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SOPN Urinary System
| Question | Answer |
|---|---|
| System responsible for maintaining homeostasis by reabsorbing and retaining materials needed by the body | Urinary System |
| main function is to transport urine from the renal pelvis to the bladder. This prevents backflow of urine to the kidney when the bladder contracts | ureters |
| Normal adult capacity of the bladder | 35-450mls. |
| urinary system regulates the metabolism of what two substances | calcium and phosphate |
| Normal urine formation is | 1 ml/minute or 30mls/hour |
| Substance that decreases the amount of urine causing tubule cells to reabsorb more water | ADH -- anti diuretic hormone |
| substance that stimulates the tubules to reabsorb Na (SALT) at a faster rate | Aldosterone |
| how many WBC's would indicate an infection | 100,000/ml |
| What would be done to confirm a suspected UTI and indentify the causative organism | Culture and Sensativity |
| What indicates the capability of the kidney to excrete nitrogenous waste | Blood Urea Nitrogen (BUN) |
| Normal range for BUN levels | 6-30mg/dl depending on Labratory |
| What is the end product of protein and muscle metabolism (more reliable than BUN) | Creatinine (Cr) |
| Normal range for Cr levels | 0.5-15 mg/dl |
| What test measures Creatinine (Cr), protein excreation in patients with renal disease, and Calcium (Ca) and Uric acid levels in patients with a history of renal calculi | 24 hour Urine collection (must be refrigerated and discard 1st sample of the day) |
| What test X-Rays the kidneys, ureters, and bladder. Used to identify abnormalities of the kidney, bladder, ureters, and stones. | KUB |
| What X-Ray examination visualizes the urinary tract after the injection of a contrast dye. | IVP (Intravenous Pyelogram) |
| What is a special X-Ray examination of the urinary bladder. Contrast is instilled into the bladder via a cystoscope and the purpose is to visualize the bladder, films are taken and the dye is drained from the bladder via catheter | Cystogram |
| What involves the use of a lighted scope to inspect the bladder, used for diagnosis and treatment of bladder cancer. (Procedure will be postponed for a UTI!) | Cystoscopy |
| Needle biopsy on a kidney and the most frequent biopsy used. Used to diagnosis renal disease or to evaluate the progression of already diagnosed renal disease | Open Renal Biopsy |
| How would you prevent a lung puncture when doing a needle biopsy | hold your breath |
| Nursing intervention after an open renal biopsy | lie prone for 1 hour bed rest for 24 hours of longer |
| Performed by injecting contrast into the renal artery via catheter inserted into the femoral artery. Purpose is to visualize the renal blood vessels | renal angiography |
| what would provide continuous drainage of the bladder | Indwelling catheter |
| what would be used after surgery for a temporary time to drain the bladder | temporary catheter |
| what would be used for long term management of urinary retention | Permenant catheter (ie: superpubic) |
| What is a sterile, closed drainage system inserted using strict aseptic technique | catheter |
| Irrigations of a catheter are done using what technique | clean technique |
| genitourinary specific antibacterials | cipro & bactrim |
| What is used in hyperkalemia, as well as IV insulin because potassium will move into the cells when insulin is given | Kayexalate |
| what therapy is used to correct acidosis | sodium bi-carbonate |
| What food is high in potassium | cirtus fruits |
| What intravesical therapy is used to treat superficial bladder tumors. It stimulates the immune system RATHER than acting directly on the cancer cells | BCG (weakened strain of Mycobacterium Bovis) |
| an antineoplastic antibiotic | valrubin (valstar) |
| inflammation of the bladder. Usually the result of an invasion of bacteria into the urinary tract. Urinary anylasis would show both red and white blood cells | Cystitis |
| Patient has Cystitis, what would you instruct your patient to do to lessen irritation to the bladder and avoid stasis | drink 2-3 liters of fluid |
| nephrolithiasis or kidney stones present in the urinary tract. frequent in men 30-50 | Renal Calculi |
| kidney stone caught in the ureter can cause | hydronephrosis |
| What would you use to medicate for a kidney stones | demerol or morphine sulfate |
| To dislodge or crush a kidney stone | cystoscopy (basket cystoscopy to scoop the stone out) |
| test where a patient is immersed in a warm bath and ultrasound waves are delivered to crush or break up the stones | shock wave lithotripsy |
| What would you do for: Large impacted stones, multiple stones, or stones that completely obstruct the urinary tract | surgery |
