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68WM6 Ph 2 GU

Urinary System

severe generalized edema anasarca
urine output less than 100ml per day anuria
a general feeling of tiredness or listlessness asthenia
the buildup of nitrogenous waste products in the blood azotemia
a medical procedure for the removal of elements from the blood through an external semipermeable membrane or the peritoneum dialysis
painful or difficult urination dyruria
blood in the urine hematuria
dilation of the renal pelvis and calyces hydronephrosis
a substance that causes destruction of the kidney nephrotoxin
excessive urination at night nocturia
low urine output less than 400ml per day oliguria
pus in the urine pyuria
the volume of urine remaining in the bladder after a pt voids residual urine
normal volume of residual urine less than 50ml
What are the 4 functions of the urinary system? excrete waste products, regulate fluid and electrolytes, maintain acid base balance, secrete erythropoietin
hormones secreted by the kidneys to stimulate the production of red blood cells erythropoietin
Which kidney is located anatomically lower than the other kidney? right kidney
the kidneys are surrounded by a layer of this kind of tissue adipose
a notch found near the center of the medial border where the ureter blood vessels and nerves enter and exit the kidney hilus
outer covering of the kidney made of strong connective tissue renal capsule
just beneath the capsule and contains 1.25 million renal tubules renal cortex
lies beneath the cortex and is darker in color; contains the triangular pyramids renal medulla
narrow points of the pyramids that drain into the calyces palilla
what is the functional unit of the kidney? nephron
lightly bound network of capillaries glomerulus
blood enters the glomerulus via which arteriole afferent
blood exits the glomerulus via which areteriole efferent
cuplike structure that collects the glomerular filtrate bowman's capsule
secreted water and electrolyes and waste products travel through the collecting duct and out of the kidney as this urine
between the ages of 40 and 70, the filtering mechanism of the kidneys becomes ____ _______ less efficient
weakened musculature in the bladder and urethra, diminished neurological sensation, and decreased bladder capacity are effects of this on the urinary system aging
females be come more prone to this urinary issue with aging UTI's
urinary retention or hesitancy in males is frequently caused by this benign prostatic hypertropy
men become more prone to UTI's with aging because of this decreased bactericidal secretion from the prostate
most commonly used urinary diagnostic test routine urinalysis
routine urinalysis can be used to test these things color, clarity, odor, pH, specific gravity, protein, glucose, ketones, RBC's and WBC's
what is the normal pH range of urine 4.6-8.0
what is the normal specific gravity of urine? 1.005 -1.030
measurement of excreted substances by the kidney during a 24 hour period 24 hour urine
substances commonly measured in a 24 hour urine protein, creatinine, urea, uric acid, catecholamines
used to confirm suspected infections, identify causative organisms, determine appropriate antimicrobial therapy, and periodically screen urine for infection culture and sensitivity
this portion of the culture and sensitivity can reliably differentiate between infection and contamination of a clean catch colony count
this test is an excellent indicator of renal function and determines efficiency of kidneys clearing creatinine from blood urine creatinine clearance
what kind of specimen is required for a urine creatinine clearance 24 hour
this test measures creatinine levels in blood serum creatinine
this test determines the kidney's ability to rid the blood of urea BUN
normal creatinine clearance 80-139 ml per minute
normal serum creatinine 0.5 to 1.2 mg per dl
normal BUN 10-20 mg per dl
an organ specific glycoprotein produced by normal prostate tissue PSA
false positive PSA can be caused by tissue manipulation
normal PSA 4 mg per dl
measurement of the weight of the solvent compared with the weight of the solute osmolality
provides information regarding the ability of the kidneys to concentrate urine osmolality
radiological procedure to evaluate the size, structure and position of the urinary tract structures KUB (kidney ureter bladder)
before IVP (intravenous pyelogram) the nurse should determine if a patient has an allergy to iodine, saltwater fish, vegetables
common side effect of contrast injection flushing, metallic taste
