Chapter 48 Flashcards
Primary regulators of fluid and acid-base balance; right is slightly lower than left due to liver; 1,200 ml of blood passes through every minute; each contains approx. 1 million nephrons; produce 60ml of urine per hour (1,500ml daily)
The Kidneys
The functionary units of the kidneys
The Nephrons
A tuft of capillaries surrounded by the bowman capsule
Glomerulus
Glucose and other solutes are absorbed in the _________
Loop of Henle
Site of water and electrolyte reabsorption
Proximal convoluted tubule
Site of additional water and sodium reabsorption
Distal convoluted tubule
In adults, the ureters range from ____ to ____ in length and about ______ in diameter
25 to 30cm; 1.25cm
Backflow
Reflux
Hollow, muscular organ which serves as a urine reservoir; normal capacity ranges from 300 to 600 ml
Urinary Bladder
Smooth muscle layers of the bladder; allow bladder to expand and contract
Detrusor muscle
Triangular area marked by ureter openings
Trigone
Openings
Meatus
The urethra is between ___ and ___ cm for women and _____ cm for men
3, 4; 20
Stretch receptors are stimulated when there is ____ to _____ ml of urine present in adult bladders and _____ to _____ ml in children
250, 450; 50, 200
Urine output increases to 250 to 500ml a day during first year; may urinate as often as 20 times daily; born without urinary control
Infants
Take responsibility for independent toileting
Preschoolers
Kidneys double in size between ages 5 and 10; urinates 6 to 10 times daily;
School-Age Children
Involuntary passing of urine
Enuresis
Involuntary passing of urine during sleep
Nocturnal Enuresis
True or False Excretory function of the kidneys diminishes with age
True
Complaints of urinary urgency and frequency are common;
Older adults
Increase urine formation through the prevention of reabsorption of water and electrolytes
Diuretics
Production of abnormally large amounts of urine by the kidneys
Polyuria (diuresis)
Polyuria following excessive fluid intake
Polydipsia
Low urine output; usually less than 500ml daily or 30ml/hr
Oliguria
Lack of urine production
Anuria
Technique by which fluid and molecules pass through a semipermeable membrane; two most common methods are hemodialysis and peritoneal dialysis
Dialysis
Voiding at frequent intervals, more than four to six times daily
Urinary frequency
Voiding two or more times nightly
Nocturia
Sudden, strong desire to void
Urgency
Voiding that is either painful or difficult
Dysuria
A delay and difficulty in initiating voiding
Urinary hesitancy
Involuntary leakage of urine or bladder control; symptom, not a disease; 13 million Americans suffer from it, 85% are women; common causes include: UTI’s, urethritis and pregnancy.
Urinary Incontinence
Overdistended bladder caused by urine accumulation; causes poor contractility of detrusor muscle
Urinary retention
Interference of normal mechanisms of urine elimination due to impaired neurologic function
Neurogenic bladder
True or False Normal urine consist of 90% water 10% solutes
False, normal urine consist of 96% water and 4% solutes
Urine remaining in the bladder after voiding; normally ranges from 50 to 100ml
Residual urine
Urea is measured as ___________
Blood Urea Nitrogen (BUN)
The _______ _________ test uses 24 hr urine and serum creatinine levels to determine the glomerular filtration rate
Creatinine clearance
A normal daily intake averaging ________ ml of measurable fluids is adequate for most adult clients
1,500
Skin that is continually moist becomes _______
Macerated (softened)
True or false Applying a condom catheter may not be delegated to unlicensed assistive personnel
False
Method of applying manual pressure on the bladder to promote bladder emptying
Crede’s maneuver / method
Clients with a retention catheter should drink up to______ ml per day, if permitted
3,000
True or false Routine changing of the catheter and tubing is recommended
False
Flushing or washing out
Irrigation
A __________ catheter is inserted surgically throughout eh abdominal wall above the symphysis pubis into the bladder
Suprapubic
When one or both of the ureters may be brought directly to the side of the abdomen to form small stomas
Ureterostomy
A ___________ diverts urine from the kidneys to a stoma
Nephrostomy
A ___________ may be formed when the bladder is left intact, but voiding through the urethra is not possible
Vesicostomy
The most common urinary diversion is the ______ _______; this is when a segment of the ileum is removed and the intestinal ends are reattached
Ileal conduit
