Kidney/Pudenda - Unit 4 - Assessment of the Renal/Urinary System Flashcards
What are the 4 organs of the renal/urinary system?
Kidneys, ureters, urinary bladder, urethra
What are the 6 functions of the renal system?
- Excretion of waste + filtration
- Body fluid composition
- RBC production
- Regulates BP
- Converts Vitamin D (to active form to absorb Vit D)
- Regulates Acid/Base Balance
There are about 100 nephrons in each kidney. T/F?
FALSE - there are about 1,000,000!!!
What is the difference between cortol neprhons and juxtoglomerular nephrons?
Cortol = short (there’s more of them).
Juxt = long (less of those), and they help when we need more fluid and shit.
What are the 3 steps of regulatory function of the kidney?
Step 1 = Glomerular filtration (small parts, like glucose)
Step 2 = Tubular reabsorption (keeps urine at about 3L/day).
Step 3 - Tubular secretion (secreted out)
What does renin do to BP?
Increases it!
What does angiotensin 2 do to BP?
Increases it
What do prostaglandins do for the kidney?
Regulate glomerular filtration
What does bradykinin do for the kidney’s?
Dilates afferent arterioles — increases permeability of some solutes
What does erythpoietin do for red blood cell production?
It increases it
What does vitamin d activation do for the kidney’s?
Increases calcium reabsorption and regulation!
What happens to the kidney’s as people age?
Reduced blood flow to kidney’s, kidney’s get smaller, thickened glomerular and tubular membranes, decreased tubular length, nocturnal polyuria, decreased GFR
If BP is low, will the kidney’s get adequate perfusion?
Not necessarily..so if someone is hypotensive, start thinking about that!
What are some assessment things to look for with the renal system?
Voiding pattern, voiding problems? , color of urine, odor of urine (sweet = ketones) pain, drainage device, history of renal issues, etc.
NSAID’s - bad for ___.
Tylenol - bad for ____.
NSAID’s bad for Kidney’s.
Tylenol bad for liver.
What are 6 warning signs of kidney disease?
Burning or difficulty urinating. More frequent urination (at night?) Bloody urine. Puffiness around eyes, swelling in body. Pain in small of back just below ribs, not aggravated by movement. HTN
A urine specimen should be taken at night, right upon peeing. T/F?
FALSE - it should be taken in the AM & midstream, if possible.
What should the pH of urine be?
4.8-7.5 (so it’s acidic)
What is specific gravity? What should it be?
Hydration - low = very hydrated. High = deHYdrated (get it!)
Normal = 1.003-1.030
What are the levels for WBC’s and RBC’s in urine?
WBC = 0-4 RBC = 0-3
Should there be any protein in the urine?
NONE
What does clear urine mean?
Excess liquids
What does bright yellow urine mean?
Vitamin supplements
What does dark yellow urine mean?
Dehydration
What does cloudy urine mean?
UTI, kidney stone
What does blue or green urine mean?
Foods, meds (amitriptyline, indocin)
What does pink or red urine mean?
Certain foods, UTI, laxatives
What does orange urine mean?
Meds (rifampin, pyridium, etc)
What does dark brown or tea colored urine mean?
Liver d/o, meds, blood in urine, foods
What’s the best test for overall indication of kidney function?
What’s the level for this test?
Creatinine clearance - 72-140
What’s the BUN test? What should it be?
Blood Urea Nitrogen - waste product of protein breakdown in the liver.
5-20 = Normal.
Creatinine - what is it? What level?
More specific - shows muscle function. When 50% of nephron function is lost, creat increases…..
Norm = 0.5-1.5
What does serum osmolality show? What’s the normal level?
Fluid balance = normal = 280-300
What does uric acid show? What’s the normal level?
It shows if the patient has gout.
Normal = 2-7
What’s the normal GFR?
125 mL/min, 180 L/day
What are some diagnostic tests for the renal system?
Abdominal X-Ray, cystoscopy, renal biopsy, IVP (flat plate of ABD Before and after contrast - shows the kidney’s ability to concentrate dye), renal ultrasound, renal arteriogram
What is a cystoscopy?
Invasive - bladder is filled with water and it’s examined
What happens if there is bright red blood after a cystoscopy?
It’s NOT NORMAL..call dr.
What condition should we watch for post cystoscopy?
Orthostatic hypotension….
What is a renal biopsy?
When a needle is inserted into the kidney to get some cells.
What do we do before a renal biopsy?
We get consent, get coags before (NO HEPARIN/COUMADIN), NPO 4-6 hours before
What do we do after a renal biopsy?
Watch for decreased HcT, hemorrhage, lay on affected side for 30-60 minutes after
