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Professional Nursing Concepts I Nursing: N2320 > Genitourinary System (Exam One) > Flashcards

Genitourinary System (Exam One) Flashcards

1
Q

Where does urine form?

A

Kidneys

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2
Q

What amount of urine is stored by the renal pelvis?

A

3mL to 5mL

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3
Q

What is the purpose of the capsule that covers the kidneys?

A
  • Shock absorber

- Protection

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4
Q

What is the difference between a child’s kidneys and an adults kidneys? Children are at an increased risk for what because of this difference?

A
  • Children lack renal capsule for kidney protection

- More susceptible to kidney injury

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5
Q

What is the first step in the process of urine production?

A

Glomerular filtration

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6
Q

Which calculation determines how well the blood is being filtered by the kidneys?

A
  • Glomerular filtration rate (GFR)

- Estimated glomerular filtration rate (eGFR)

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7
Q

What is the normal value for glomerular filtration rate?

A

120 mL/minute

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8
Q

A glomerular filtration rate of what value may indicate kidney failure?

A

<15 mL/minute

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9
Q

What cellular mechanism is responsible for selective reabsorption?

A

Hormones

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10
Q

The proximal tubules are the only site for what?

A

Glucose reabsorption

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11
Q

The proximal tubules are responsible for the reabsorption of what solutes?

A
  • Glucose
  • Amino acids
  • Phosphate
  • Citrate
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12
Q

The proximal tubule is considered what?

A

Metabolic organ

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13
Q

Inflammation of the bladder is known as what?

A

Cystitis

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14
Q

Decreased kidney function is denoted by what amount of urine output per hour?

A

<30 mL

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15
Q

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

A

1,500 mL

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16
Q

What disease will accelerate the decrease of renal size with age?

A

Atherosclerosis

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17
Q

What does proper anatomy of the ureteropelvic junction (UPJ) help prevent?

A
  • Urine reflux

- Infection

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18
Q

What is the functional unit of the kidney?

A

Nephron

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19
Q

List the functions of the kidneys. Identify which function is considered the primary function.

A
  • Filtration of blood (primary)
  • Create urine
  • Rid the body of waste
  • Excrete or conserve fluid
  • Maintain electrolyte balance
  • Acid-base balance
  • Activate Vitamin D
  • Produce erythropoietin
  • Produce renin
  • Regulate blood pressure
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20
Q

What is the normal value for estimated glomerular filtration rate?

A

> 60 mL/minute

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21
Q

Which substances are reabsorbed into the blood after filtration?

A
  • Water
  • Sodium
  • Chloride
  • Calcium
  • Bicarbonate
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22
Q

Which substances are filtered out into the urine?

A
  • Potassium
  • Hydrogen ions
  • Ammonia
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23
Q

What is the purpose of the kidneys activating vitamin D?

A

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

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24
Q

What is the purpose of erythropoietin?

A

Stimulates bone marrow to produce red blood cells

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25
Q

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

A

Anemia

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26
Q

The loop of Henle is responsible for what body function?

A

Homeostasis

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27
Q

If a patient is receiving a diuretic medication, there should be an increase in what?

A

Urine output

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28
Q

If calcium absorption is decreased, which hormone will increase in order to correct this deficit?

A

Parathyroid hormone

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29
Q

Which part of the urinary system is responsible for carrying urine to the bladder?

A

Ureters

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30
Q

What is hydronephrosis?

A

Backflow of urine into the kidneys

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31
Q

If a patient has urine discoloration, such as red, orange, or blue, what question should the nurse ask the patient?

A

Are they currently taking any medications?

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32
Q

List normal physical assessment findings of the urinary system.

A
  • No costovertebral angle (CVA) tenderness
  • Non-palpable kidney and bladder
  • No palpable masses
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33
Q

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

A
  • Place a flat hand on the costovertebral angle (CVA)
  • Make a fist using other hand
  • Thump the flat hand using fist

-Tenderness may be indicative of pyelonephritis, kidney disease, or kidney stones

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34
Q

What is the normal range for serum creatinine?

A

0.6 - 1.2 mg/dL

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35
Q

What is the normal range for blood urea nitrogen (BUN)?

