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MedSurg Nursing; N1110 > Genitourinary System > Flashcards

Genitourinary System Flashcards

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1
Q

What are the functions of the kidneys?

A 
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
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2
Q

What is the purpose of the kidneys activating vitamin D?

A

Vitamin D must be in its active form so that the body can absorb calcium

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3
Q

What type of calcium imbalance is present when there is decreased renal function? Why?

A

Hypocalcemia
The kidneys cannot activate vitamin D
Without the active form of vitamin D, calcium cannot be absorbed

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4
Q

What is the purpose of erythropoietin?

A

Erythropoietin stimulates the bone marrow to produce red blood cells

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5
Q

What blood condition is present when there is decreased renal function?

A

Anemia

The kidneys are not producing erythropoietin. Bone marrow is not stimulated to make red blood cells

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6
Q

When is erythropoietin production increased? Why?

A

Living at an increased altitude
COPD

There is a lack of oxygen within the body/blood stream. The body produces more red blood cells so there will be more hemoglobin available to carry oxygen. To make more red blood cells, erythropoietin production is required by the kidneys.

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7
Q

What conditions will activate RAAS?

A 
Decreased renal perfusion
Decreased blood pressure
Decreased extracellular fluid (intravascular volume)
Decreased serum sodium
Increased urine sodium
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8
Q

What is the end production of RAAS?

A

Aldosterone causes vasoconstriction of the arteries, thus increasing blood pressure

Aldosterone causes the kidneys to increase sodium retention, water follows. Extracellular fluid increases, which increases blood pressure

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9
Q

What labs assess kidney function?

A

BUN
Creatinine
eGFR
Creatinine Clearance (aka Glomerular Filtration Rate)

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10
Q

What diagnostic test is the best indicator of kidney function?

A

Creatinine Clearance (aka Glomerular Filtration Rate)

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11
Q

What is the normal range for Creatinine Clearance (aka Glomerular Filtration Rate)?

A

About 120 mL/min

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12
Q

What does Blood Urea Nitrogen measure?

A

BUN measures the amount of urea nitrogen within the blood

Urea-nitrogen is a waste by product of protein

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13
Q

What does Creatinine measure?

A

The amount of creatinine within the blood

Creatinine is a waste by product of creatine

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14
Q

Which lab is more indicative of kidney function? BUN or Creatinine? Why?

A

Creatinine. Creatinine solely measures kidney function

BUN can be elevated for non-kidney related issues (example: high protein diet)

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15
Q

What does aldosterone do?

A

Aldosterone acts on the kidneys to retain sodium. Water follows.
Sodium and water are reabsorbed into the body
Potassium is excreted into the filtrate/urine

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16
Q

What does Antidiuretic Hormone (ADH) do?

A

Promotes the reabsorption of water from the filtrate into the body

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17
Q

What does Atrial Natriuretic Hormone do?

A

Blocks aldosterone when the atria are stretched / fluid overloaded

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18
Q

What does Parathyroid Hormone (PTH) do?

A

Promotes the reabsorption of calcium from the filtrate into the blood
Excretes phosphate into the filtrate/urine

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19
Q

What is the normal amount of urine production in 24 hours?

A

1,000 mL - 2,000 mL

20
Q

What is the normal specific gravity of urine?

A

1.005 to 1.030

21
Q

If specific gravity is low (less than 1.005), what does that tell us?

A

The urine is very dilute
There is more fluid in the urine than waste/particles

The person may have increased their fluid intake
The person may be taking a diuretic

22
Q

If specific gravity is high (greater than 1.030), what does that tell us?

A

The urine is very concentrated
There is more waste/particles than fluid

The patient may be dehydrated

23
Q

How does aging affect the kidneys?

A

Decreased ability to concentrate urine
Glomerular filtration rate decreases
Number of nephrons decrease

24
Q

How does aging affect the bladder?

A 
Decrease bladder size and muscle tone.  This causes:
Dysuria
Increased frequency
Incontinence
Urine retention
25
Q

How does aging affect males?

A

Prostate enlarges

26
Q

How does aging affect females?

A

Pelvic floor muscles weaken
Incontinence is common
Prone to UTIs

27
Q

What is Benign Prostatic Hyperplasia?

A

BPH is when the prostate grows

Urinary obstruction is common

28
Q

What are signs and symptoms of Benign Prostatic Hyperplasia?

A 
Decreased amount of urine
Decreased force of the stream
Difficulty starting urine stream
Dribbling after urination is complete
Urine retention
Feelings of bladder fullness after urination
Overflow incontinence
Interrupted stream
29
Q

How is Benign Prostatic Hyperplasia diagnosed?

A

Prostate Specific Antigen blood test

30
Q

What therapeutic measures are taken when a patient has Benign Prostatic Hyperplasia?

A

Administer medications that relax the smooth muscles of the prostate and the bladder
Tamsulosin (Flomax)

31
Q

When a patient has Benign Prostatic Hyperplasia, what other issues is the patient at risk for developing?

A

Frequent UTIs

Chronic Kidney Disease

32
Q

What will daily weights tell the provider?

A

Fluid balance

33
Q

What symptoms may be present if the patient is fluid overloaded?

A

New onset edema
Shortness of breath
Weight gain

34
Q

How does a provider assess for costovertebral tenderness? What does it tell us?

A

Place a flat hand on the costovertebral angle (CVA)
Using the other hand, make a fist, and thump the flat hand.

If tenderness is present, there may be pyleonephritis, kidney disease, kidney stones

35
Q

What is stress incontinence?

A

Involuntary urine loss from increased abdominal pressure

36
Q

What is urge incontinence?

A

Involuntary urine loss with strong desire to void

37
Q

What is functional incontinence?

A

Involuntary urine loss from impairment of physical and/or mental function

38
Q

What is overflow incontinence?

A

Involuntary urine loss associated with bladder distention

39
Q

What is total incontinence?

A

Involuntary urine loss continuously

Unpredictable loss of urine

40
Q

What causes acute urine retention?

A

Anesthesia
Medications
Local trauma

41
Q

What causes chronic urine retention?

A

Enlarged prostate
Medications
Urinary strictures
Tumors

42
Q

What should be monitored if a patient is at risk for or has urine retention?

A

Urine output
Bladder distention
Bladder scan

43
Q

What are signs and symptoms of Chronic Kidney Disease?

A 
Fluid overload
Electrolyte imbalances
Retention of waste products
Acid-Base imbalances
Anemia
44
Q

What is the nurses priority when the patient has an AV fistula or AV graft?

A

Check for a bruit and a thrill

45
Q

What is the difference between a bruit and a thrill?

A

Feel a thrill

Listen for a bruit

MedSurg Nursing; N1110 (15 decks)

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