| Lithotripsy that involves an incision THRU THE KIDNEY | Nephrolithotomy |
| Lithotripsy that involves the REMOVAL OF THE STONE THRU THE PELVIS | Pyelolithotomy |
| Lithotripsy that involves the REMOVAL OF THE STONE THRU THE URETER | Uterolithotomy |
| What would you never do to a renal or urethral catheter | irrigate |
| what would you never do to a nephro or urethral catheter | clamp |
| treatment for bladder cancer involves the removal of the bladder and requires urinary diversion | Cystectomy |
| Name: Transplant ureters to a section in the terminal ileum and bring the ileum out thru a stoma. Iliostomy bag is used to collect the urine. Skin barrier needed to protect the skin, and need to increase fluids in the diet | Ileal conduit |
| ureters are introduced to sigmoid allowing the urine to flow thru the colon and out thru the rectum | uretersigmoidscopy |
| brings ureters thru the abdominal wall and the stoma is created | cutaneous uterostomy |
| insert the catheter into the renal pelvis of the kidney via a flank incision | nephrostomy |
| what is the most common cancer in men with metastasis early to the lungs, liver, bone, and brain. Most common symptom is painless hematuria | renal tumors |
| An acute inflammation of the kidney (usually both) that affects the capillary loops in the glomeruli. Usually post strep infection and treated with penicillian or emycin. Urine looks like Coca Cola and has proteinuria | glomerulonephritis |
| What is associated with protein wasting (proteinuria) | nephrotic syndrome |
| Diet to treat: decrease - restrict Salt(Na) and protein due to increased BUN, this allows the kidney to rest | glomerularnephritis |
| What disease is caused by the progressive impairment of renal function caused by the destruction of glomeruli | chronic glomerulonephritis |
| partial or total loss of kidney function. Occurs suddenly and usually is reversible with treatment. Has a high risk for acidosis due to fluid retention | acute renal failure |
| sudden interruption of kidney function resulting from obstruciton, reduced circulation, or diease of renal tissue. May progress to end stage disease | Acute renal failure |
| Acute renal failure stage 1 *Patient is acutely in during this phase and the longer the phase the worse the prognosis* | oilguria phase less than 400cc's in 24 hours. With pruritis |
| acute renal failure stage 2 | Diuretic phase 1000cc's in 24 hours specific gravity decreases. Decreased BUN and Cr levels |
| acute renal failure stage 3 | recovery phase takes up to a year while the kidney recovers |
| Result of gradual progressive loss of renal function. Symptoms appear after 75% of filtration is lost. Progressive loss of nephrons that leads to increased retention of water and waste products | Chronic Renal Failure |
| S&SX: Large volume of dilute urine, polyuria, nocturia, HTN, increased bleeding tendencies, urinary odor of breath, uremic frost, puritis, behavioral changes, and weightloss | Chronic Renal Failure |
| Yellowish appearance of wastes of metabolism not excreted by the kidneys into the urine are excreted thru the skin and collect on the surface | Uremic Frost |
| end stage renal failure | uremia |
| How would you decrease the work of the kidneys | restrict protein, potassium, and Salt |
| The removal of waste products using a semi-permeable membrane. Main indicator for the need of this treatment is a rising potassium level | Dialysis |
| A catheter is inserted thru a sm incision in the abdomen between the umbilicus and symphis pubis. For permenant and for long use. 2000cc's of dialysising fluid is allowed to enter over a certain time frame. Cath clamped and the fluid remains for a time | Peritoneal Dialysis |
| Chronic renal failure needs | emotional support |
| Usually done 3X a week in a hospital or clinic setting. Synthetic materials inside the kidney mchine serves as a semi permeable membrane | Hemodialysis |
| The shunt is checked by | bruit (hear) and thrill (feel) |
| mental status changes may indicate? | disequilibrium or electrolyte imbalance |
| What drugs suppress the body's immunologic function? | prednisone and Imuran |
| surgical opening into the kidney and placement of a catheter in the renal pelvis for urinary drainage | nephrostomy |
| catheter inserted into the bladder for urinary drainage. Used with urethral injury. Prostatic obstruction, or urethral stricture. May be used for long term catheterization. Clamp and release regime until the patient can void normally then discontinue | Supra Pubic Tube |
| Tubular device inserted into the ureters to maintain the flow of urine in patients that have a kink. Soft and flexible, made of silicone, can be temp or permenant. | Uretal Stent |
| surgical removal of a kidney | nephrectomy |
Created by:
Beezle
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