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Urinary System

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