A

10 - 20 mg/dL

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36
Q

What is known about the urinary system and aging?

A

Function and muscle tone decreases

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37
Q

Serum creatinine can only be increased by what pathological disease?

A

Kidney disease

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38
Q

An elevation of blood urea nitrogen (BUN) may be indicative of what condition(s) or disease(s) besides renal disease?

A
  • Upper GI bleed
  • High-dose steroid consumption
  • Heart failure
  • Dehydration
  • High-protein diet
  • Infection
  • Stress
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39
Q

Where is urea made?

A

Liver

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40
Q

Why might high ammonia levels be seen in a patient with kidney failure and liver failure?

A

-Liver may be unable to convert ammonia to urea during liver failure

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41
Q

A urine specimen collected at which time of day is most desirable as it is the most concentrated and the best indication of kidney function?

A
  • Morning void

- First void of the day

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42
Q

What will daily weights tell the provider?

A

Fluid balance

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43
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
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44
Q

What substances should not cross into the renal tubules?

A
  • Blood cells
  • Platelets
  • Protein
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45
Q

What is the most common laboratory test for urine?

A

Urinalysis

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46
Q

What laboratory test is used to identify specific organisms present in the urine?

A

Urine culture

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47
Q

Describe the process of a clean catch specimen. What must females do specifically regarding a clean catch?

A

-Clean urethral area
-Void small amount in toilet
-Void in sterile cup
Women must keep labia open during entire process

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47
Q

Describe the process of a clean catch specimen. What must females do specifically regarding a clean catch?

A
  • Clean urethral area
  • Void small amount in toilet
  • Void in sterile cup
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48
Q

A creatinine clearance most closely approximates what other laboratory value?

A

Glomerular filtration rate (GFR)

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49
Q

What does a creatinine clearance evaluate?

A

How well kidneys remove creatinine from blood

50
Q

Describe the process of a creatinine clearance diagnostic study. What must be done specifically regarding the first void?

A
  • Collect 24-hour urine specimen
  • Continuously add all voided urine to large specimen container
  • Keep urine on ice or refrigerated
  • Send to lab at end of collection

-Must discard the first voided sample

51
Q

What must be done after a creatinine clearance diagnostic study has been completed? Why?

A
  • Draw blood sample

- Compare serum creatinine to creatinine clearance results

52
Q

What is the primary regulatory system for magnesium?

A

Urinary excretion

53
Q

Phosphorus causes vascular calcification leading to what conditions?

A
  • Decreased perfusion

- Heart failure

54
Q

How does serum albumin related to kidney failure?

A

Protein is spilled along with albumin in the urine

55
Q

What will be elevated on a urinalysis if the patient has a urinary tract infection?

A
  • Leukocytes
  • Bacteria
  • Nitrites
56
Q

Describe the process of a cystoscopy.

A
  • Tube inserted into bladder through urethra
  • Inspect inside of bladder
  • Possible bladder tissue obtained for biopsy
57
Q

What education should the nurse provide to a patient following a cystoscopy regarding what to expect?

A
  • Pink/tea-tinged urine
  • Urinary frequency
  • Burning upon urination
58
Q

The nurse should immediately notify the health care provider if what conditions arise following a cystoscopy?

A
  • Bright red urine or clots
  • Fever
  • Increase in WBC
59
Q

Describe the process of an intravenous pyelography.

A
  • IV contrast injected into the veins

- X-ray imaging performed to examine kidneys, ureters, and urinary bladder

60
Q

Before the patient receives an intravenous pyelography study, what should the nurse assess or obtain?

A
  • Allergies

- Informed consent

61
Q

Following an intravenous pyelography study, what should the nurse monitor?

A
  • Urinary output
  • Hydration
  • Vital signs
  • Allergic reaction
62
Q

When should vital signs be obtained on a patient undergoing a renal biopsy?

A
  • Before
  • During
  • After
63
Q

Following an intravenous pyelography study, list the interventions to be performed by the nurse.

A
  • Obtain vital signs
  • Apply pressure to site for 30 minutes
  • Monitor hemoglobin and hematocrit
  • Promote bed rest
64
Q

A patient who underwent a renal biopsy 9 hours ago currently has a temperature of 100.3 and hematuria. What is the priority nursing intervention?

