Diabetes-related Kidney and Bladder Problems (Nursing)

by Rhonda Lawes, PhD, RN

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    00:01 Let's start with the kidneys, okay.

    00:02 So high glucose damages the kidneys.

    00:06 The reason is the nephrons, those little filtering units of the kidneys are filled with tiny little...

    00:13 you got it, blood vessels, and we know, that high glucose damages blood vessels.

    00:19 Also you end up with higher levels of glucose in your blood stream.

    00:23 So it's overwhelming the kidney trying to filter it out even has to dump some into the urine.

    00:27 So this is problematic.

    00:29 Over time these high sugar levels in the blood can cause these vessels to become narrow and clogged.

    00:36 Now here's another tip, you know that, high blood glucose from diabetes is often accompanied by high blood pressure, hypertension, which can also be brutal on kidney.

    00:48 So it's very common for client who's diabetic to also have high blood pressure.

    00:53 Put these together.

    00:56 That's a really bad combo.

    00:58 So it's important you understand, the higher that blood sugar is the more damage we're going to do to the kidneys because those nephrons, the filtering units are going to get blocked up and narrowed.

    01:12 So this is where we're going to get a little more personal with Mr. Sanchez and he may traditionally not be used to talking this about anyone.

    01:22 He's not, may not be comfortable.

    01:24 See how my words are stumbling even talking about it.

    01:27 That's what we don't want you to do.

    01:29 But if you find yourself doing that, it's okay.

    01:32 Stop, pause, smile, make eye contact, because we want to help. Mr. Sanchez understand that nerves are what controller and keep us safe.

    01:43 Well, it doesn't seem so hard.

    01:45 But that means everything from being able to control your bladder to being able to have sex.

    01:50 Hello now everybody's attention, right? So it's important that you just stay calm and say, Mr. Sanchez. This may not be comfortable for you.

    02:00 But I want you to understand the impact of diabetes in every aspect of your body.

    02:05 So, these nerves remember we talked that high glucose can impact your blood supply and it can impact your nerves and those are really important in your ability to control your bladder.

    02:17 Now nobody wants to talk about this Mr. Sanchez.

    02:20 I understand this may not feel comfortable for you to talk with me about it.

    02:24 But I know that this is really important.

    02:26 So even if you're feeling uncomfortable, you let me know when you want to stop or take a break but let's share some information with you and see if this helps.

    02:34 So you stay calm, and professional, he'll feel more comfortable if you appear comfortable.

    02:39 So no matter what you feel like on inside, on the outside, you need to make eye contact and act like this is no big deal.

    02:47 This may be a conversation you need to practice out loud so you can be calm in appearance when you have it.

    02:55 Because here's what we're talking about, high glucose from diabetes leads to bladder problems and impotence, see the blood vessels and the nerves that control the bladder are damaged and they can cause urine leaking and incomplete emptying.

    03:11 Well, if you'll notice Mr. Sanchez is a little advanced in years if he isn't having problems with his prostate right now, he likely is going to.

    03:21 So you see the bladder there right? We've got the kidneys would be just above your screen then we got the ureters coming down to the bladder.

    03:28 And right around that that greenish looking organ that we've colored there is his prostate.

    03:34 Is that grows, it's going to put pressure on that exit valve where the year and exits the body.

    03:40 So he may be having problems because his prostate is kind of strangulating where urine exits the body but also the blood vessels and nerves that control the bladder are damaged and so that can cause leaking and incomplete emptying.

    03:54 No one again I can't say it enough wants to talk about this and yet they do.

    04:00 Because they want to find a resolution for this problem.

    04:04 Now in addition to the bladder problems because we know the high blood sugar damages those blood vessels and those nerves they can also cause sexual problems.

    04:14 It is not uncommon for a male to struggle with impotence because of the diabetes because the nerves that control sexual function are damaged and that's why the patient may experience impotence.

    04:25 So this is a conversation that you just, gently, calmly, and professionally bring up.

    04:31 Ask him if he would like some more information, that's also a cue, to know if he wants to talk more about it, or he doesn't want to.

    04:38 I think you'll be surprised, even in what you would consider a non-traditional setting, like you would not expect to talk to someone maybe older than you and a male if you are a female or even if you're a male you would not expect to be talking about sexual function, but let them drive the conversation.

    04:55 You introduced it, you present it.

    04:58 They'll tell you how much more information they want to have.

    05:01 I think you'll be surprised sometimes, people are very open and just thankful that you asked them the question.

    About the Lecture

    The lecture Diabetes-related Kidney and Bladder Problems (Nursing) by Rhonda Lawes, PhD, RN is from the course Diabetes Type 1 and 2: Complications and Symptoms (Nursing).

    Included Quiz Questions

    1. Small blood vessels
    2. Nerves
    3. Arteries
    4. Lymph nodes
    5. Ureters
    1. Urine leakage and incomplete emptying
    2. Burning with urination and hematuria
    3. Difficulty starting a stream and cloudy urine
    4. Polyuria and bladder spasms
    1. Nephrons
    2. Ureters
    3. Renal artery
    4. Renal pelvis

    Author of lecture Diabetes-related Kidney and Bladder Problems (Nursing)

     Rhonda Lawes, PhD, RN

    Rhonda Lawes, PhD, RN

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