Genitourinary/Reproductive System (Exam One) Flashcards
What is the last major organ system that is perfused from the abdominal aorta?
Renal system
How much blood should circulate to the kidneys every minute?
1200 mL per minute
What is the uretropelvic junction (UPJ)?
Narrow point where each ureter joins the kidney
What is the ureterovesical junction (UVJ)?
Point where each ureter inserts the side of the bladder
What does proper anatomy of the UVJ help prevent?
- Urine reflux
- Infection
What is the detrusor?
Bladder muscle responsible for filling and emptying the bladder
True or False: The pelvic cavity can hold a large amount of fluid or bleeding before signs and symptoms appear.
True
What is the length of the urethra for a male?
8 to 10 inches
What is the length of the urethra for a female?
1 to 2 inches
What is hypospadias and epispadias?
Congenital malformation of male urethra
Where is the urethral meatus positioned with hypospadias?
Urethral meatus is abnormally placed on ventral (underside) of penis
Where is the urethral meatus positioned with epispadias?
Urethral meatus is abnormally placed on dorsal (topside) of penis
Are babies born with hypospadias or epispadias circumcised at birth? Why or why not?
- No
- The foreskin is used during reconstruction surgery
What is the functional unit of the kidney?
Nephron
What are the functions of the kidneys? Which is the primary function?
- Filtration of blood (primary)
- Create urine
- Rid the body of waste in the form of urine: urea, bacterial toxins, water-soluble drugs, drug metabolites
- Excrete or conserve fluid
- Keep electrolytes balance
- Acid-base balance
- Activate vitamin D
- Produce erythropoietin
- Produce renin (for RAAS)
- Regulates blood pressure
What is the normal blood pH?
7.35 - 7.45
What organ regulates the Renin-Angiotensin-Aldosterone System?
- Kidneys
- The kidneys will release renin to activate RAAS
What conditions would cause the kidneys to activate the Renin-Angiotensin-Aldosterone System?
- Decreased blood flow to the kidneys (decreased renal perfusion/renal ischemia)
- Decreased arterial blood pressure (i.e. hypotension)
- Decreased blood volume
- Decreased serum sodium (hyponatremia)
- Increased urine sodium
What is the purpose of the Renin-Angiotensin-Aldosterone System?
- To retain sodium, thus retaining fluid
- Increasing blood volume & increasing blood pressure
- Increasing serum sodium levels
- Increase renal perfusion
What are the steps of the Renin-Angiotensin-Aldosterone System?
- Kidneys release Renin
- Renin meets up with Angiotensinogen (which comes from the liver)
- Chemical reaction occurs between Renin & Angiotensinogen –> Angiotensin I is created
- Angiotensin Converting Enzyme (which comes from the lungs) converts Angiotensin I to Angiotensin II
- Angiotensin II promotes vasoconstriction of the arteries/arterioles
- Angiotensin II acts on the adrenal cortex, releasing aldosterone
- Aldosterone acts on the kidneys to retain sodium
- Retention of sodium causes fluid to be retained & potassium to be excreted
- Blood volume increases, blood pressure increases, renal perfusion increases, serum sodium levels increases
- When blood pressure is an appropriate level, the kidneys will stop releasing Renin and will stop RAAS
What is a normal GFR?
120 mL/min
What is a normal eGFR?
> 60 mL/min
What substances can be reabsorbed into the blood after filtration?
- Water
- Sodium
- Chloride
- Calcium
- Bicarbonate
What substances filter out into the urine?
- Potassium
- Hydrogen ions
- Ammonia
What substances should not cross into the renal tubules?
- Blood cells
- Platelets
- Protein
What is the most common laboratory test for urine?
Urinalysis
What laboratory test is used to identify specific organisms present in the urine?
Urine culture
Describe the process of a clean catch specimen? What must females do specifically regarding a clean catch?
- Clean urethral area
- Void small amount in toilet
- Void in sterile cup
- Women must keep labia open during entire process
The average adult and child should have how much urine output per hour?
30 mL
What is the normal protein value?
0 - 18 mg/dL
What is the normal value for red blood cells?
0 - 4
Should glucose, ketones, bilirubin, nitrates, and leukocytes be present in the urine?
No
What is a normal serum creatinine level?
0.6 - 1.2
What is a normal BUN level?
10 - 20
What is a normal creatinine clearance test?
85 - 135
What is known about the urinary system and aging?
Function and muscle tone decreases
Men have more problems with their urinary system due to what?
Enlarged prostate
In pediatrics, if an infection or rash is not being caused by an anatomical issue, the nurse should look at what?
- Type of diapers
- Bubble bath
- Baby powder
- External irritants
What is included in the physical assessment for all patients?
- Vital signs
- Lung sounds
- Costovertebral angle (CVA)
- Edema
- Daily weights
- Intake and output
What is a costovertebral angle (CVA) test?
- Press on kidneys using fist to asses for pain
- If pain is present, patient will have acute pyelonephritis
What test is used to determine if a patient has acute pyelonephritis?
Costovertebral angle (CVA)
What does a KUB x-ray show?
- Tumors
- Swollen kidneys
- Kidney stones
- Ureters
- Bladder
What should the nurse assess for before doing an intravenous pyelogram (IVP)?
- Contrast dye allergies
- Creatinine levels
- Hydration (before and after)
What is contrast-induced nephropathy? What causes it?
- Toxicity in the kidneys
- Decline in renal function and rise in serum creatinine
- Caused by IV or oral contrast dye for CT scan or MRI
What are the nursing priorities regarding contrast-induced nephropathy?
- Hydration protocols
- Encourage PO fluids
List renal diagnostic tests?
- Cytoscopy
- Renal ultrasound
- Renal biopsy
What is a cytoscopy?
Endoscopy through urethra to visualize bladder or collect specimens
What is stress incontinence?
- Involuntary urinary loss from increased abdominal pressure
- Sneezing, coughing, laughing
Who is most at risk for stress incontinence?
Women after childbirth
What is urge incontinence?
Involuntary urinary loss with abrupt and strong desire to void
Urge incontinence is most common in what population?
Older adults
What is functional incontinence?
Can not make it to bathroom due to physical or mental function
What is overflow incontinence?
- Involuntary loss of urine associated with bladder overdistention
- Dribbling
What is total incontinence?
- Continuous
- Unpredictable loss of urine
What are the causes of acute urinary retention?
- Anesthesia
- Medications
- Local trauma
What are the causes of chronic urinary retention?
- BPH
- Medications
- Strictures
- Tumors
What is the normal residual volume on a bladder scan?
<50 mL
What population usually benefit from intermittent catheterization?
Those unable to void due to retention or neurological condition
What is a suprapubic catheter?
- Permanent catheter
- Can only be inserted by a physician