Genitourinary Overview And Assessment Flashcards by Elizabeth Gausin

Kidney function

Regulate the volume and composition of ECF
Excrete waste products from the body
Control BP
Erythropoietin production
Vitamin d activation
Acid base balance regulation

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Glomerular filtration

Catch the beads and now its going to go through tubes to filter some more

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GFR

125ml/min

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ADH

Important in water balance
Regulated by posterior pituitary gland

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Aldosterone

Reabsorptiom of na & water
Released from adrenal cortex

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Ureters

Carry urine from renal pelvis to bladder
Ureteral lumens are narrow

Some occlusion can happen here

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Urethra

Women 1-2 inches
Men 8-10 inches
Women higher risk for UTI

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Bladder

Reservoir for urine
Capacity 600-1000ml
Detrusor (bladder muscle)
Urination,micturition, voiding

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Contincence

Voluntary control

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Stress incontinence

Like when you sneeze or do activity and accidentally pee

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Why is it important to assess gender

Women high risk of uti

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Assessment history collection

Are they taking baths, homeless
Gender/age
Dietary habits
Previous surgeries /hospitalization
Family / personal health history

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What can antibiotics cause

Yeast infections(kills good flora)
Nephrotoxic (check kidney function

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Medication use

Prescription/otc
(Antibiotics , nsaids)
Vitamins herbal supplements
Potential nephrotoxic agent

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Diuretics

Watch i&o

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Anuria

Inability to urinate

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Oliguria

Production abnormally small

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Nephrotoxic drugs

Amphotericin , vancomycin, gentamicin , chemo therapy drugs, cocaine , heroine

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Polyuria

Going more than normal
Excessive
Frequent

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Health perception / management pattern

Assess how pt takes care of them selves and assess where they see themselves going from here

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Nutritional metabolic pattern

How’s apetite, weight loss (dehydration, tumor)
weight gain ( fluid retaining)

Elimination pattern

Activity - exercise pattern

Functional incontinence when they get up and start walking

Sleep rest pattern

Are they getting up and going to the rest room at night interrupting sleep

Sexuality reproductive pattern

Changes in sexual activity?

Physical examination

Inspection Auscultation Palpation( shouldn’t feel kidney , maybe the right but if you can palpate it its concerning) Percussion

If BUN is elevated by its self

Could be dehydrated

If BUN and creatine are up together

Possibly mean that kidneys aren’t functioning properly

If kidneys are affected we may see

Hyperkalemia (so assess heart)

Creatine

.6-1.3

BUN

7-21

Urinalysis

First morning void Examine urine within one hour

Urine culture and sensitivity

Will tell us what antibiotic we will use

Composite urin collection

Measures specific components in urine

Creatine clearance

24 hour urin collection Approximates GFR Discard first urination Save urin from all subsequent urinations for 24 hours Have pt urinate at the end of 24 hours and add specimen to collection

Creatine is a

Waste product of protein

KUB (kidneys ureters bladder )

Helps see size and shape X-ray examination

Intravenous pyelogram (IVP)

Contraindicated in pt who have poor kidney function Injection of Contrast medium

Renal ultra sound

Uses sound waves

Cystography/cystourethrography

Picture Cyst or tumor may be causing issues so they want a picture

Ct scan

Without contrast (not as good image but will give you a good picture)

Cystoscopy

scope of bladder

Renal biopsy

Get consent form signed and make sure they know they are at high risk of bleeding (kidneys are vascular) Needle will go through (CT or ultrasound will guide it ) Contraindicated of bleeding isorders, single kidney, uncontrolled hypertension

Renal angiogram

Helps look at blood vessels in your kidney

Before biopsy

Type and cross match pt for blood Consent sign Assess coagulation status Pt history and me history Review lab values -cbc h&h clotting factors Make sure they aren’t taking blood thinners

After biopsy

Apply pressure dressing Keep pt positioned on affected side for 30-60 min Bed rest for 24 hours VS 5-10 min for first hour Assess frequently signs of bleeding infection

Renal arteriogram before

Cathartic or. Emma maybe used the night before Before injection of contrast material assess for iodine sensitivity Prior to contrast media injection, notify pt of possible transient warm feeling along the course of blood vessels

Enema

Cleanse

After renal arteriogram

Place a 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)

What happens if femoral starts bleeding out after angiogram

Put fist in artery for pressure and call for help