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241 EXAM 1
CHAPTER 18 URINARY
| Question | Answer |
|---|---|
| Erythropoietin | tells bone marrow to make RBC |
| Filtration of the Kidneys | blood is filters through the kidneys. the more pressure the more filtrate. Adjust the body's needs |
| Reabsorption in the kidney's | nutrients, water electrolytes take place and excretion of waste and electrolytes |
| What does the collecting ducts do? | transport urine to the renal pelvis |
| ADH | controls reabsorption of water |
| Aldostrone | holds on to sodium and water and excretes potassium |
| Atrial natriuretic peptide ANP | controls fluid fluid balance and reducing sodium |
| How much blood from out cardiac output enters the kidney? | 20-25% Kidneys love blood and need it to function |
| What can happen ig there is a obstruction to the blood flow of the kidney? | Necrosis and infraction |
| what is the pourpose of the dual arterioles? | control the pressure and the glomerular capillaries and Glomerular filtration rate (GFR) |
| what does the pressure tell us? | the GFR |
| How is filtration maintained consistent blood flow to the nephrons? | Vasoconstriction-decrease BF and increases BP and vasodilation- increase BF and decreases BP |
| Autoregulation | small local reflex adjustments (constrict/dilate) |
| Sympthaic nerves system SNS | fight or flight. increases vasoconstriction |
| Renin | secreted by cells in the kidneys when blood flow is reduced. stimulates Angiostesten I constricting so the BP will come back up to restore BF to the kidneys |
| Micturition | voiding/ urinarting |
| Urinalysis | Testing urin |
| Urine color and oder | Cloudy- protein in urine. Dark color- hematuria or excessive bilirubin or concentrated. Oder- infection or dietary components |
| BUN blood urine nitrogen and creatinine test | elevated levels indicates failure to excrete nitrogen waste from low GFR |
| Serum pH and bicarbonate blood test | ABG. Decreased GFR and failure to control acid base balance |
| Hemoglobin test | Low is when a patient is anemic. Decreased erythropoietin |
| Urine Culture and Sensitivity | Culture- identify organism in urine. Sensitivity- we see what meds the organism is sensitive to then find a med that will work |
| Cystoscope | uses camera to view lower tract, removal of kidney stones |
| Dialysis is used to? | sustain life after kidneys fail. |
| Hemodialysis | shunt(arm), catheter surgically implanted. goes through a tub into machine where waste fluid and electrolytes are filtered out then blood is retuned to the vein. 4 hours |
| Peritoneal dialysis | inserted catheter and happens every night all night. waste fluid and electrolytes are filtered out and drains out to a container |
| What do Diuretic | remove excessive sodium and water. increasing water through kidneys and more output. reduces fluid volume in tissues. Loss of electrolytes is the only bad part |
| Incontinence | loss of voluntary control of the bladder |
| stress incontinence | increased intraabdominal pressure forcing urine through the sphincter from coughing. |
| over flow incontinence | incompetent or week sphincter where urine comes through because it wont close completely |
| Retention | inability to empty bladder because bladder wont let go of the urine. requires manuel release of bladder |
| Neurogenic Bladder | patient with spinal cord injury and nerves are not working property |
| What is a UTI and what is the bacteria causing it? | bladder infection. the whole track. E-Coli |
| S/S of cystitis and Urethritis and what treatment? | Pain, dysuria, urgency, frequency, nocturia, fever nausea, malaise. leukocytosis, cloudy urine, pyuria- discharge in urine. Cervicitis, infertility, PID. Antibiotics |
| Pyelonephritis | infection of one or both kidneys |
| S/S of Pyelonephritis and treatment | Dysuria, dull aching pain in lower back, fever, nausea, malaise, leukocytosis. Hematuria and bacteria. Antibiotics and increases fluid intake |
| Glomerulonephritis (Acute post streptococcal Glomerulonephritis) | happens after a strep infection (Group A beta) 10 days - 2 weeks after strep infection. 3-7 years of age |
| What does Glomerulonephritis do to the kidney? | filtration causing the decreasing of GFR and not filter waste correctly. |
