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Medical-Surgical Nursing 1 > Genitourinary system > Flashcards

Genitourinary system Flashcards

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1
Q

Bean-shaped paired organs found in the posterior abdominal wall, retroperitoneal

A

Kidney

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2
Q

What are the functions of the kidneys?

A
  • Urine formation
  • Excretion of waste products
  • Regulation of electrolytes
  • Regulation of acid-base balance
  • Control of water balance
  • Control of blood pressure
  • Renal clearance
  • Regulation of red blood cell production
  • Synthesis of vitamin D to active form
  • Secretion prostaglandins
  • Regulates calcium and phosphorus balance
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3
Q

What is the process of renal circulation?

A 
Renal Artery (hilum) branches into afferent arterioles
|
(Glomerular Capillary beds)
|
Efferent Arterioles
|
Renal Vein
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4
Q

Anatomic & functional unit of the kidney where using is formed

A

Nephron

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5
Q

The three-step process of urine formation in the nephrons

A
  1. Filtration – transfer of water and waste from blood to glomerulus
  2. Reabsorption – water and necessary ions are transferred back into the blood
  3. Excretion – excess substances and wastes are removed and transferred into urine
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6
Q

What are the parts of nephrons?

A
  • Glomerulus
  • Bowman’s capsule
  • Proximal Convoluted Tubules (PCT)
  • Loop of Henle
  • Distal Convoluted Tubules (DCT)
  • Collecting Tubules
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7
Q
  • It expands as it enters the kidney to form the renal pelvis (subdivided into calyces each containing renal papillae)
  • Collects urine secreted by the kidney & propels it to the bladder by peristaltic wave
A

Ureters

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8
Q
  • Hollow, spherical, collapsible bag of smooth muscle
  • Behind the symphysis pubis
  • Reservoir for urine
  • Capacity of the adult bladder 300-500 mL
A

Urinary Bladder

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9
Q

Musculo-membranous tube lined with mucosa opening to urinary meatus

A

Urethra

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10
Q

What are the normal urine values?

A 
Color: amber/straw (light yellow)
Odor: aromatic
Consistency: clear or slightly turbid
pH: 4.5-8
Specific gravity: 1.010-1.020
WBC/RBC: (-)
Albumin: (-)
E coli: (-)
Mucus thread: few
Amorphous urate: (-)
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11
Q

It is the infection of the urinary bladder that is usually caused by an ascending bacterial infection or E. Coli

A

Cystitis

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12
Q

Inflammation of the urethra with causative agents: E. Coli, staphylococcus, streptococci, pseudomonas

A

Urethritis

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13
Q

It is the formation of stones at the urinary tract

A

Nephrolithiasis or Urolithiasis

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14
Q

What are the types of stones found in the urinary tract?

A

Acidic and Alkaline stones

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15
Q

It is the slow enlargement of the prostate gland in men > 40 years old

A

Benigh Prostatic Hyperplasia

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16
Q

It is the infection of the kidney due to bacteria, fungus, and virus

A

Pyelonephritis

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17
Q

What are the 2 types of pyelonephritis?

A

• Acute

  • Bacterial contamination from urethra by instrumentation (iatrogenic) or hematogenous spread
  • E. Coli/streptococcus

• Chronic

  • Idiopathic; obstruction or reflex (stone, tumor, or neurogenic bladder)
  • Progressive scarring of the kidney resulting in weight loss, hypertension and renal failure
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18
Q

It is the inflammatory & degenerative disorder of the glomerulus. It is also the damage to both kidney from filtration of trapping of antibody-antigen complexes within the glomeruli resulting to decrease glomerular filtration rate

A

ACUTE GLOMERULONEPHRITIS (AGN)/NEPHRITIC SYNDROME

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19
Q

What are the 2 types of Acute Glomerulonephritis?

A

• Acute Post-Streptococcal

  • After 7 - 10 days after streptococcal throat infection
  • Immune reaction to the presence of an infectious organism (group A beta hemolytic streptococcus/GABHS)

• Chronic Glomerulonephritis

  • Hypertensive nephrosclerosis
  • Heat failure
  • Chronic renal failure
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20
Q

Renal pathology characterized by increased glomerular permeability and is manifested by massive proteinuria

A

Nephrotic Syndrome

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21
Q

Acute tubular necrosis (ATN) renal parenchymal failure, Acute tubule-interstitial Nephritis

A

Acute Renal Failure

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22
Q

What are the causes of Acute Renal Failure?

A

• Pre-renal

  • Hypoperfusion of kidney
  • Volume depletion
  • Impaired cardiac efficiency
  • Vasodilation

• Intra-renal

  • Actual damage to kidney tissue
  • Prolonged renal ischemia
  • Nephrotoxic agents
  • Infectious process

• Post renal

  • Obstruction to urine flow
  • Urinary tract obstruction
  • Calculi (stones), tumors
  • Benign prostatic hyperplasia
  • Blood clots
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23
Q

What are the four phases of Acute Renal Failure?

