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Genitourinary & Endocrine > Endocrine & Endocrine > Flashcards

Endocrine & Endocrine Flashcards

1
Q

what is the function of the kidneys?

A

regulate the volume and composition of ECF
excrete waste products from the body
control BP
erythropoietin production
vitamin d activation
acid base regulation

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2
Q

what are the cortex of the kidneys?

A

loop of henle
collecting tubes

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3
Q

where is blood filtered in the kidneys?

A

glomeruli

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4
Q

how is blood filtered in the glomeruli?

A

filtered by hydrostatic pressure
passess through the bowman’s capsule
glomerular filtrate passes down the tubule

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5
Q

what is the normal GFR?

A

125 ml/min

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6
Q

decreased kidney capillary, increases what to get through?

A

protein

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7
Q

where is absorption mostly done?

A

GI

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8
Q

ADH is needed for?

A

it is important for water balance
regulated by posterior pituitary gland

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9
Q

what is Aldosterone needed for?

A

reabsorption of sodium and water
released from the adrenal cortex

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10
Q

what is the kidneys major role?

A

water balance
electrolyte balance
acid-base balance
control bp

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11
Q

what do ureters do?

A

carry urine from renal pelvis to the bladder

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12
Q

true or false the ureteral lumens are narrow?

A

true

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13
Q

what is the bladder?

A

reservoir for urine (600-1000ml)
the bladder is a muscle (detrusor)

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14
Q

how long is the female and male urethra?

A

female: 1-2 inches (3-5 cm)
male- 8-10 in (20-25 cm)

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15
Q

who is at most risk for UTI?

A

female

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16
Q

what is the urethrovesical unit?

A

-formed by bladder, urethra, and pelvic floor muscles

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17
Q

voluntary control of the urethrovesical unil is defined as continence, true or false?

A

true

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18
Q

how is the urethrovesical unit stimulated?

A

impulses are sent to the brain to the sacral area to the spinal cord to control the tubule

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19
Q

what is stress incontience?

A

something is pushing on it to where you can’t control

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20
Q

what is the assessment (history collection)

A

gender/age
socioeconomic/occupation
dietary/personal habit
previous surgeries/hospitalization
family/personal health history

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21
Q

what is anuria?

A

inability to urinate

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22
Q

what is olguiria?

A

small amounts of urine

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23
Q

what is polyuria?

A

too much urine

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24
Q

what is the objective data assessment for genitourinary?

A

inspection
ausculation
palpation
percussion

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25
Q

what is normal BUN?

A

7-21

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25
Q

what is normal creatinine?

A

0.6-1.3

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26
Q

what are the blood diagnostics for kidney eval?

A

serum creatinine
blood urea/nitrogen
BUN/creatinine ration
estimated GFR

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27
Q

what does the BUN indicate?

A

renal function and hydration status

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28
Q

what are the urine diagnostic studies for kidney eval?

A

urinalysis
urine studies
creatinine clearance

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29
Q

how to preform a urinalysis?

A

first morning void
examine urine within 1 hour

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30
Q

what is a urine studies?

A

urine culture and sensitivity
looking for infection

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31
Q

what is a creatinine clearance? and how to perform it?

A

collect 24 hours specimen
discard the first urination
collect for 24 hour hours into a large container and place on ice
have pt urinate at end of 24 hours and add specimen to collection

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32
Q

with renal impairment serum creatinine goes up but the urinary clearance will go down?

A

true

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33
Q

what does the KUB radiographic diagnostic show?

A

exams of abd and pelvis
delineates size, shape, and position of kidneys, ureter, and bladder. can see radioplaque and foreign bodies

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34
Q

what does IVP ct scan show?

A

see urinary tract after IV contrast media is inserted. evaluates shape of kidney, ureters, bladder. Cysts, tumors, and ureteral obstruction distort normal appearance of these structures

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35
Q

why should patients with decreased renal function not have an IVP?

A

contrast media can be nephrotoxic

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36
Q

what should be seen before patient goes in for IVP?

