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GENITOURINARY KQ
Genitourinary System
| Question | Answer |
|---|---|
| what is the purpose of urine formation? | removal of toxic waste products form the blood |
| What are the other 4 functions of the kidneys? | regulation of blood volue, electorolyte balance, acid base balance |
| What bony structure protects the kidneys | ribcage |
| What is the indentation on the medial side of the kidneys called | hilus |
| where does the renal artery enter (location on kidney) | hilus |
| where does the renal vein and ureter emerge (location on the kidney) | hilus |
| What does the ureter do? | carry urine from the kidneys to the bladder |
| what are the 3 distinct areas of the kidney called? | renal cortex, renal medulla, renal pelvis |
| What is in the renal cortex? | nephrons - corpuslces and convuluted tubules |
| What is in the medulla? | loops of henle, renal pyramids, apex or pailla |
| Where is urine formed? | in the nephrons |
| ____________ is a capillary network that arises from an afferent arteriole and empties into an efferent arteriole | glomerulus |
| Where does the blood come from that enters the renal artery? | abdominal aorta |
| The exchanges that take place in the capillaries of the kidneys form urine from __________ | blood plasma |
| What 3 processes does the formation of urine involve? | glomerular filtration i nthe renal corpuscles, tubular reabsorption and tubular secretion |
| What is filtration? | process by which blood pressure forces plasma and dissolved materials out of capillaries |
| What is the blood pressure in the glomeruli? | 60mmHg |
| What is the GFR by definition | amount of filtrate formed by the kidneys in 1 minute |
| What is the average GFR? | 100-125 ml/ minute |
| ____________is the recovery of useful materials form the renal filtrate and their return to the blood in the peritubular capillaries | Tubular reabsorption |
| ________transport requires energy (ATP) | active |
| negative ions are reabsorbed by what type of transport? | passive |
| How is water reabsorbed ? | osmosis |
| Waste product such as ammonia may be secreted intot he filtrate and be eliminated in what? | urine |
| what ions are exchanged in the kidneys to maintain acid-base balance? | hydrogen and bicarbonate |
| What cells in the walls of the afferent arterioles secrete the enzyme renin? | juxtaglomerular |
| What hormone is secreted by the kidneys during states of hypoxia? | erythropoietin |
| What does the urethra do? | carry urine from the bladder to the exterior |
| What type of reflex is urination? | spinal cord |
| What is the stimulus for urination | stretching of the detrusor muscle |
| What is the normal amount of urinary output | 1000-2000ml per 24 hours |
| What 2 common references to urine color are used | straw or amber |
| What is the normal specific gravity of urine? | 1.010-1.025 |
| If the specific gravity of the urine is high is it concentrated or dilute? | concentrated |
| What is the normal pH of urine? | 4.6-8.0 |
| What is the urine 95% made up of? | water |
| What is urea formed by? | the liver |
| where does creatinine come from (metabolism) | energy source in muscles |
| Uric acid comes from what? | metabolism of nucleic acids |
| At what age is the # of nephrons is approximately 1/2 the original number? | 70 - 80 years old |
| The urinary bladder decreases in size and tone as one ages (true or false) | true |
| What does the BP usually do in renal dissease? | increase |
| What is the most definitive lab test for renal function? | serum creatinine |
| What is a KUB? | xray exam of the kidney-ureter-bladder |
| What is the KUB also referred to as? | a flat plate of the abdomen |
| What can a KUB show? | tumors, swollen kidneys, and calcium based stones |
| What is an IVP? | intravenous pyelogram |
| What does an IVP do? | outlines the renal structures |
| What does the aftercare for an IVP include | drinking large amounts of fluid to clear the kidneys of the dye |
| What is a renal angiography? | it is a test to visualize the renal arteries |
| Where is the scope in a "cysto" inserted? | into the bladder through the urethra |
| What purposes can a Cysto be used for? | inspect the inside of the bladder, collect urine spec from either kidney, visualize the renal structure, biopsy any growths, remove tumors, remove stones from bladder or ureters, dilate ureters |
