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phase 2 urinary revi
phase 2 urinary
| Question | Answer |
|---|---|
| Route of blood flow | Renal artery to afferent arterioles to gloerulus exit by efferent arterioles |
| Nephron consists of | Renal corpuscle and renal tubule |
| Renal corpuscle consists of | glomerulus surrounded by Bowman's capsule |
| tubule consists of | proximal tubule, loop of Henle and distal tubule |
| Formation of urine has three processes | glomerular filtration, tubular reabsorbtion and tubular secretion |
| Glomerular filtration depends on: | blood pressure and blood volume |
| 99% of water, electrolytes and hormones reabsorbed | tubular reabsorption |
| ADH is secreted by | pituitary gland |
| ADH regulated by | plasma osmolarity |
| Aldosterone secreted by | adrenal glands |
| ADH regulates | Na and K levels |
| Moves substance out of blood and into urine | secretion |
| Urine cosists of | 95% water,5% urea, Na, K, Cl, uric acid, creatinine and ammonia |
| acts on tubules to reabsorb Ca and decrese phosphate reabosrption | PTH |
| Function of angiotensin II | vasoconstriction and stimulates secretion of aldosterone |
| Release of Renin | Raises BP |
| Characteristics of urin | straw, pH 4.6-8.0, specific gravity 1.003-1.030 |
| measure amount of urea and nitrogen in the blood, general indicator of kidney fn | BUN |
| Normal BUN | 10-20 mg/dl |
| Most reliable meaure of renal function | serum creatinine |
| Serum creatinine | shows effectiveness of glomerular filtration |
| Normal serum creatinine level | (f)0.5-1.1 mg/dl: :(m)0.6-1.2mg/dl |
| general outline of kidneys may reveal tumors, calculi | Flat plate (KUB) |
| contrast dye, assesses kindey function | Intravenous pylegoram |
| study of renal blood vessels | angiogram (arteriogram) |
| indicates size, shape and location of kidneys, detects renal trauma, atherosclerosis, radioactive isotope | renal scan |
| used to determine type and stage of renal disorder | renal biopsy |
| must do PT, PTT, platelet count | renal biopsy |
| direct visualization of the bladder | cystoscopy |
| outlines contour of the bladder | cytsogram |
| evaluates bladder tone, residual urine | cystometrogram |
| bladder and utethra are x rayed during and after urination | cystourethrogram |
| used if ureter obstructed | nephrostomy tube |
| used to break up renal calculi | lithotripsy |
| older people present with altered mental status | UTI |
| Urethritis | inflammation of the urethra |
| most frequent cause of urethritis | e. coli |
| s/s of urethritis | dysuria, frequency, urgency, bladder spasms |
| cystitis | inflammation of the bladder |
| s/s cystitis | fever, fatigue, pain at symphis pubis, urgency, frequency, dysuria, hematuria, nocturia, bladder spasms, incontinence, low grade fever and tea-colored or dark or cloudy urine |
| most common cause of cystitis | e. coli |
| pyelonephritis | inflammation of the renal pelvis |
| s/s pyelonephritis | high fever, chills, nausea, vomiting, dysuria, severe pain in flank area |
| cause of acute pyelonephritis | bacteria (e. coli) |
| cause of chronic pyleonephritis | reflux of urine |
| tx goal for pyleonephritis | prevent further damage |
| hereditary disorder in which grapelike cysts replace normal tissue | polycystic kidney disease |
| s/s polycystic kidney disease | dull aching abdominal, lower back or flank pain |
| acute glomerulonephritis | inflammation of the capillary loops in the glomeruli |
| cause of glomerulonephritis | strep A. antibodies |
| s/s of glomerulonephritis | tea colored urine, decreasing output, peripheral and periorbital edema, RBCs and proteins present in urine |
| s/s renal calculi | sudden, severe pain |
| hydronephrosis | stretching of the renal capsule from urine retention |
| prevention of recurrence of renal calculi | high fluid intake, restrict calcium or purines, regular exercise |
| s/s urologic trauma | hematuria, low abdominal pain, pain radiating to the shoulder |
| Grey Turner's sign | bruising on abdomen or in the flank area |
| s/s ruptured baldder | hematuria, oliguria, pelvic pain |
| S/s renal cancer | anemia, weakness, weight loss and gross hematuria (classic sign) |
| radical nephrectomy | treatment of choice for renal cancer |