| S/S of Glomerulonephritis | dark and cloudy urine, sever edema(facial, eyes and whole body), , BP elevated, flank pain, malaise, fever, leukocytosis, oliguria-decreased output |
| How to diagnosis Glomerulonephritis? | elevated BUN and creatinine, decreased GFR, strep antibodies, metabolic acidosis, high protein and blood cells |
| How to treat Glomerulonephritis? | steroids to decrease edema, antihypertention, sodium protein and fluid restriction |
| Nephrotic syndrome | abnormality in glomerular capillaries and increased permeability. low serum albumin will leak out of the blood into the urine. decrease plasma osmotic pressure causing edema. |
| S/S of Nephrotic syndrome | Proteinuria, lipiduria, frothy urine, weight gain and edema from excessive fluid, skin breakdown and infection |
| Treatment of Nephrotic syndrome | steroids to reduce inflammation, sodium restriction, hight protein diet |
| Urolithiasis or urinary calculi | Kidney stones. can develop anyway in urinary tract. There is excessive amounts of calcium 75% in blood (hypercalcemia) or insufficient fluid intake. blocking the flow causing bacteria. |
| s/s of Urolithiasis | flank pain, renal colic (intense spasms) until it stone passes. Nausea, vomiting, tachycardia, sweating |
| Treatment of Urolithiasis and treatment? | small stones will pass on there own. large stone- lithotripsy to break up into smaller pices. Increase fluid intake |
| Hydronephrosis | complication from blocked flow of urine from kidney to bladder. it is a secondary cause and can result from renal failure |
| Renal cell carcinoma (kidney) | primary tumor in the renal cortex. |
| S/S of Renal cell carcinoma and treatment? | asymptomatic until it is metastasized. painless hematuria , dull, aching flank pain, papable mass, unexplained weight loss. nephrectomy |
| Bladder cancer | multiply tumors dingoes by urine cytology and biopsy. |
| S/S of Bladder cancer and treatment? | hematuria, dysuria, recurrent infections, gender, habits, exposure to chemicals. surgical resection of tumors or bladder, chemo, radiation, urinary diversion to collect urine |
| Nephrosclerosis | vascular changes. thicken and harding of the walls and narrowing of blood vessels. reducing blood supply to kidney causing ischemia and a release of renin |
| Treatment of Nephrosclerosis | reduce sodium intake to reduce water retention that increasing BP. take Antihypertensive meds to decrease BP |
| Vesicoureteral reflex | defect valve in the bladder causing urine to back flow in the kidneys |
| Agenesis | failure of one kidney. incidental finding if found at all because your body can run off of one kidney |
| Hypoplasia | kidney does not develop to normal size |
| Ectopic kidney | kidney and ureter is not in the correct position witch can work properly but also can be come kinked and cause infection |
| Fusion | both kidneys during development become one large horseshoe shape kidney. Function is normal |
| Polycystic kidney | multi cyst in the kidneys and get bigger and expand over years causes the kidney to become enlarged they compress and destroy the heathy kidney. |
| when do the S/S ocure for Polycystic kidney | around age 40 with the kidney becomes destroyed. uses an abdominal CT scan or a MRI |
| Acute renal failure | temporally failure of both kidneys. dialysis may be used when they are healing. |
| Why do people get Acute Renal Failure? | Reduced blood flow into the kidney. inflamed or necrosis of the tubules causing obstruction of back pressure leading to GFR and oliguria and anuria |
| S/S of Acute Renal Failure and treatment? | rapidly, elevated BUN and creatinine, metabolic acidosis, hyperkalemia . dialysis |
| Chronic renal failure | Gradual irreversible destruction. gradual loss of nephrons and asymptomatic till advanced, it can only be slowed down |
| S/S of Chronic renal failure | Oliguria, dry Pruritic- itchy skin, bruising, peripheral neuropathy, sexual dysfunction, menstrual irregular, encephalopathy, congestive heart failure, hypocalcemia, hyperphosphatemia, osteodystrophy, osteoporosis, pneumonia |
| What are the key indicators of Chronic renal failure ? | Anemia, acidosis, azotemia- build up of waste products in blood |
| What is the treatment of Chronic renal failure? | Meds that make body produce RBC, dialysis, fluid restriction, kidney transplant |
Created by:
mmarino2