examination of the lower urinaty tract with a sterile cystoscope retrograde pyelography
patient may be asked to void during this procedure voiding cystourethrography
noninvasive procedure used to identify the kidney's shape, size, location, collecting systems, and adjacent tissues ultrasound
visual examination to inspect, treat, evaluate, or diagnose disorders of the urinary bladder and proximal structures cystoscopy
following cystoscopy, what should the nurse encourage? increased oral hydration
performed with a nylon brush via a urethral catheter during a cystoscopy brush biopsy
performed through the skin to directly visualize the upper urinary structures nephroscopy
evaluates blood supply to the kidneys, evaluates masses and detects potential complications after renal transplant renal angioogram
rectangular area created from ligaments that suspends and anchors the bladder within the pelvic and pubic bones trigone
a continuous layer of cells that line the renal pelvis, ureters, and urinary bladder transitional epithelium
contains layer of smooth and involuntary muscle that contracts to expel bladder contents through the urethra bladder wall
extends from the urinary bladder to the exterior urethra
surrounds the male urethra prostate
provides involuntary control over the discharge of urine from the bladder internal sphincter
a circular band of skeletal muscle that is under voluntary control located at the end of the urethra external sphincter
composed of the kidneys, renal pelvis, and ureters upper urinary tract
bladder, urethra, pelvis floor muscles lower urinary tract
how much does the normal bladder hold? 750 to 1000 mL of urine
average hourly output of urine for an adult 30cc
voiding occurs more often than normal frequency
conditions that can result in urinary frequency infection, disease of urinary tract, metabolic disease, hypertension, medications
conditions that can result in dysuria infection of lower urinary tract, irritation following intercourse, bath and feminine hygiene products
bed wetting enuresis
strong desire to urinate urgency
conditions that can result in urgency inflammatory lesions, bacterial infections, chronic prostatitis
excessive urination at night nocturia
conditions that can result in nocturia decrease renal concentration ability, heart failure, diabetes mellitus
large volumes of urine voided in a given time polyuria
passage of gas in urine during voiding pneumaturia
conditions that can result in urinary hesitancy urethral compression, outlet obstruction, neurogenic bladder (trauma) UTI
conditions that can result in urinary incontinence infection, sphincter damage, spinal damage, congenital defects, bladder trauma
four types of urinary incontinence stress, urge, overflow, functional
medications usued in the treatment of urinary incontinence ditropan, dibenzaline, urecholine, detrol
exercises that can be helpful in mitigating incontinence in female patients kegels
signs/symptoms of bladder or urinary tract infection urinary discomfort, rash, lower abdominal pain, fever/chills, cloudy or foul smelling urine
causes of urinary retention in males benign prostatic hypertrophy, strictures, foreign bodies, phimosis, urethritis
causes of urinary retention in both males and females obstruction, postoperative, trauma, medication side effect, fecal impaction, infection
cause of urinary retention seen only in females retroverted uterus
residual urinary retention greater than 50mL indicates urinary retention
urinary analgesics pyridium, prosed DS
antispasmodics used for patients with urinary retention uroxatol, ditropan, detrol, detro LA
loss of voluntary bladder control resulting in urinary retention or incontinence neurogenic bladder
conditions that can result in neurogenic bladder congenital anomaly, neurological disease, trauma
caused by a lesion above the voiding reflex arc resulting in bladder wall atrophy and decreased capacity spastic bladder
caused by a lesion of a lower motor neuron resulting in distension with urine stasis and incomplete emptying, and loss of urge to foid flaccid bladder
diaphoresis, flushing, and nausea followed by episodes of urinary incontinence would be indicative of spastic bladder
medications used to enhance urinary output diuretics
carbonic anhydrase inhibitor diuretic acetazolamide
loop diuretics bumetanide (bumex), furosemide (lasix), toresemide (demadex)
osmotic diuretic mannitol (osmitrol, resectisol)
potassium sparing diuretics amiloride (midamor), spironolactone (aldactone), triamterene (dyrenium)
thiazide diuretics chlorothiazide (diuril), hydrochlorothiazide (esidrex)
