The renal system includes the kidneys, ureters, bladder and urethra. (virtual medical center 2006) It consists of all the organs responsible for the formation and release of urine. The kidneys perform vital functions like getting rid of waste through the excretion of urine. It regulates the amount of water in the body and allows filtration of sodium and chlorides. (virtual medical center 2006) It maintains the volume and composition of body fluid. (renal system 2006) The kidneys are “bean-shaped organ located in the lower part o the belly, situated in the posterior wall of the abdomen. (renal system 2006)

The left kidney is slightly higher than the right in the abdomen to allow for the liver. (renal system 2006) There are two distinct regions of the kidney; medulla and cortex. The blood supply is taken directly from the aorta thru renal arteries and returned to the inferior vena cava thru renal veins. (renal system 2006) The nephron is the unit of the kidney that acts and responsible for ultrafiltration and excretion of the waste products. (renal system 2006) Urine, the filtered waste material, will be passed down the ureters and collects in the bladder. (renal system)

The ureters are tubes lined with smooth muscle. The 25-30cm long tubes help carry the urine through the bladder. The urine will be forced forward with the help of the muscular tissue. (virtual medical center 2006) Then the urethral sphincter at the base of the bladder relaxes, the detrusor contracts, and urine is negated thru the urethra. (renal system 2006)

The bladder is located in our pelvis and pyramidal in shaped. It stores the urine and releases it into a tube which extracted the urine out of the body. (virtual medical center 2006) It can normally hold up to 500mls of urine. It has three openings which includes two for the ureters and one for the urethra. (virtual medical center 2006) The main muscle of the bladder is called detrusor that contracts to allow the urine to flow. The nervous control of the bladder that sends signal and tell us that the bladder is full is located in the brain and spinal cord. (virtual medical center 2006) The blood supply of the bladder is from many blood vessels named vesical arteries, obturator, uterine, gluteal and vaginal arteries. (virtual renal system site)

The tube that is located from the bladder neck to the top of the vaginal opening is the female urethra whereas, the male urethra is running from the bladder to the tip of the penis. Female urethra is more prone to infections from bacteria than male urethra due to it is shorter in size. (virtual medical center 2006) The blood vessels of the female urethra are the internal pudendal and vaginal arteries. The male urethra is supplied through inferior vesical and middle rectal arteries. (virtual renal system site)

An acute renal failure is a disease of the kidneys and a common medical condition that complicates hospital and intensive care unit admissions. (virtual medical center 2006)  It occurs suddenly and initiated by primal causes like dehydration, infection, kidney injuries and chronic use of over the counter pain medications. (virtual medical center 2006) It is often reversible and with no lasting damage. In renal failure, kidneys are not functioning properly or not work at all. Kidneys are unable to filter waste, produce urine and imbalances fluids. The dysfunction of the kidneys results building up of toxins which produces complications. (Gunsch 2006)

Renal failure symptoms include edema or the accumulation of fluid distinctive in swelling, decrease in urination, general ill feeling, exhaustion and headaches. (Gunsch 2006)Often, these symptoms were not experience by a person with renal failure. (Gunsch 2006) A person with renal failure can actually lead a normal life. The recovery of the patient with renal failure will be depending on the severity, treatment options and patient’s coping to the rigors of renal failure. But to some cases, dialysis and kidney transplant is needed. (Gunsch 2006) Management of the treatment includes general measures or monitors to prevent complications, treat precipitating cause, and can be treated with medications or may require dialysis.  (wirual medical center 2003)

Mary is admitted to the ward with acute renal failure. She is very confused and anxious. She is accompanied by her husband and daughter. She has high blood pressure and a respiratory rate of 30. She also has low urine out put. Mary might have felt self pity and a burden to her family. In Roper’s activities of living model (1918-2004), it stresses patient’s continual assessment, facilitation of normal activities of living and individualized care.

It considers and respects the characteristics of a person prior to development. (Roper 1918-2004) The “model of living” incorporates twelve activities that engaged a person whether sick or well. (Roper 1918-2004) It includes maintaining a safe environment, breathing, communication, mobilizing, eating and drinking, eliminating, personal cleansing and dressing, maintaining body temperature, working and playing, sleeping, expressing sexuality and dying   (Roper 1918-2004)

To be able to provide care for Mary without making her feel as a burden or imbecile, she should be given the chance to have her individualism. Although she should be given special care and attention, she should be given a part to the treatment she is undergoing. Like if in case she needs to take her medicine, she should be the one to take it but her family or the attendants should also notify her the appointed time that it should be taken. Communication is highly regarded in this situation as well. Through having conversation with the patient not only shows that you care for her but also makes her feel that she is not disgusting.

Mary should also be given assistance in personal cleansing, dressing and maintaining to have a good environment but not to a point that her personality will be injured. Her family should be involved in every activities or treatment that she is undergoing. Mary could have a certain activity every week that will detach her in always thinking about her sickness that makes her confused and anxious. Certain social activities or programs should be conducted or if in case having a new learning experience like training for dressmaking, cosmetology, or the likes that will be useful as well when she’ s already well. Death issues should also be planned so that she will have a pain free and dignified death wherever possible. Spiritual emphasis is also helpful for Mary to cope up with the situation. Lastly, she should also be treated and informed that her sickness could be cured and not malignant.

REFERENCES: retrieved 13 October 2006, Kidney, Available at:

Gunsch, J. 2006, What is Renal Failure?, Available at:

Northern Care Homes Directory 28 August 2000, Hulton Care Nursing Home, Available at:

Renal System retrieved 13 October 2006, Available at:

Roper, Nancy, 1918-2004, Activities of Living Model, Available at:

Virtual Medical Center 28 March 2006, Anatomy & Physiology of the Renal System, Available at:

Virtual Medical Center  9 October 2003,  Renal Failure – Acute, Available at:

Wikipedia retrieved 13 October 2006, Kidney, Available at: