risk of spreading pathogens.
Protect Confidentiality
Always follow confidentiality rules.
Never discuss the client or information about the client with anyone who is not involved in the client’s care.
Exam Clue Words
- First: Acute renal failure begins with the oliguria phase before diuresis and recovery.
- Report: Urine output below 30 mL per hour in a client with a catheter should be reported immediately.
- Only: Only specially trained nurses perform dialysis.
- Always: Always follow confidentiality rules when caring for a client.
- Never: Never discuss client information with someone who is not involved in the client’s care.
Fast Review
Focus on the facts that are easiest to mix up or forget.
- The major urinary structures are the kidneys, ureters, bladder, and urethra.
- A UTI is an infection in the urinary system, and pathogens can enter through the urethra.
- UTI signs can include frequency, urgency, oliguria, dysuria, hematuria, pyuria, fever, chills, foul-smelling urine, and lower abdominal or back pain.
- Sudden confusion in an older person can indicate a possible urinary infection.
- Renal calculi are kidney stones. Poor fluid intake, immobility, and prolonged bed rest are risk factors.
- Acute renal failure begins suddenly. Oliguria comes first, followed by diuresis and recovery.
- In acute renal failure, oliguria means urine output below 400 mL in 24 hours.
- During diuresis, urine output is about 1 000 to 5 000 mL per day.
- Urine output below 30 mL per hour in a catheterized client should be reported immediately.
- Chronic renal failure develops over many years, and signs and symptoms appear after 80 to 90% of kidney function has been lost.
- Dialysis removes wastes and excess water from the blood, and only specially trained nurses perform it.
- Support includes following the care plan, protecting comfort and confidentiality, preventing infection, and reporting and recording pain.
Final Pep Talk
This topic has several unfamiliar urine terms, similar symptoms, and important numbers. Work through one section at a time, and give yourself extra review time for the phases and measurements that are harder to remember.