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