Genitourinary #1
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| What are the functions of the kidney? | show 🗑
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| List the processes of urine formation (there's 3). | show 🗑
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| show | Amount of fluid filtered from the blood per minute. Normal range is 120-125 mL/min (adults).
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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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| show | Substances (like ammonia) are not filtrated out of the blood resulting in toxicity.
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| show | ADH (Anti-diuretic hormone) secretion causes pores of collecting tubules to enlarge -> water in interstitial spaces then reabsorbed and urine is concentrated.
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| show | Urea, uric acid, creatinine, ammonia, potassium, phosphate
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| What waste products decrease when kidneys are not functioning? | show 🗑
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| What are the functions of renal hormones? | show 🗑
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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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| Describe stress incontinence and treatments. | show 🗑
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| Describe urge incontinence and treatments. | show 🗑
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| show | No urge to void-usually caused by spinal cord lesions. Tx = surgery, urecholine, bladder compression, intermittent self-catherization (most common).
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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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| show | Enlargement of the prostate gland that causes bladder outlet obstruction.
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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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| show | Monitor for s/s infection, hemorrhage, and pain. If obstruction, turn off irrigation and irrigate catheter with 30-50 mL of NS with lg piston syringe. Increase fluid intake to 2-2.5 L/d
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| show | Caused by calcium phosphate, calcium oxalate, struvite, and cystine/uric acid. Either by diet or tumors, gout, or hyperparathyroidim.
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| What are the s/s of kidney stones? | show 🗑
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| show | Morphine (preferred) or other opiod analgesic, NSAIDs, antispasmodics, antiemetics
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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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| What should be included in discharge teaching after percutaneous nephrolithotripsy? | show 🗑
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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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| show | Increase fluid to 3 L/d, drink water at bedtime, avoid excessive sweating/dehydration, treat UTIs promptly, and diet restrictions (depends on composition)
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| Name which medications treat each type of stone. | show 🗑
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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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| show | Limit protein intake (only high biologic value protein) to lower uremia, restrict sodium according to OP, restrict fluid, limit phosphorus, and admin antihypertensives/diuretics/analgesics.
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| show | Avoid tight clothing around waist, no contact sports, how to take BP, and advise to have genetic counseling as each child has a 50% chance of having gene
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| What are the s/s of acute post-streptococcal glomerulonephritis? | show 🗑
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| What are the s/s of chronic glomerulonephritis? | show 🗑
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| show | Increase: BUN, creatinine, potassium, phosphorus. Decrease: GFR, Na (may also be normal), calcium, pH (acidosis)
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| show | Condition of increased glomerular permeability that allows larger molecules to pass through the membrane into the urine to be excreted.
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| What are the s/s of nephrotic syndrome? | show 🗑
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| Describe tx of nephrotic syndrome. | show 🗑
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