Genitourinary #1
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| What are the functions of the kidney? | show 🗑
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| show | Glomerular filtration, tubular reabsorption, tubular secretion
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| What is glomerular filtration rate (GFR)? | show 🗑
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| Describe tubular reabsorption. | show 🗑
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| show | Basically the reverse of reabsorption. Substances move from the blood into the tubules to be filtrated.
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| What happens when tubular secretion is not as effective? | show 🗑
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| How is solute balance and water transport regulated? | show 🗑
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| What waste products increase when kidneys are not functioning? | show 🗑
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| What waste products decrease when kidneys are not functioning? | show 🗑
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| show | Activate vit D (allows absorption of calcium and phosphate) and secrete erythropoietin (stimulates bone marrow to produce RBCs)
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| show | NSAIDs, antibiotics (aminoglycosides, sulfonamides), chemotherapy/immunosuppressants, heavy metals, antihyperlipidemics ("statins"), street drugs
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| What can cause incontinence? | show 🗑
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| show | Loss of urine with increased abdominal pressure (ex. coughing). Tx = kegels, wt loss, estrogen, anticholinergics/antispasmodics, surgery, estrogen, electrical stimulation
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| show | Strong desire to void with large loss of urine. Tx = anticholinergics, tricyclic antidepressants, bladder training
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| Describe overflow incontinence and treatments. | show 🗑
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| show | Leakage in socially unacceptable circumstances. Tx = applied devices (caths, diapers), environmental alterations (raise toilet seat), surgery, bladder training, kegels
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| What is benign prostatic hypertrophy (BPH)? | show 🗑
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| show | Difficulty in starting (hesitancy) and continuing urination, reduced force, incomplete bladder evacuation, dribbling, nocturia
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| show | Prostate gland exam and blood studies (increased BUN, creatinine, and WBC [if infection], may have increased PSA)
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| What medications treat BPH? | show 🗑
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| show | Transurethral resection of the prostate (TURP). Criteria = chronic UTIs, hematuria, hydronephrosis, and acute urinary retention.
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| Describe post-op care for BPH sx. | show 🗑
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| What causes urolithiasis? | show 🗑
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| show | PAIN! N/V, diaphoresis, pallor, oliguria or anuria.
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| List meds to relieve pain from kidney stones. | show 🗑
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| show | Key hole surgery that uses energy to break up calculi. NPO 4 hrs before and no anticoagulant meds at least 1 wk before.
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| show | Strain urine so composition of stone can be identified and prevented, no driving for 1-2 wks, no tub baths, follow-up appt in 1-4 wks, return to work in 4d-6 wks. If stent placed-critical to have it removed.
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| What are important interventions to remember for a percutaneous nephrostomy tube? | show 🗑
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| What are important interventions to remember for a lithotripsy? | show 🗑
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| What are contraindications for a lithotripsy? | show 🗑
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| show | Bruising, colicky pain (stone not removed), and bright red or tea-colored urine
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| List other treatments for stones. | show 🗑
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| show | Thiazide diuretics for hypercalciuria. Allopurinal for hyperoxaluria and gout. AMPG and Captopril for cystinuria.
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| show | Inherited disorder in which grape-like cysts form within the nephrons. S/s can appear at 30 y/o
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| show | Steady dull or colicky abd/flank pain, proteinuria, hematuria, HTN, and increased abd girth.
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| show | HTN, ineffective breathing pattern, or renal failure
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| Describe management of polycystic kidney disease. | show 🗑
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| What should you teach a pt with polycystic kidney disease? | show 🗑
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| show | Onset of 5-21 d after strep infection (throat, tonsils, or skin), generalized edema, HTN, oliguria, hematuria. RARELY leads to renal failure!
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| show | Onset of 20-30 yrs with unknown cause, mild proteinuria/hematuria, HTN, occasional edema, and fatigue. ALWAYS leads to renal failure!
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| Which labs increase or decrease in chronic glomerulonephritis? | show 🗑
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| What is nephrotic syndrome? | show 🗑
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| show | Severe proteinuria, edema, HTN, low albumin, high serum lipid levels.
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| Describe tx of nephrotic syndrome. | show 🗑
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