BN Ch.27 The Urinary System

Question 1

The functional units of the kidney are called __________.

Answer 1

nephrons

Question 2

Angiotensin II stimulates the adrenal cortex
to secrete __________.

Answer 2

aldosterone

Question 3

At one end of each microscopic nephron,
the __________ are partially enclosed in
a funnel-shaped structure called Bowman
capsule.

Answer 3

glomeruli

Question 4

The male urethra passes through the __________ gland.

Answer 4

prostate

Question 5

Involuntary micturition is called urinary __________.

Answer 5

incontinence

Question 6

What is the function of the Proximal convoluted tubule?

Answer 6

The proximal convoluted tubule reabsorbs some needed electrolytes (potassium, chlorine), water, and glucose, as well as some amino acids and bicarbonate.

Question 7

What is the function of the Loop of Henle?

Answer 7

The loop of Henle reabsorbs water and additional electrolytes.

Question 8

What is the function of Distal convoluted tubule?

Answer 8

The distal convoluted tubule reabsorbs sodium, water, and the remainder of glucose.

Question 9

Serves as a reservoir for urine

Answer 9

Urinary Bladder

Question 10

Conducts urine from the kidneys to the urinary bladder.

Answer 10

Ureter

Question 11

Extracts wastes from blood, balances body fluids, and forms urine

Answer 11

Kidney

Question 12

Conducts urine from the bladder to the outside of the body for elimination

Answer 12

Urethra

Question 13

Write the correct sequence of the stages involved in the renin-angiotensin-aldosterone (RAA) mechanism for raising the blood pressure in the boxes provided below.

1. Constriction of blood vessels
2. Formation of angiotensin I
3. Secretion of aldosterone
4. Formation of angiotensin Il
5. Sodium and water retention
6. Secretion of renin
7. Increase in cardiac output
8. Increase in peripheral resistance

Answer 13

6. Secretion of renin
7. Formation of angiotensin I
8. Formation of angiotensin Il
9. Constriction of blood vessels
10. Increase in peripheral resistance
11. Secretion of aldosterone
12. Sodium and water retention
13. Increase in cardiac output

Question 14

What is the trigone?

Answer 14

• The trigone is a triangular portion of the urinary bladder that does not expand and stretch, even when the bladder is full.
  
  • It is present on the floor of the urinary bladder. The attachments of the two ureters and the urethra form the three points of this triangle.

Question 15

Describe the blood supply of the kidney.

Answer 15

• The renal arteries from the aorta supply blood to the kidneys.
• They diverge and form smaller arteries until they form the afferent arterioles.
• These arterioles supply blood to the glomeruli.
• The blood from the glomerulus is carried away by the efferent arterioles.
• The efferent arterioles branch off to become peritubular capillaries.
• They surround the convoluted tubules.
• These capillaries drain into interlobular veins.
• These veins drain into the arcuate veins and the interlobar veins.
• The interlobar veins end in the renal veins, which drain into the inferior vena cava.
• The inferior vena cava returns the blood to the heart.

Question 16

What are the differences between the male and the female urethra?

Answer 16

• The male urethra is long, about 8 in (20 cm) in length.
• It passes through the prostate gland, where the two ducts of the male sex gland adjoin.
• Then the urethra passes through the length of the penis to its tip.
• The male urethra serves as a passage for both the urinary system and the male reproductive system.
• The female urethra is short.
• It is only about 1.5 in (3.8 cm) long.
• It opens to the outside at the urinary meatus or urinary canal.
• The female urethra acts as a passage for urine only.

Question 17

To be able to effectively administer care for
clients with disorders of the urinary tract, a
nurse needs to understand the functions
performed by the various organs of the
urinary tract.

1. An older adult client complains of a frequent urge to void.

a. Which factors bring about change in the
urinary tract due to aging?

Answer 17

The functioning of the urinary tract is affected by the following factors as the age advances:

• The kidney weight decreases by about 20% by 80 years of age.
• The number of nephrons is decreased by 30% to 50%.
• The membranes of the nephron thicken.
• There is a decrease in renal blood flow.
• The lining of the urinary bladder becomes fibrotic.
• The muscles of the ureters and bladder weaken.
• In women, the pelvic muscles weaken and relax due to decreased levels of estrogen and perinatal trauma from childbirth.
• In men, cancer or benign hypertrophy of the prostate is common.

Question 18

What are results of the effect of aging on
the urinary tract?

Answer 18

• The effects of aging on the urinary tract lead to the following results:
• The urine is dilute because of lessened ability to concentrate the urine.
• There is a rise in blood urea nitrogen (BUN), creatinine, and uric acid.
• The susceptibility to gout is increased.
• Less urine is formed.
• Capacity of the bladder is decreased, leading to urinary frequency and incontinence.
• Urinary retention may be seen.
• Nocturia or incontinence may be seen.
• There may be sexual dysfunction.
• Uterine or bladder prolapse may be seen.
• Bladder infections may commonly occur.

Question 19

What are the functions of the urinary system that a nurse should be aware of?

Answer 19

• A nurse should be aware of the following functions of the urinary system:
  
  • Maintenance of homeostasis,
  • Hormone production,
  • Processing of body wastes,
  • The process of elimination.
• In maintenance of homeostasis, the urinary system:
  
  • Controls the water and blood volume
  • Helps in maintaining the blood pressure
  • Regulates the serum electrolyte levels
  • Maintains the pH balance of the blood
  • Activates vitamin D required for bone calcifications
• In hormone production, the urinary system secretes:
  
  • Renin and erythropoietin.
• In processing of body wastes, the kidneys in the urinary system form the urine, and the urinary bladder stores the urine.
• In the process of elimination, the urinary system helps in eliminating wastes, excess salts, and toxic materials.

Question 20

What are the nursing interventions that
should be performed when caring for an
older adult client?

Answer 20

The nurse should perform the following nursing interventions for an elderly client:

• Monitor the fluid intake and urinary output.
• Assess the client for dehydration and edema.
• Assess blood pressure of the client.
• Assess daily weights if needed.
• Be alert that certain medications can concentrate the blood.
• Watch for toxic levels of certain substances.
• Watch the laboratory reports for any abnormality
• in levels of BUN, creatinine, and uric acid.
• Offer fluids throughout the day (maintain a minimum of 2,000 mL/d).
• Administer diuretics carefully.
• Allow for frequent bathroom visits.
• Watch for bladder infection.
• Allow 3 hours between the last fluid intake and bedtime.
• Do not use any evening fluids that stimulate voiding, such as tea, coffee, cola, and alcohol.
• Keep a night light on to make nighttime bathroom visits safe.
• Allow the use of pads for ambulatory clients.

Question 21

A client complains of a decreased amount
of micturition. When the urine is examined,
it is found to be dark yellow or amber in
color.

a. What does this indicate?

Answer 21

• Amber or dark yellow urine indicates that the urine is concentrated and contains little water.
• This indicates that the client has dehydration.

Question 22

Which factors affect the quantity of urine
produced?

Answer 22

• There are various factors that influence the quantity of urine, including:
  
  • The total amount of fluid the person takes into the body
  • The amount of perspiration
  • Hemorrhage and blood loss
  • Blood pressure
  • Vomiting
  • External temperature
  • Drugs
  • Fever, and various diseases