A
  1. Onset - Benign with initial insult and ends when oliguria develops
  2. Oliguric Phase - Is accompanied by an increase in the serum concentration of substances usually excreted by the kidney
  3. Diuretic Phase - marked by a gradual increase in urine output, which signals that glomerular filtration
    has started to recover.
  4. Recovery Phase - signals the improvement of renal function and may take 3 to 12 months
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24
Q

It is the irreversible condition of progressive damage to the nephrons & glomerulus and the retention of waste product (uremia)

A

Chronic Renal Failure

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25
Q

What are the 5 stages of CKF?

A

Stage 1 - Kidney damage with normal or increased GFR

Stage 2 - Mild increase in GFR

Stage 3 - Moderate increase in GFR

Stage 4 - Severe increase in GFR

Stage 5 - Kidney Failure (ESRD)

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26
Q

What are the 3 stages of CRF?

A
  1. Diminished renal reserve volume
  2. Renal Insufficiency
  3. End-stage renal disease (ESRD)
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27
Q

Dialyzing solution is introduced via a catheter inserted in the peritoneal cavity

A

Peritoneal Dialysis

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28
Q

Client is attached (via a surgically created AV fistula or Graft) to a machine that pumps blood along a semi-permeable membrane, dialyzing solution is on the other side of the membrane, and osmosis, diffusion of waste, toxins, and fluid from the client occurs

A

Hemodialysis

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29
Q

What are the 3 kinds of hemodialysis access?

A
  1. AV Fistula - Commonly in the forearm anastomosis artery to vein either side to side or end to end
  2. AV Graft - Can be created by subcutaneously interposing a biologic, semibiologic, or synthetic graft material between an
    artery and vein
  3. Vascular Access Devices - Creation of a double-lumen large core catheter into the subclavian, internal jugular or femoral vein
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30
Q

What are the possible vascular access complications?

A
  • Poor blood flow
  • Clotting
  • Infection
  • Pseudoaneurysm / aneurysm
  • Ischemia of the hand
  • May contribute to congestive heart failure
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31
Q

Kidney transplantation involves transplanting a kidney from a living donor or deceased donor to a recipient who are longer has renal function

A

Renal Transplant

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32
Q

Where do organs come from for renal transplant?

A
  • Living related donors
  • Living unrelated Donors
  • Decreased Donor
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33
Q
  • Necessary for chemical reactions and transport

- Contained in the body in several compartments separated by semi-permeable membranes.

A

Body Fluids

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34
Q

What are the three major compartments?

A
  • Intracellular—the area inside the cell membrane, containing 65 percent of body fluids
  • Extracellular—the area in the body that is outside the cell, containing 35 percent of body fluids
  • Tissues or interstitial area—contains 25 percent of body fluids
35
Q

Charged molecules contributes to fluid concentration. Allows fluid movement from one compartment to another.

A

Electrolytes

36
Q

What are the major electrolytes in the ICF?

A

Potassium and Phosphorus

37
Q

What are the major electrolytes in the ECF?

A

Sodium and Chloride

38
Q

What is the normal lab values for Sodium?

A

135-145 mEq/L

39
Q

What is the normal lab values for Potassium?

A

3.5-5.5 mEq/L

40
Q

What is the normal lab values for Calcium?

A

4.5-5.5 mEq/L or 8.5-10 mg/dL

41
Q

What is the normal lab values for Phosphorus?

A

1.7-2.6 mEq/L

42
Q

What is the normal lab values for Chloride?

A

98-108 mEq/L

43
Q

What is the normal lab values for Magnesium?

A

1.5-2.5 mEq/L

44
Q

What are the 3 movements of fluids and electrolytes?

A
  1. DIFFUSION — movement of SOLUTE; high to low concentration
  2. OSMOSIS — movement of SOLVENT; low to high concentration
  3. HOMEOSTASIS — balance of fluid in the body
45
Q

What is the normal specific gravity for urine?

A

1.010-1.020

46
Q

Indirectly indicates fluid volume in the blood. The test measures the number of blood cells per volume of blood.

A

Hematocrit

47
Q

Measures the concentration of particles dissolved in blood.

A

Serum Osmolality

48
Q

Measures the concentration of particles dissolved in the urine. The test can show how well the kidneys are able to clear metabolic waste and excess electrolytes and concentrate urine.

A

Urine Osmolality

49
Q

It is the major cation INSIDE (ICF) the cell. It is critical to neuromuscular function because it plays an important role in action potentials, nerve
polarization/depolarization and excitability.

A

Potassium

50
Q

May be caused by the use of diuretic medications that result in the excretion of potassium in the urine and by the loss of potassium through diarrhea or excessive sweating.

A

Hypokalemia

51
Q

Results most commonly from decreased excretion of potassium owing to renal failure. May result from excessive intake or overaggressive treatment of potassium deficit with potassium supplements.