thiazide like diuretics chlorthalidone (hygroton, thalitone), indapamide (lozol), metolazone (mykrox, zaroxolyn)
this electrolyte imbalance can cause enhanced digitalis glycoside toxicity hypokalemia
signs and symptoms of hypokalemia weakness, numbness, tingling, parasthesia, confusion, excessive thirst
patients on diuretics should have these lab values monitored frequently potassium, blood glucose, BUN, serum uric levels
oral diuretics should be administered at what time of day morning
potassium replacement should be administered if levels are below 3mg/dL
desired effects of diuretics decreased blood pressure, increased urine output, decreased edema, decreased intracranial pressure
these diuretics are appropriate for the prevention of renal calculi composed of uric acid or cystine, prevention of altitude sickness, treatment of increased intraocular pressure, and to decrease the frequency of seizures carbonic anhydrase inhibitor diuretics
these diuretics are appropriate for use in the treatment of hypertensions, edema from CHF, or from hepatic or renal disease loop (high ceiling) diuretics
loop diuretics are contraindicated uncorrected electrolyte imbalance, hepatic coma, anuria
Loop diuretics can generally decrease blood concentration of ____________ and increase blood concentration of ___________ ______________ such as BUN, serum glucose, creatinine, uric acid, and cholesterol electrolytes, metablolic byproducts
these diuretics are used as ADJUNCTS in the treatment of oliguric renal failure, edema, increased intracranial pressure, and toxic overdose osmotic diuretics
osmotic diuretics are contraindicated anuria, dehydration, ACTIVE INTRACRANIAL BLEEDING
osmotic diuretics can be given to treat this electrolyte deficiency hypomagnesemia
these diuretics are given to control pregnancy related seizures osmotic diuretics
these diuretics counteract potassium loss caused by thiazide and loop diuretics potassium sparing diuretics
these diuretics cause loss of sodium bicarbonate and calcium while saving potassium and hydrogen ions at the distal tubule potassium sparing
potassium sparing diuretics are contraindicated hyperkalemia
strange side effect of potassium sparing diuretics bluish urine
these diuretics are used alone or in combination in the treatment of hypertension and edema due to CHF, renal dysfunction, cirrhosis, corticosteroid therapy, and estrogen therapy thiazide diuretics
these diuretics increase the kidney's filtration of sodium and water and promote the excretion of chloride, potassium, magnesium, and bicarbonate thizide diuretics
thiazide diuretics are contraindicated anuria, lactation
common adverse side effect of thiazide diuretics in diabetics hyperglycemia
a patient taking thiazide diuretics is experiencing the desired effects of the medication if blood pressure decreases, edema decreases, urine output increases
these diuretics increase excreation of sodium and water by inhibiting sodium reabsorption in the distal tubule thiazide like diuretics
these medications provide relief from pain, itching, burning, urgency, and frequency associated with infection or urologic procedures urinary tract analgesics
pyridium is contraindicated glomerulonephritis, hepatitis, uremia, renal failure, G6PD deficiency
patients taking pyridium should be warned about this odd side effect bright orange urine
these medications are used to treat frequent urination, urgency, nocturia, incontinence, and overactive bladder urinary tract antispasmodics (anticholinergics)
commonly used urinary tract antispasmodics oxybutynin oral or transdermal
oxybutynin is contraindicated glaucoma, intestinal obstruction, toxic megacolon, paralytic ileus, myasthenia gravis, hemorrhage/shock, obstructive uropathy
side effect of ocybutynin that males specifically should be warned about impotence
these medications are used to treat urinary retention (nonobstructive) urinary tract stimulants
these medications for urinary retention mimic the effects of the parasympathetic nervous system to stimulate gastric motility and micturation urinary tract stimulants (cholinergics)
commonly used urinary tract stimulants bethanechol chloride (urecholine); neostigmine (prostigmin)
urinary tract stimulants are contraindicated mechanical obstruction of GI or GU tract
antidote for cholinergics atropine
bacteria in the urine bacteriuria
commmon cause of nonsocomial urinary tract infections catheters
chronic conditions that increase a patient's risk of urinary tract infections diabetes, MS, spinal cord injuries, hypertension, kidney disease
