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Module 4 (MedSurg 2) > GU Assessments > Flashcards

GU Assessments Flashcards

1
Q

Kidney Function

A

Regulate the volume and composition of extracellular fluid (ECF)
Excrete waste products from the body
Control BP
Erythropoietin production
Vitamin D activation
Acid-Base balance regulation

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2
Q

How many nephrons are in one kidney?

A

1 million

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3
Q

What gender gets more UTIs? Why?

A

female
the urethra is shorter and closer to the rectum where E. coli is

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4
Q

Where are the kidneys and what do they look like?

A

bean shaped behind the peritoneum
right is slightly lower than left
adrenal gland on top of each

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5
Q

Why is the right kidney lower than the left?

A

liver placement on the right

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6
Q

Where is the entrance of the renal artery and nerves + exit of the renal vein?

A

Hilus -medial side of kidney

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7
Q

What is the parenchyma?

A

tissue of the kidney
outer = cortex
inner = medulla

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8
Q

What is a nephron?

A

the functional unit of the kidney

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9
Q

Each nephron contains what

A

glomerulus
Bowman’s capsule
tubular system

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10
Q

What is located in the cortex of the kidney?

A

loop of Henle
collecting tubules

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11
Q

About how many mL/min of blood flow to the kidneys?

A

1200

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12
Q

Blood flow to the kidneys accounts for what percentage of cardiac output?

A

20-25

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13
Q

How does blood filter through the kidneys?

A

Renal artery
glomerulus
capillaries
venous system

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14
Q

Urine formation

A

Glomerular filtration
Tubular reabsorption
Tubular secretion
Urine concentration

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15
Q

Glomerular filtration

A

blood being filtered by hypostatic pressure through the glomerulus
Through Bowman’s capsule to tubule

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16
Q

Glomerular filtration Rate normal value

A

125 mL/min

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17
Q

How many gallons of water a day in filtered by healthy kidneys?

A

47.6

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18
Q

Tubular reabsorption

A

Where the necessary fluids and nutrients are reabsorbed into the body

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19
Q

Where does water absorption occur in the kidney process?

A

renal medulla

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20
Q

Nephron function can contain small amounts of waste products that are okay in the blood but large amounts

A

are harmful and renal failure
bc of toxin build up

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21
Q

PVT means

A

Proximal convoluted tubule

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22
Q

Where does most of the reabsorption occur in the tubular reabsorption (amino acids, Na, Cl, and others)?

A

PCT

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23
Q

What is the order of tubular reabsorption?

A

PCT (reabsorbs essential nutrients)
Loop of Henle
Descending (hypertonic)
Ascending
DCT
Collecting tubule or Bloodstream

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24
Q

What analogy does Mrs.Moreno use when discussing tubular reabsorption?

A

Coffee filter

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25
Q

What is the entire pathology of the healthy kidney?

A

Renal artery
Glomerulus
Bowman’s capsule

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26
Q

Tubular secretion

A

secreted bad stuff out of the bloodstream and to be excreted

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27
Q

Urine concentration

A

water, urea, Na, k, Cl, Creatinine, and more

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28
Q

A damaged kidney has what type of pores? Allowing for?

A

large; allow larger molecules to exit (protein)

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29
Q

ADH

A

water balance
regulated by the posterior pituitary gland

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30
Q

Aldosterone

A

reabsorption of Na and water
released from the adrenal cortex through the RAAS system

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31
Q

What hormones maintain homeostasis with each other?

A

ADH and Aldosterone

32
Q

Ureters

A

carry urine from the renal pelvis to the bladder
lumens narrow
ease for occlusion and kidney stones

33
Q

Bladder

A

reservoir for urine
detrusor muscle
urination, micturition, voiding

34
Q

Bladder Capacity

A

600-1000 mL

35
Q

Urethra lengths for females and males

A

Fem: 1-2 inches
Male: 8-10 inches

36
Q

Continence

A

voluntary control of the ureterovesical unit

37
Q

Bladder distention stimulates

A

stretch receptors = damage
impulses to the brain

38
Q

What conditions could affect the continence of the bladder?

A

DM
MS
Paralysis

39
Q

What would you use to strengthen the bladder detrusor muscle?

A

Kegel Exercises

40
Q

Who is more susceptible to infection?