A

BUN and creatinine

37
Q

what does the ct scan show?

A

visualizes kub. can detect tumors, abscesses, and obstruction.

38
Q

what are the renal surgical diagnostic studies?

A

renal biopsy
cystoscopy
renal arteriogram

39
Q

how and what is a renal biopsy?

A

obtains tisse for examination to determine the type of disease
-usually done as a skin biopsy through needle insertion into lower lobe of kidney under CT or ultrasound guidance

40
Q

what are the contraindications of a renal biopsy?

A

bleeding disorders
single kidney
uncontrolled hypertension

41
Q

what is renal biopsy’s #1 risk factor?

A

bleeding

42
Q

what is done before a renal biopsy?

A

-type and crossmatch patient for blood
-ensure consent is signed
-assess coagulation status
-pt history and medication history
-review labs (CBC & H&H) (clotting factors)

43
Q

what to do after renal biopsy?

A

apply pressure
keep pt positioned on affected side for 30-60min
bed rest for 24 hours
vs q5-10 min for the first hour
assess frequently for signs of bleeding or infection

44
Q

what to do before a renal arteriogram (angiogram)?

A

-cathartic or enema may be used the night before
-before injection of the contrast material, assess for iodine sensitivity
-prior to contrast media injection, notify pt of possible transient warm feeling along the course of blood vessels
-look at the kidney function before procedure

45
Q

what to do after the renal arteriogram (angiogram)

A

-place pressure dressing over femoral artery injection site
-observe site for bleeding and inflammation
-have pt maintain bed rest with affected leg straight
-take peripheral pulses in the involved leg every 30-60 min to detect occlusion of blood flow (from thrombus or emboli)

46
Q

what is a UTI?

A

bacteria enters the sterile bladder causing inflammation

47
Q

what is the common bacterial infection in a UTI?

A

escherichia coli (E. coli)

48
Q

what can cause a CAUTI?

A

e.coli
prseudomonas species

49
Q

what are the lower UTIs?

A

urethritis
cystitis

50
Q

what is the upper uti?

A

pyelonephritis

51
Q

what are the different type of UTIs

A

lower uti
upper uti
urosepsis

52
Q

what are the risk factors of UTI?

A

immunosuppressed/immunocompromised
diabetes
Hx of kidney problems
have undergone multiple antibiotic courses
have traveled to developing countries
catheterization
cystoscopy examination
occupation/habitual delay
STI

53
Q

what is urethritis?

A

inflammation in the urethra

54
Q

what is cystitis?

A

inflammation of the bladder

55
Q

what are signs and symptoms of urethritis?

A

pain/burning/dysuria
frequency
urgency
nocturia
males: clear mucous like discharge
females: lower abd discomfort

56
Q

what are the signs and symptoms of cystitis?

A

bladder irritability
hesitancy
suprapubic pain
incontinence
nocturnal enuresis

pain/burning/dysuria
frequency
urgency
nocturia

57
Q

what are the diagnostic studies for LOWER UTI?

A

-H&P
-UA (get before antibiotics)
+nitrates
+WBC
+Leukocyte esterase
-urine culture and sensitivity (determine the bacteria and susceptibility to antibiotic drug)
-imaging studies

58
Q

what is pyelonephritis?

A

inflammation of renal parenchyma and collecting system

59
Q

how does pyelonephritis occur?

A

usually begins with lower UTI
preexisting factor may present
vesicoureteral reflex
-retrograde movement or urine from lower to upper urinary tract

60
Q

what are the causes of pyelonephritis?

A

dysfunction of lower UTI
obstruction from BPH
stricture
urinary stone
CAUTI
-recurring episodes lead to scarred, poorly functioning kidney and chronic pyelonephritis

61
Q

what are the typically signs and symptoms of pyelonephritis

A

fever
chills
flank pain

62
Q

what are other clinical manifestations of pyelonephritis?

A

fever/chills
N/V
fatigue/malaise
flank pain
may also have s/s of cystitis

63
Q

what are the diagnostic studies of pyelonephritis?