infection/inflammation of the urethra urethritis
infection/inflammation of the urinary bladder cystitis
infection/inflammation of the kidney pyelonephritis
infection/inflammation of the prostate prostatitis
what type of organism most commonly causes UTI's gram negative bacteria
methods for preventing urinary tract infections increased fluid intake, avoid coffee, tea, colas, and alcohol, shower rather than bathe, wipe from front to back, avoid irritating substances, wear cotton underwear, void every 2 to 3 hours
how is urethritis classified by presence or absence of gonorrhea
most common cause of nonspecific urethritis chalmydia
signs and symptoms of urethritis dysuria, frequency, pruritis, urethral discharge, NO FEVER
causes of cystitis urethral reflux, diagnostic studies, fecal contamination (e. coli), catheters, sexual intercourse
signs and symptoms of cystitis urgency, frequency, dysuria, perineal and suprapubic pain, nocturia, hematuria, chills and fever
antibiotics commonly used for treatment of cystitis septra, bactrim, macrodantin
most common cause of pyelonephritis e. coli
chronic pyelonephritis is most commonly associated with recurrent infections or chronic obstruction
kidney failure develops when large numbers of ________________ are destroyed nephrons
pain in this area is a key sign of pyelonephritis costovertebral angle
urinary antiseptic used to treat gram negative microbes only; common side effects include vertico, weakness, nausea, and vomiting quinolone (nalidixic acid)
urinary antiseptic used to treat gram positive and negative microbes, common side effects include, loss of apppetite and nausesa/vomiting nitrofuratoin
urinary antiseptic used to suppress fungi and gram positive or negative organisms; used to prevent reinfection after antibiotic use and rarely causes side effects methenamine (mandelamine)
urinary antiseptic; broad strectrum effective against gram positive or negative organisms fluoroquinolone
signs of super infection black, furry overgrowth on tongue; vaginal itching or discharge; loose or foul smelling stools; allergic reaction
methenamine is converted to ___________ in the urine formaldehyde
this supplement can help to acidify urine vitamin C
mouth should be rinsed following administration of nitrofurantoin to prevent this teeth staining
a patient with UTI should be encouraged to __________ oral fluid intake increase
nonbacterial prostatitis results from _______ of the urethra occlusion
signs and symptoms of prostatitis burning, perineum discomfort, dysuria, frequency and urgency, URINARY RETENTION
how long are antibiotic administered for prostatitis? 4 to 12 weeks
these activities should be avoided in acute prostatitis arousal, sexual intercourse
possible complications of urinary obstruction electrolyte imbalance, infection (from urine stasis), ischemia (due to compression), atrophy of renal tissue
causes of urinary obstruction strictures, kinks, cysts, tumors, calculi, BPH
catheter choice of urinary obstruction is dependent on location of obstruction
mesh like tube or coil inserted via cystoscopy to regain patency of ureter ureteral stent
possible complications of ureteral stent placement diabetes insipidus, dehydration
cause of hydronephrosis obstruction
prolonged pressure associated with hydronephrosis can result in renal fibrosis and loss of function
signs and symptoms of hydronephrosis flank pain, nausea and vomiting related to pain
factors that increase risk for renal calculi immobility, hyperparathyroid (overproduction of calcium), recurrent UTI, dehydration, excessive vitamin D intake, osteoporosis
age group and gender in which renal calculi are most common 20-30 year old males
stones in the kidney nephrolithiasis
stones in the ureter ureterolithiasis
stones in the bladder cystolithiasis
signs and symptoms of urolithiasis flank pain, hematuria, pyuria, vomiting, hydronephrosis
removal of stone from ureter ureterolithotomy
removal of stone from renal pevis pyelolithotomy
removal of ston from renal parenchyma (tissue) nephrolithotomy
alkylating or acidifying agents instilled to dissolve stone chemolysis
to verify passsage of stone, what must be done to urine? straining
loss of voluntary voiding control resulting in urinary retention neurogenic bladder
factors that increase the risk of renal tumors gender, smoking, family history, preexisting renal disorders
signs and symptoms of renal tumors intermittent hematuria, weight loss, dull flank pain, mass in flank, fatigue
treatment for renal tumors includes surgery (nephrectomy), radiation, chemotherapy