A

old
females
postpartum females (hormone changes with natural flora)
homeless
occupation (nurses)

41
Q

Hx Collection for GU assessment

A

gender
age
socioeco
occupation
dietary
surgeries
health hx

42
Q

What should you ask a pt about GU?

A

Probiotics, bathtub, douching, perfumes in peri-area
Meds, immobility
Hx kidney stones, UTIs, CA, Cath use

43
Q

Medication Use for GU

A

Rx, OTC, illegal, antibiotics
Vitamins supplements
Potential nephrotoxic agents

44
Q

Anuria

A

– inability to urinate

45
Q

Oliguria

A

– small amounts

46
Q

Polyuria

A

frequent or large

47
Q

Hematuria

A

blood in urine

48
Q

What are some nephrotoxic antibiotics?

A

Vancomycin
Gentamycin
Amphotericin
- illegal drugs, chemotherapy

49
Q

Smoking causes what

A

vasoconstriction

50
Q

What health perception question would you ask a GU pt?

A

visual changes
smoked
energy level

51
Q

What nutrition question would you ask a GU pt?

A

weight chnage
supplements
caffeine
spice

52
Q

What elimination question would you ask a GU pt?

A

blood in urine
awaken at night
color
smell
constipation or diarrhea
controlling bowels

53
Q

What activity question would you ask a GU pt?

A

ADLs
worsening
stopping
awaken at night
daytime sleepiness
urge
sex pleasure

54
Q

Objective assessment of GU

A

Inspect
Listen
Palpate
Percuassion in costal vertebral space if able

55
Q

Blood Studies for UA

A

Creatinine
BUN
Ration
GFR
24 Hour
HIGH K

56
Q

Normal BUN

A

7-21

57
Q

Normal Creatinine

A

0.7-1.4

58
Q

If BUN is elevated by Creatinine is not what does it mean

A

dehydrated

59
Q

If BUN and Creatinine are both high what does that mean?

A

renal or kidney damage

60
Q

UA

A

FIRST morning void (concentrated)
within 1 hour to lab

61
Q

Culture and sensitivity is used for

A

bacteria identification and medicine needed

62
Q

Creatinine Clearance

A

24 hour
closely approximates GFR
discard 1st urine and collect EVERY void for 24 Hours and at the end go one last time
ON ICE

63
Q

Creatinine is the

A

waste product of protein

64
Q

Radiographic Exam for GU

A

KUB (stones and foreign X-RAY exams)
IVP (contrast not for kidney failure)
CT (good for not contrast)
Cystography
Ultrasound (masses)

65
Q

IVP is contraindicated because

A

the dye is nephrotoxic
- no kidney disease
elevated BUN, Creatinine and GFR

66
Q

If IVP is used then

A

assess for allergies
notify of warm and flushed feelings
increase fluid intake to flush out dye

67
Q

Dx Studies of GU

A

Renal Bx (renal tissue for exam by needle)
Cystoscopy
Arteriogram(visual blood vessels)

68
Q

Renal Bx Post Op

A

lay on the biopsy site for maximum pressure (stop bleeding)
affected side for 30-60 mins
bed rest for 24 hours
avoid lifting 5-7 days and don’t take anticoagulant until Physician orders

69
Q

How often are VS done on a Renal Bx pt?

A

5-10 mins 1st hours
then every 15 etc

70
Q

What are you looking for during VS of renal Bx pt?

A

low BP, HR
Fever, chills
urine frequency
dysuria
hematuria
massive pain
means infection or bleeding

71
Q

Renal Bx Contraindications

A

bleeding disorders
single kidney
uncontrolled HTN
suspected renal infection
hydronephrosis
vascular lesions

72
Q

Renal Bx Pre-Op

A

Type and Cross for transfusion
consent
coagulation
Hx
CBC and H&H
Blood thinner held not aspirin or warfarin

73
Q

Arteriogram Renal Before

A

enema, antibiotic
assess for iodine sensitivity for contrast
warm feeling

74
Q

After arteriogram renal

A

Pressure dressing over femoral artery
observe for bleeding and inflammation
bed rest with affected leg straight
Peripheral pulses 30-60 mins to detect occlusion

75
Q

If they start to bleed from the femoral artery what do you do

A

put your fist there to stop the bleeding

76
Q

What are the labs of a gerontologic pt?

A

low creatinine clearance
HIGH BUN AND CREATININE slightly
less muscle mass

Module 4 (MedSurg 2) (36 decks)

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