Kidney/Pudenda - Unit 4 - Assessment of the Renal/Urinary System

Question 1

What are the 4 organs of the renal/urinary system?

Answer 1

Kidneys, ureters, urinary bladder, urethra

Question 2

What are the 6 functions of the renal system?

Answer 2

1. Excretion of waste + filtration
2. Body fluid composition
3. RBC production
4. Regulates BP
5. Converts Vitamin D (to active form to absorb Vit D)
6. Regulates Acid/Base Balance

Question 3

There are about 100 nephrons in each kidney. T/F?

Answer 3

FALSE - there are about 1,000,000!!!

Question 4

What is the difference between cortol neprhons and juxtoglomerular nephrons?

Answer 4

Cortol = short (there’s more of them).

Juxt = long (less of those), and they help when we need more fluid and shit.

Question 5

What are the 3 steps of regulatory function of the kidney?

Answer 5

Step 1 = Glomerular filtration (small parts, like glucose)

Step 2 = Tubular reabsorption (keeps urine at about 3L/day).

Step 3 - Tubular secretion (secreted out)

Question 6

What does renin do to BP?

Answer 6

Increases it!

Question 7

What does angiotensin 2 do to BP?

Answer 7

Increases it

Question 8

What do prostaglandins do for the kidney?

Answer 8

Regulate glomerular filtration

Question 9

What does bradykinin do for the kidney’s?

Answer 9

Dilates afferent arterioles — increases permeability of some solutes

Question 10

What does erythpoietin do for red blood cell production?

Answer 10

It increases it

Question 11

What does vitamin d activation do for the kidney’s?

Answer 11

Increases calcium reabsorption and regulation!

Question 12

What happens to the kidney’s as people age?

Answer 12

Reduced blood flow to kidney’s, kidney’s get smaller, thickened glomerular and tubular membranes, decreased tubular length, nocturnal polyuria, decreased GFR

Question 13

If BP is low, will the kidney’s get adequate perfusion?

Answer 13

Not necessarily..so if someone is hypotensive, start thinking about that!

Question 14

What are some assessment things to look for with the renal system?

Answer 14

Voiding pattern, voiding problems? , color of urine, odor of urine (sweet = ketones) pain, drainage device, history of renal issues, etc.

Question 15

NSAID’s - bad for ___.

Tylenol - bad for ____.

Answer 15

NSAID’s bad for Kidney’s.

Tylenol bad for liver.

Question 16

What are 6 warning signs of kidney disease?

Answer 16

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

Question 17

A urine specimen should be taken at night, right upon peeing. T/F?

Answer 17

FALSE - it should be taken in the AM & midstream, if possible.

Question 18

What should the pH of urine be?

Answer 18

4.8-7.5 (so it’s acidic)

Question 19

What is specific gravity? What should it be?

Answer 19

Hydration - low = very hydrated. High = deHYdrated (get it!)

Normal = 1.003-1.030

Question 20

What are the levels for WBC’s and RBC’s in urine?

Answer 20

WBC = 0-4
RBC = 0-3

Question 21

Should there be any protein in the urine?

Answer 21

NONE

Question 22

What does clear urine mean?

Answer 22

Excess liquids

Question 23

What does bright yellow urine mean?

Answer 23

Vitamin supplements

Question 24

What does dark yellow urine mean?

Answer 24

Dehydration

Question 25

What does cloudy urine mean?

Answer 25

UTI, kidney stone

Question 26

What does blue or green urine mean?

Answer 26

Foods, meds (amitriptyline, indocin)

Question 27

What does pink or red urine mean?

Answer 27

Certain foods, UTI, laxatives

Question 28

What does orange urine mean?

Answer 28

Meds (rifampin, pyridium, etc)

Question 29

What does dark brown or tea colored urine mean?

Answer 29

Liver d/o, meds, blood in urine, foods

Question 30

What’s the best test for overall indication of kidney function?
What’s the level for this test?

Answer 30

Creatinine clearance - 72-140

Question 31

What’s the BUN test? What should it be?

Answer 31

Blood Urea Nitrogen - waste product of protein breakdown in the liver.

5-20 = Normal.

Question 32

Creatinine - what is it? What level?

Answer 32

More specific - shows muscle function. When 50% of nephron function is lost, creat increases…..

Norm = 0.5-1.5

Question 33

What does serum osmolality show? What’s the normal level?

Answer 33

Fluid balance = normal = 280-300

Question 34

What does uric acid show? What’s the normal level?

Answer 34

It shows if the patient has gout.

Normal = 2-7

Question 35

What’s the normal GFR?

Answer 35

125 mL/min, 180 L/day

Question 36

What are some diagnostic tests for the renal system?

Answer 36

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

Question 37

What is a cystoscopy?

Answer 37

Invasive - bladder is filled with water and it’s examined

Question 38

What happens if there is bright red blood after a cystoscopy?

Answer 38

It’s NOT NORMAL..call dr.

Question 39

What condition should we watch for post cystoscopy?

Answer 39

Orthostatic hypotension….

Question 40

What is a renal biopsy?

Answer 40

When a needle is inserted into the kidney to get some cells.

Question 41

What do we do before a renal biopsy?

Answer 41

We get consent, get coags before (NO HEPARIN/COUMADIN), NPO 4-6 hours before

Question 42

What do we do after a renal biopsy?

Answer 42

Watch for decreased HcT, hemorrhage, lay on affected side for 30-60 minutes after