most common site of cancer in the urinary tract bladder
genetic disorder where multiple fluid filled cysts slowly replace much of the kidney polycystic kidney disease
renal function compromise in polycystic kidney disease is caused by pressure, secondary infection, tissue scarring from cyst rupture
most common site of cysts in polycystic kidney disease collecting ducts
signs and symptoms of polycystic kidney disease flank pain, HEADACHE, GI upset, voiding disturbances, recurrent uti's, hypertension
what is the treatment for polycystic kidney disease relief of pain and symptoms, no cure
secretes alkaline fluid that helps neutralize seminal fluid and increases sperm motility prostate
signs and symptoms of BPH urinary retention, hematuria, oliguria, renal insufficiency
to avoid rapid decompression of bladder, drainage should be stopped at 1000 mL
most common procedure for relief of BPH transurethral resection of prostate
antihypertensive used in the treatment of BPH terazosin hydrochloride (Hytrin)
androgen inhibitor used in the treatment of BPH finasteride (proscar)
proscar (finasteride) is contraindicated women
side effects of androgen inhibitors that the patient should understand decreased libido, decreased ejaculate volume, impotence
urinary tract antispasmodic used in the treatment of BPH alfuzosin (uroxatral)
alfuzosin (uroxatral) is contraindicated hepatic impairment, alpha blockers, renal impairment, women or children
possible sytemic side effect of alfuzosin (uroxatral) hypotension
at risk age group for prostate cancer over 50
by the time prostate cancer causes urinary symptoms, this has usually already occurred metastasis
the key objective difference between BPH and prostate cancer feeling of prostate, boggy and enlarged with BPH, firm and possible nodules, with cancer
which prostatectomy procedure provides access to pelvic lymph nodes? retropubic prostatectomy
in this prostatectomy the approach is through the bladder suprapubic prostatectomy
in this prostatectomy the prostate is removed via the urethra tranurethral prostatectomy
this prostatectomy is one of the most effective ways of curing cancer radical perineal prostatectomy
trauma to the urethra can result in strictures
in this prostatectomy the approach is low on the abdomen and leaves the bladder intact retropubic prostatectomy
general term the encompasses all urinary calculi urolithiasis
proteinuria, hypoalbuminemia, and edema along with anorexia, fatigue, and alteration of renal function would be indicative of nephrotic syndrome (nephrosis)
urine with protein in it can appear foamy
diet for nephrotic syndrome low sodium, high protein
signs and symptoms of glomerulonephritis periorbital edema, visual disturbanses, nausea, anorexia, anemia, nosebleeds, headache, irritability, malaise, edema, dyspnea, hematuria, oliguria, anuria, nocturia, flank pain/tenderness
glomerulonephritis can cause this, which can lead to cerebral and cardiac complications hypertension
glomerulonephritis is usually treated with antibiotics (to prevent infection), diuretics, antihypertensives, vitamins, iron supplements, corticosteroids
diet for glomerulonephritis low protein, low sodium
clinical manifestations of chronic glomerulonephritis anasarca, headaches (in morning), hypertension, visual disturbances, cerebral edema, heart failure, dyspnea, nocturia, proteinuria, anemia
urea in the blood can cause this uncomfortable side effect pruritis (itching)
causes of acute renal failure thrombosis in renal arteries, sever hypotension, burns, sepsis, blood transfusion reactions
these two heavy metals are nephrotixic lead, mercury
recovery from acute renal failure may take this long one year
a patient with chronic renal failure may have lost this percentage of function before symptoms develop 80
terminal stage of renal failure uremia
causes of chronic renal failure chronic kidney disease, urinary tract obstruction, diabetes mellitus, congenital abnormalities, lupus, hypertension
a patient with chronic renal failure will smell like urine
indications for hemodialysis severe renal failure, acute poisoning, metabolic acidosis, sever volume overload
peritoneal dialysis is contraindicated systemic inflammatory disease, previous abdominal surgery, chronic back pain
surgical removal of kidney nephrectomy
a catheter inserted into the kidney pelvis for drainage nephrostomy
how much fluid can safely be used for irrigation of a nephrostomy tube 5mL
most common urinary diversion following cystectomy ileal conduit
continent urinary diversion technique ileal urinary resoirvoir
Created by: ewoff85