| nephron | Microscopic functional units of the kidney, comprised of kidney cells and capillaries, each capable of forming urine |
| glomerulus | Little ball-shaped cluster of capillaries located at the top of each nephron |
| Bowman's capsule | Top part of the nephron that encloses the glomerulus |
| renal tubule | Stem portion of the nephron |
| creatinine | Waste product of muscle metabolism filtered out of the blood by the kidneys and excreted in the urine |
| urea | Waste product formed in the liver, filtered out of the blood by the kidneys, and excreted in urine |
| ureter | Tube that carries urine from the kidney to the bladder |
| urethra | Single canal that carries urine to the outside of the body |
| albuminuria | Presence of albumin in the urine; occurs in renal disease or in normal urine after heavy exercise; aka proteinuria |
| anuria | Absence of urine formation |
| bacteriuria | Presence of bacteria in the urine |
| dysuria | Painful urination |
| nocturnal enuresis | Bed wetting during sleep |
| hematuria | Presence of blood in the urine |
| glucosuria | Glucose (sugar) in the urine |
| incontinence | Involuntary discharge of urine or feces |
| ketonuria | Presence of ketone bodies in the urine |
| nocturia | Urination at night |
| oliguria | Scanty production of urine |
| polyuria | Condition of excessive urination |
| pyuria | Presence of white cells in the urine, usually indicating infection |
| nephritis | Inflammation of the kidney |
| pyelonephritis | Inflammation of the renal pelvis |
| urinary tract infection (UTI) | Invasion of pathogenic organisms (commonly bacteria) in the structures of the urinary tract, especially the urethra and bladder; symptoms include dysuria, urinary frequency, and malaise |
| nephrolithiasis | Presence of renal stone or stones caused by mineral buildup in the kidneys - most commonly as a result of hyperuricuria (excessive amount of uric acid in the urine) or hypercalciuria (excessive amount of calcium in the urine) |
| cystitis | Inflammation of the bladder |
| uremia | Excess of urea and other nitrogenous waste in the blood as a result of kidney failure; aka azotemia |
| cystoscopy | Examination of the bladder using a rigid or flexible cystoscope |
| urinalysis (UA) | Physical, chemical, and microscopic examination of urine |
| specific gravity (SpGr) | Measure of the kidney's ability to concentrate or dilute urine |
| nitrite | Chemical test used to detect bacteria in the urine |
| blood urea nitrogen (BUN) | Blood test to determine the level of urea in the blood - a high value indicates the kidney's inability to excrete urea |
| urine culture and sensitivity (C & S) | Isolation of a urine specimen in a culture medium that propagates the growth of microorganisms; organisms that grow in the culture are identified, and drugs to which they are sensitive are listed |
| hemodialysis | Method to remove impurities by pumping the patient's blood through a dialyzer, the specialized filter of the artificial kidney machine (hemodialyzer) |
| peritoneal dialysis | Method of removing impurities using the peritoneum as the filter; catheter insertion in the peritoneal cavity is required to deliver cleansing fluid (dialysate) that is washed in and out in cycles |
| Foley catheter | Indwelling catheter inserted through the urethra into the bladder; includes a collection system that allows urine to be drained into a bag - can remain in place for an extended time |
| suprapubic catheter | Indwelling catheter inserted directly into the bladder through an abdominal incision above the pubic bone; includes a collection system that allows urine to be drained into a bag - used in patients requiring long-term catheterization |
| diuresis | increased secretion of urine |
| glycosuria | sugar in the urine |
| acute renal failure | renal failure associated with burns or other trauma or with acute infection or obstruction of the urinary tract |
| hematuria | blood in the urine |
| polyuria | renal disorder characterized by the production of large volumes of pale dilute urine |
| -cele | hernia |
| calculus | concretion of mineral salts, also called a stone |
| cystogram | x-ray of the bladder |