A

Hyperkalemia

52
Q

Major cation in the extracellular fluid and spaces. Its concentration across the cellular membrane plays an important part in neuromuscular cell activity.

A

Sodium

53
Q

Most often results from excessive fluid retention or infusion that dilutes the sodium in the blood.

A

Hyponatremia

54
Q

Results from excessive sodium intake or sodium retention with excessive loss of water owing to diarrhea, diuretic medication use, vomiting, sweating, heavy respiration, or severe burns.

A

Hypernatremia

55
Q

Most of the _______ in the body comes from the salt (sodium chloride) ingested and absorbed in the intestines as
food is digested.

A

Chloride

56
Q

Any condition that causes a loss of sodium owing to decreased reabsorption of sodium and chloride.

A

Hypochloremia

57
Q

Also results from metabolic acidosis owing to the loss of base and respiratory alkalosis that occurs with
hyperventilation.

A

Hyperchloremia

58
Q

Mineral necessary for clotting (factor IV). Has a role in cardiac muscle contraction and excitability.

A

Calcium

59
Q

Low calcium levels

A

Hypocalcemia

60
Q

Most commonly from increased parathyroid function often owing to a tumor or from cancer in the bones that releases
calcium into the bloodstream.

A

Hypercalcemia

61
Q

It is found primarily in the intracellular environment and is bound to adenosine triphosphate (ATP). It is important in almost all the body’s metabolic functions.

A

Magnesium

62
Q

Excessive urinary loss of magnesium

A

Hypomagnesemia

63
Q

Excessive intake of magnesium

A

Hypermagnesemia

64
Q

Necessary to maintain acid base balance (through the buffer system)

A

Phosphate

65
Q

True or False:

High Phosphate=Low Calcium

Low Phosphate=High Calcium

A

True

66
Q

May result from poor absorption such as occurs with ingestion of antacids that bind to phosphate

A

Hypophosphatemia

67
Q

Owing to the release of phosphate from the bones by tumors

A

Hyperphosphatemia

68
Q

What is the normal ABG value for blood pH?

A

7.35-7.45

69
Q

What is the normal ABG value for Partial Pressure Carbon Dioxide (PCO2)?

A

34-45 mmHg

70
Q

What is the normal ABG value for Partial Pressure of Oxygen (PO2)?

A

80-100 mmHg

71
Q

What is the normal ABG value for Bicarbonate?

A

22-26

72
Q

Refers to the decreased blood pH?

A

Acidosis

73
Q

Refers to the increased blood pH?

A

Alkalosis

74
Q

Refers to the fluid loss without electrolyte loss

A

Dehydration

75
Q

Occurs when loss of ECF volume exceeds the intake of fluid ratio of serum electrolytes to water remains the same.

A

Fluid Volume Deficit (FVD) or hypovolemia

76
Q

Diagnostic findings for FVD or Hypovolemia

A

Diagnostic Findings:
• BUN elevated out of proportion to the serum creatinine
• Urine specific gravity is increased
• Decreased urinary sodium and chloride.
• Urine osmolality can be greater than 450 mOsm/kg

77
Q

Management for FVD/Hypovolemia

A

Fluid replacement through:

Isotonic electrolyte solutions
- Lactated Ringer’s solution 0.9% sodium chloride

Hypotonic electrolyte solution
- 0.45% sodium chloride

78
Q

It refers to an isotonic expansion of the ECF caused by the abnormal retention of water and sodium in approximately the same proportions in which they normally exist in the ECF.

A

Fluid Volume Excess or Hypervolemia

79
Q

What are the diagnostic findings for Hypervolemia?

A

Diagnostic Findings:
• BUN and hematocrit are decreased because of plasma dilution
• The urine sodium level is increased if the kidneys are attempting to excrete excess volume.
• Chest x-ray may reveal pulmonary congestion.

80
Q

What are the managements for hypervolemia?

A
  • Diuretics - to reduce edema
  • Potassium supplements - to avoid hypokalemia from the use of diuretics
  • Hemodialysis or peritoneal dialysis may be used to remove nitrogenous wastes and control potassium and acid—base balance, and to remove sodium and fluid.
81
Q

Expected blood gas changes include a low pH (less than 7.35) and a low bicarbonate level (less than 22 mEq/L)

A

Metabolic Acidosis

82
Q

Evaluation of arterial blood gases reveals a pH greater than 7.45 and a serum bicarbonate concentration greater than 26 mEq/L.

A

Metabolic Alkalosis

83
Q

A clinical disorder in which the pH is LESS than 7.35 and the PaCO2 is GREATER than 45 mm Hg

A

Respiratory Acidosis

84
Q

A clinical condition in which the arterial pH is GREATER than 7.45 and the PaCO2 is LESS than 35mmHg.

A

Respiratory Alkalosis

Medical-Surgical Nursing 1 (2 decks)

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