A

Notify HCP!

65
Q

Describe the intended use of a single lumen catheter.

A

Simple draining or irrigation

66
Q

Describe the intended use of a double lumen catheter.

A

Permit addition of a retention balloon

67
Q

Describe the intended use of a triple lumen catheter.

A

Simultaneous drainage and irrigation of thick fluids such as pus or blood

68
Q

What is the normal range for pH on a urinalysis?

69
Q

What is the normal range for specific gravity on a urinalysis?

A

1.003 - 1.030

70
Q

List over-the-counter nephrotoxic medications.

A
  • Aspirin
  • Naproxen
  • Ibuprofen
71
Q

List the signs and symptoms of an upper urinary tract infection.

A
  • Fever
  • Chills
  • Flank pain
72
Q

An upper urinary tract infection involves what anatomical structures?

A
  • Renal parenchyma
  • Pelvis
  • Ureters
73
Q

List the signs and symptoms of a lower urinary tract infection.

A
  • Stinging/burning urination
  • Frequency
  • Urgency
  • Cloudy/dark urine
  • Malodorous urine
  • Blood in urine
  • Nocturia
  • Bladder distention
  • Retention
  • Dysuria
74
Q

Why is urine acidic?

A

Prevents infection

75
Q

List natural defense mechanisms for preventing a urinary tract infection.

A
  • Complete emptying of bladder
  • Proper ureterovesical junction (UVJ) anatomy
  • Ureteral peristaltic activity
  • Urine pH
76
Q

Describe an uncomplicated urinary tract infection.

A

Usually only involves the bladder

77
Q

Describe a complicated urinary tract infection.

A

Coexists with another complication or disease process

78
Q

A complicated urinary tract infection may be accompanied by what other complications or diseases process’?

A
  • Obstruction
  • Calculi
  • Catheter
  • Diabetes
  • Pregnancy
  • Recurrent infection
79
Q

What is the most common symptom of a urinary tract infection in an older adult?

80
Q

What education should the nurse provide to a patient with a urinary tract infection?

A
  • Finish all prescribed antibiotics
  • Completely empty bladder every 3-4 hours
  • Empty bowel regularly
  • Wiping front to back
  • Adequate fluid intake
  • Avoid bladder irritants
  • Cranberry juice
81
Q

What is the most common causative organism in cystitis?

82
Q

What type of patients are most vulnerable to developing cystitis?

A
  • Sexually active women

- Pregnant women

83
Q

What values on a urinalysis are assessed specifically for the purpose of diagnosing a urinary tract infection?

A
  • Leukocyte esterase
  • Nitrites
  • WBC
84
Q

T/F: Nitrites are a normal finding in urine.

A

False

NitrAtes are a normal finding in urine

85
Q

Urine specimens must be evaluated within what time frame?

86
Q

What should the nurse obtain before beginning antibiotic therapy for a patient with a urinary tract infection?

A

Urine culture and sensitivity

87
Q

How long is antibiotic therapy indicated for an uncomplicated urinary tract infection?

A

1 to 3 days

88
Q

List medications commonly prescribed for a urinary tract infection.

A
  • Bactrim (trimethoprim/sulfamethoxazole)

- Macrodantin (nitrofurantoin)

89
Q

How long is antibiotic therapy indicated for an complicated urinary tract infection?

A

7 to 14 days

90
Q

What education should the nurse provide to a patient who has been prescribed phenazopyridine?

A
  • Stains urine reddish-orange

- Stop taking medication once pain subsides but continue antibiotic therapy

91
Q

What education should the nurse provide to a patient who has been prescribed methenamine/phenyl salicylate?

A
  • Stains urine blue or green

- Stop taking medication once pain subsides but continue antibiotic therapy

92
Q

Urinary analgesics such as phenazopyridine and methenamine/phenly salicylate are use in combination with what other medication(s)?

A

Antibiotics

93
Q

The patient asks the nurse why they cannot use urinary analgesics for a prolonged period of time. What is the best response by the nurse?

A

Long-term use of these medications can cause hemolytic anemia

94
Q

A patient with cystitis who has been taking antibiotics for 3 days, suddenly develops flank pain and a low grade fever. What is the primary nursing intervention?