| cystoureterography | Cyctography that includes the ureters |
| nocturia | excessive urination at night |
| cystoplasty | surgical repair of the bladder |
| pyuria | presence of white blood cells in the urine |
| epispadias | a congenital abnormality in males in which the urethra is on the upper surface of the penis |
| retrograde pyelogram | x-ray imaging of the kidneys, ureters, and bladder after injection of contrast through a urinary catheter into the ureters |
| nephrectomy | surgical removal of a kidney |
| polycystic kidney | Multiple fluid-filled sacs form in and on the kidney |
| ureters | The tubes that carry urine from the kidneys to the bladder. |
| oliguria | production of an abnormally small amount of urine |
| urinary retention | inability to empty the bladder |
| nephr/o | kidneys |
| specific gravity | the density of a substance relative to the ratio of water in urine; 1.003-1.030 |
| urinary catheterization | passage of a catheter into the urinary bladder to withdraw urine |
| hemodialysis | the process of removing waste products from the blood due to kidney failure |
| cystitis | inflammation of the urinary bladder and ureters |
| cystoscopy | visual examination of the urinary bladder |
| nephrosonography | process of recording the kidney using sound |
| urethral stricture | narrowing of the urethra |
| nephropexy | surgical fixation of the kidney |
| stress incontinence | urinary incontinence that occurs when involuntary pressure is put on the bladder by coughing or laughing or sneezing or lifting or straining |
| nephritis | inflammation of the kidney |
| IVP | Intravenous Pyelography |
| nephrologist | a physician who studies and treats diseases of the kidney |
| cystoscopy | visual examination of the urinary bladder |
| UTI | urinary tract infection |
| nephrolysis | freeing of a kidney from adhesions |
| hydronephrosis | abnormal condition of water in the kidney |
| ureterostenosis | narrowing of the ureter |
| dysuria | painful urination |
| nephrolithiasis | kidney stones |
| lithotripsy | surgical crushing of a stone |
| Functions of the urinary system | remove wastes from blood to from urine, remove nitrogenous waste products of cellular metabolism, regulates fluid and electrolyte balance |
| Nephron | the functional unit of the kidney and forms the urine |
| under 30ml for 1 hour | this output level could signify a problem |
| Nephron filtrates | H2O, glucose, amino acids, urea, creatine, major electrolytes |
| BPH (benign prostatic hyperplasia) | prostatic hypertrophy, prostate gland enlargement can cause bothersome urinary symptoms. Untreated prostate gland enlargement can block the flow of urine out of the bladder and can cause bladder, urinary tract or kidney problems. |
| CKD | Chronic Kidney Disease, kidney can't process and function, can't make substances (ex. Vitamin D) into a usable form for the body |
| maintain chemical homeostasis of the blood | what is the main purpose of the urinary system |
| either side of the vertebral columns T-12...L-3 | The kidneys are located |
| right kidney location | which kidney is lower? |
| what can cause reflex incontinence | damage to the spinal cord above the sacral, can't tell when have to go |
| the nephron | blood filtrates through this specific part of the kidney |
| ureter | connects kidneys to the bladder |
| renal colic | painful obstruction of ureter commonly from kidney stones, pain comes from peristaltic waves |
| micturition | urinate |
| bladder | distensible, muscular sac, reservoir for urine (full bladder approx. 450mls) organ of excretion, lies in pelvic cavity behind symphysis pubis |
| 750-100ml | approximate amount the bladder can hold, 250ml creates the urge to void. |
| meatus | external opening of the urethra |
| Urinary alterations | urinary retention, urinary tract infection, urinary incontinence, urinary diversions (stoma) |
| disease affecting urination | diabetes mellitus, multiple sclerosis, anything affecting the CNS |
| infant and children urinary issue | unable to concentrate urine b/c kidneys are immature, urine is light yellow, void frequently |
| 24 months | when does voluntary control develop |
