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GENITOURINARY KQ

Genitourinary System

QuestionAnswer
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