| What is a renal ultrasound used for? | used to help diagnose tumors of the kidney and to look for enlargement of the kidneys, kidney stones and changes of the renal structures with chronic infection |
| What is a renal biopsy used for? | to diagnose or gain information about the kidney disease |
| How long is a pt on bedrest following a renal biopsy? | 24 hours |
| __________incontinence is the loss of urine associated with coughing laughing etc | stress |
| _____________incontinence is involuntary loss of urine associatied with abrupt desire to void | urge |
| ______________incontinence si cased by chronic impairment , unable to get to toilet intime due to physical function or cognitive ability | functional |
| __________incontinence is a continuous and unpredictable loss of urine | total |
| What is acute retention often caused by? | surgeries, anesthesia, medications, local trauma |
| What of the methods of catheterization is the most preferred (if needed) (to prevent infection risk)? | intermittent |
| What is urethritis | inflammation of the urethra |
| What are the symptoms of urethritis? | urinary frequency, urgency and dysuria |
| What is the treatment for urethritis? | antibiotic, pyridium |
| What is pyridium? | a urinary analgesic |
| What is the normal dose for pyridium and for what duration? | (HAH gotcha- check your drug guide!) |
| What is cystitis? | inflammation and infection of the bladder wall |
| what are the symptoms of cystitis? | dysuria, frequency, urgency, cloudy urine |
| What may a UA with a pt with cystitis look like? | cloudy, presence of WBCs, bacteria and sometimes RBCs, postive nitrites, positive leukocyte esterase |
| What is pyelonephritis | infection of the kidneys |
| What is usually the cause of pyelonephritis? | ascending bacterial infection |
| What are the signs and symptoms of pyelonephritis? | urgency, frequency, dysuria, FLANK PAIN, fever and chills |
| What is the distinguishing characteristics between those with pyelonephritis and cystitis? | pyelo they are more sick, and show signs of systemic disease |
| What type of pain is present with pyelo? | costovertebral |
| With a kidney infection the urine will show _____________not present with cystitis | casts |
| Repeated kidney infections can result in __________and loss of kidney function | scarring |
| When septicemia results from a urinary cause it is called _______ | urosepsis |
| What does the plan focus on for a pt with a UTI? | comfort and treatment of infection, prevention of future infections |
| What is a urethral stricture? | narrowing of the lumen of the urethra |
| what causes strictures? | scar tissue |
| What is a common cuase of strictures? | injury from insertion of catheters or surgical instruments |
| Why are those with urethral strictures prone to UTIs? | because there is a diminished urine stream/obstruction of urine flow |
| What is a urethroplasty? | surgical repair of the ureter |
| What is the common surgical intervention for stricture? | dilation |
| What is renal calculi? | small stones that form somewhere in the renal structures |
| What is the condition called when stones are found in the kidneys? | nephrolithiasis |
| What are the 4 types of stones in order of frequency? | calcium oxalate, calcium phosphate, magnesium ammonia, uric acid and cystine |
| The majority of calculi contain what? | calcium |
| What can cause calculi formation? | family history, dehydration, infection (provides a nucleus), dietary factors, immobility |
| What are the s/sx of renal calculi? | excruciating FLANK pain, renal colic, |
| Stones of what size can be passed via urination? | 5mm or smaller |
| What must be done to urine after voided to find a stone? | strain it |
| What is lithotripsy? | it is sued to break stones into smaller parts |
| What is ESWL? | extracorporeal shock wave lithotripsy |
| What is used in ESWL to break up the stone? | ultrasonic waves |
| Wht sould a patient do after lithotripsy to aid the smaller particles to be urinated out? | increase fluid intake |
| A pt should be taught that _____________in urine is common after lithotripsy | blood |
| What is a percutatneous nephrolithotomy? | a scope is inserted into the kidney to break up a stone and irrigate the renal pelvis |
| What is a regular nephrolithotomy? | a surgical incision is made into the kidney and the stone is removed |
| What is hydronephrosis? | urine backing up and distends the ureters and progresses to the kidney |
| What does treatment of hydronephrosis always involve? | relieving the obstruction |