A

Notify HCP!

95
Q

Acute pyelonephritis most often occurs following what types of procedures or conditions?

A
  • Bacterial contamination

- Invasive procedures

96
Q

Acute pyelonephritis that goes undiagnosed or untreated can lead to what condition(s)?

A
  • Septic shock

- Death

97
Q

_____ of people die as a result of unresolved bacteremia involving gram-negative organisms.

98
Q

List signs and symptoms of acute pyelonephritis.

A
  • CVA tenderness/flank pain
  • WBC casts
  • Fever
  • Chills
  • Nausea/Vomiting
  • Fatigue
  • Tachycardia
  • Tachypnea
99
Q

What do white blood cell (WBC) casts indicate?

A

Involvement of parenchyma

100
Q

Signs and symptoms of acute pyelonephritis typically improve within how many hours after beginning drug therapy?

A

48 to 72 hours

101
Q

List the signs and symptoms of sepsis or bacteremia.

A
  • Elevated temperature
  • Tachycardia
  • Hypotension
102
Q

What are renal calculi? Where is the most frequent site of occurrence?

A
  • Stones that form in the urinary tract

- Most frequent site is kidneys

103
Q

List dietary substances that put the patient at an increased risk for developing renal calculi.

A
  • Calcium
  • Uric acid
  • Purine
  • Vitamin D
  • Protein
  • Oxalate
  • Alkali
104
Q

List foods high in purine.

A
  • Red meat
  • Seafood
  • Alcohol
  • Coffee
  • Sweetbreads
105
Q

List education the nurse should provide to the patient in order to help prevent the reoccurrence of renal calculi.

A
  • Adequate hydration
  • Decrease caffeine intake
  • Avoid foods with purine, calcium, oxalate
106
Q

List nursing interventions for a patient with renal calculi.

A
  • Administer analgesics
  • Strain all urine
  • Encourage increased fluid intake
  • Monitor I&O’s
  • Encourage ambulation
107
Q

What medication is administered to decreased uric acid levels?

A

Allopurinol

108
Q

List nursing interventions for renal and bladder trauma.

A
  • Monitor for shock
  • Assess BP and HR
  • Monitor I&O’s
  • Provide pain relief
  • Assess for hematuria
  • Assess for myoglobinuria
109
Q

What is the most prominent risk factor for developing kidney cancer?

110
Q

What is the most common type of kidney cancer?

A

Renal cell carcinoma

111
Q

What is a major symptom of benign nephrosclerosis?

A

Hypertension

112
Q

A patient with uncontrolled blood pressure who is prescribed aggressive hypertensive therapy should have what diagnostic test done?

A

Kidney ultrasound

113
Q

List treatment options for renal cell carcinoma.

A
  • Simple nephrectomy

- Partial nephrectomy

114
Q

What education should the nurse provide do a patient who is post bladder cancer surgery?

A
  • Drink large volume of water
  • Urine will be pink for several days
  • Urine should NOT be red or contain clots
115
Q

What medications are given for Chrons disease, inflammatory bowel disease, and ulcerative colitis?

A

Anti-inflammatory medications

116
Q

List examples of anti-inflammatory medications.

A
  • Aminosalicylates

- Sulfasalazine

117
Q

List the priority nursing intervention for a patient with severe ulcerative colitis?

A
  • NPO

- Bowel rest

118
Q

The nurse knows to monitor for what in a patient who is having an increased amount of watery bowel movements?

A

Blood in stool

119
Q

List environmental factors that may cause an inflammatory bowel disease (IBD) exacerbation?

A
  • Stress
  • Smoking
  • Diet
120
Q

A patient is prescribed sulfasalazine. What potential side effects should the nurse inform this patient of?

A
  • Photosensitivity
  • Aching joints
  • Fever
  • Headache
  • Vomiting
121
Q

What types of foods should be avoided during an an inflammatory bowel disease exacerbation?

A

High-fiber foods

122
Q

In a patient with Crohn’s disease, where are fistulas most likely to develop?

A

Between the bowel and the bladder

Professional Nursing Concepts I Nursing: N2320 (9 decks)

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