| adults urinary issues | 1500-1600cc per 24 hour, concentrates urine - normal color is amber, (nocturia -unusual), decreased renal blood flow during rest, has ability to concentrate urine |
| 1.005 to 1.030 | normal urine specific gravity (weight of concentration of substance compared to an equal amount of water) |
| components of urine culture and sensitivity | requiers a sterile or clean voided urine sample, culture i.d. the organism, sensitivity determines which antibiotics are effective |
| broad spectrum antibiotic | given (started) rather than wait for lab results on culture and sensitivity which could take 48 hours |
| Urinary issues with Elderly | impaired voiding, mobility - too weak to move, diseases (CVA, parkinson's), alzheimer's forgetting to go, glomerular filtration declines, loose muscle tone & capacity to hold urine (causing frequency), don't completely empty -residual urine |
| GFR - glomerular filtration rate | best way to test your kidney function rate and determine what stage of kidney disease |
| residual urine | becomes more alkaline and this promotes organism growth |
| urinary retention | accumulated urine in the bladder |
| urinary incontinence | loss of voluntary control to void |
| ways to get incontinence | nerve damage to bladder or brain, spinal cord injury, or aging process |
| total incontinence | no control |
| stress incontinence | small amounts of urine excreted involuntarily with coughing or laughing |
| acid urine on skin | skin break down can occur related to incontinence because of |
| nocturia | waking up a night to go |
| enuresis | involuntary discharge of urine |
| nocturnal enuresis | bed wetting |
| oliguria | diminished capacity to form urine, decrease in renal perfusion |
| anuria | no urine, caused by decrease in renal perfusion |
| min. output 30ml or 720 ml 24 hours | symptom of oliguria |
| polyuria | excessive output of urine |
| diabetes insipidus | causes excessive output of urine |
| ways of healthy urinary elimination | urinate as soon as the urge is felt, avoid stasis and distention, drink 2 to 3 liters of fluid/day limit caffein and alcohol |
| kegel exercises | strengthens urinary muscles (particularly good for woman) |
| renal calculus | kidney stone |
| measures to promote voiding | privacy and natural position, providing commode or bathroom, running water, warm water, warm water to dangle fingers, warm water over perineum, gently stroking inner thighs or pressure to symphysis pubis, pain relief, sitz bath -warmth to the bladder & pe |
| acidifying urine | inhibits microorganisms |
| foods to help prevent infection | cranberry juice, whole grain breads, meats, eggs, prunes, plums |
| indwelling catheter care | monitor for problems, perineal hygiene @ least 2X/day and prn, do not advance catheter further into urethra during perineal care |
| prevent infection and maintain unobstructed flow of urine | goal of indwelling catheter care |
| nephrostomy | artificial tube directly into the kidney (nephron) |
| "Are you allergic to shellfish?" | to find if they have allergies, this is a good question to ask regarding Intravenous Pyelogram X-Ray's |
| Intravenous Pyelogram | X-Ray Used to evaluate kidneys, ureters, and bladder, diagnose stones & tumors, IV contrast |
| Renal ultrasound | I.D.'s gross structural abnormalities, uses high frequency sound waves, no special prep |
| cystoscope | fiber optic evaluation of urinary system, local or general sedation, fluids are restricted before procedure |
| KUB | Kidneys, Ureter, Bladder |
| anti depressives | what can increase weight gain |
| male peri care | begin penile head, move down along shaft, retract foreskin, rinse and dry |
| catheter care | clean Q8 hours, clean perineum and 2 inch of catheter, no powders or lotions, keep bag off floor but below bladder, empty when full or q 8-12 hours |
| urinary ostomies | provides drainage of urine that bypasses the bladder = urinary diversion |
| ureterostomy | ureter to abdominal wall left, right bilateral |
| ileal conduit | in order to drain the urine into a detached section of ileum (a part of the small intestine). The end of the ileum is then brought out through an opening (a stoma) in the abdominal wall |
Created by:
SGT.MOSS
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