| Where are stents placed to relieve hydronephrosis? | in the ureters |
| Where is a nephrostomy tube inserted to drain urine? | directly into the kidney pelvis |
| What is an ileal conduit? | a diversion where urine will be diverted out of the body via a stoma using either ileum or colon sections are used |
| What does urine from an ileal conduit normally look like? | contains mucous because the ileum normally secretes mucous |
| What is a Kock pouch? | urinary diversion, that is made from ileum that is made into a reservoir and is intermittenly cath'd |
| What is a neo bladder? | a new bladder form a section of intestine which the pt can void normally via urethra |
| What are the signs and symptoms of kidney cancer?(3 classic) | hematuria, dull pain in FLANK, mass in the area |
| What symptoms of metastasis may be first manifested? | weight loss and increasing weakness |
| What is a radical nephrectomy? | kidney removal along with adrenal gland and other surrounding structures |
| What is PKD? | polycystic kidney disease |
| Is PKD hereditary? | yes |
| What is the characteristized formations found in kidney with PKD? | grapelike cysts that contain fulid blood or urine |
| What is the treatment to stop the progression of PKD? | there is none |
| What is diabetic nephropathy? | long term complication of DM in which the effects of DM result in damage to the small blood vessels in the kidneys |
| How long after onset of DM does renal damage show up? | 15 to 20 years |
| How is diabetic nephropathy risk reduced? | control of blood glucose levels |
| What is microalbuminuria? | loss of small amounts of protein in the urine |
| How is diabetic nephropathy diagnosed? | watching for onset of protein spillage |
| What 2 tests confirm the presence of diabetic nephropathy? | serum creat and 24 hr creat. clearance |
| what is the treatment of choice for those with diabetic nephropathy? | kidney transplant |
| What is nephrotic syndrome? | large mts of protein are lost in the urine from increased glomerular membrane permeability |
| where do albumin and other serum proteins maintain fluid within the ____________space | vascular |
| What is anasarca | massive widespread edema |
| What are the complications of nephrotic syndrome? | impaired immune function, nutiritional imbalances, increased blood coagluation |
| How is diet adjusted with nephrotic syndrome? | low salt, moderate protein |
| What drugs are indicated with nephrotic syndrome? | diuretics, lipid lowering drugs, anticoagulants, steroids |
| What is nephrosclerosis? | sclerotic changes, arteriosclerosis thickening of renal blood vessels |
| Waht is the treatement of nephrosclerosis? | treatment of hypertension |
| What is the prognosis for nephrosclerosis? | poor |
| What is glomerulonephritis? | inflammatory disease of the glomerulus |
| What causes the inflammation in glomerulonephritis? | it is the result of the deposition of antigen-antibody complexes in the basement membrane of the glomerulus |
| What causes glomerulonephritis? | group A beta hemolytic strep |
| What is Goodpastures syndrome? | when glomerulonephritis is caused by an autoimmune response |
| What are the symptoms of glomerulonephritis? | fluid overload, oliguria, hypertension, electorlyte imbalances and edema |
| How long does it take for acute glomerulonephritis to resolve spontaneously? | 1 week |
| What does CRRT do? | removes fluid continuosly in a controlled manner for those in fluid overload |
| What is chronic renal failure? | gradual decrease in the function of kidneys of time |
| What is acute renal failure? | loss of kidney function is sudden with a rapid onset of hours to days |
| What are the 3 categories of renal failure? | prerenal, intrarenal and postrenal |
| What is hemodialysis? | use of artificial kidney to remove waste products |
| What is a dialyzer called? | artificial kidney |
| What is PD? | peritoneal dialysis |
| What is peritoneal Dialysis? | peritoneal membarne is used to remove excess wastes and fluids using the peritoneal membrane with a catheter inserted into the peritoneal cavity |
| Who is the princess of Mod V? | Mrs. Q!! |
| LAST MINUTE ADDITION: If a person is on PD and they do not return sufficient fluid during an exchange what intervention is used to get remaining fluid to drain? | have person roll from one side to another or assist them in the turning process |
Created by:
Kelly Quijano
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