A

H&P
UA
urine culture/sensitivity
imagine studies (US, CT scan, cystoscopy)
CBC
blood culture
percussion for flank pain

64
Q

what is urosepsis?

A

UTI has spread systemically
life-threatening condition requiring emergent treatment
usually begins lower tract and ascends urethral route

65
Q

what are frequent causes of urosepsis?

A

escherichia coli
proteus
klebisiella
enterobacteria

66
Q

what are the clinical manifestations of urosepsis?

A

shiver, fever, or very cold
extreme pain or general discomfort
pain or discolored skin
sleepy difficult to rous confused
i feel like i might die
short of breath
N/V
malaise/fatigue
fever, hr increase
bp decrease

67
Q

what are uti preventions/treatment

A

antibiotics
NSAIDS or antipyretic drugs
vit c
urinary analgesics
phenazopyridine (pyridium)
fluids
IV/PO
cranberry juice

68
Q

what are the antibiotics for a UTI?

A

Nitrofurantoin, ampicillin, amoxicillin, cephlasporins, fluoroquinolones

69
Q

what are the analgesic for a UTI?

A

Phenazopyridine/pyridium

70
Q

what are the antifungals for UTI

A

amphotericin or fluconazole

71
Q

what is nitrofirantoin (macrodantin)

A

antibiotic
given 3 or 4 times a day
long-lasting preparation (macrobid) is taken twice daily

72
Q

what is Ampicillin, amoxicillin, cephalosporins?

A

antibiotic
treats uncomplicated UTI no stricture, normal bacteria

73
Q

what are fluoroquinolones?

A

antibiotic
treat complicated UTI
ex. ciprofloxacin (Cipro)
active against broad spectrum bacteria
po or iv route

74
Q

what are the adverse effects of Fluoroquinolones

A

tendon rupture
phototoxicity
N/V/D abd pain
dizziness, HA, restlessness, confusion

75
Q

what are the antifungals?

A

amphotericine or fluconazole

76
Q

what are antifungals?

A

UTIs secondary to fungi
harder on the veins, more toxic
not compatible with NS, have to hang with D10, no flushing with NS

77
Q

what os glomerulonephritis?

A

inflammation of the glomeruli
destruction of glomeruli

78
Q

when is glomerulonephritis commonly seen?

A

after strep infection or untreated strep infection

79
Q

what are the risk factors of glomerulonephritis?

A

kidney infection
nephrotoxic drugs
immunocompromised system
systemic disease

80
Q

what are the clinical manifestations of glomerulonephritis?

A

general body edema
decreased urine output
oliguria/hematuria/proteinuria
hypertension
increase BUN/creatinine
history of group A strep
evidence of immune-mediated response

81
Q

what are the nurse management of glomerulonephritis?

A

-daily wt and i&o
-measure abd girth
-medications
antihypertensive
diuretics
corticosteroids
dietary
-low in sodium/low to moderate protein/fluid restriction

82
Q

what are nephrotoxic drugs?

A

nsaids
antibiotics
contrast media

83
Q

HADSTREP

A

hypertension
Asa titer(+) this is for strep
decreased gfr
swelling in face/eyes
tea colored urine
recent strep infection
elevated BUN and creatinine
proteinuria

84
Q

what is renal calculi?

A

occurs in the kidneys, ureters, and bladder, with renal stones being the most prevelant
-calcification in the urinary system
-microscopic crystals in the urinary tract aggregate together causing a stone to occur

85
Q

what are renal calculi clinical manifestation?

A

pain (pain meds)
n/v
urinalysis (blood in urine)
+rbc
uti like symptoms (blocking and developing UTI

86
Q

What is the #1 symptom of renal calculi?

A

pain

87
Q

what are the medication nursing management for renal calculi?

A

narcotics and nsaids
antimetic
alpha-adrenergic blockers

88
Q

what are the lab nursing management for renal calculi?

A

increased BUN/creatinine
UA
cbc-infections, increased WBC

89
Q
A

Genitourinary & Endocrine (1 decks)

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