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Med Surg > Med Surg-Urinary > Flashcards

Med Surg-Urinary Flashcards

1
Q

Kidneys

A

Dark red, bean shaped organs 4-5in long, 2-3in wide, and about 1 inch thick.

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2
Q

Nephrons slow down

A

Age 40

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3
Q

Urine Formation daily

A

1000-2000mL

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4
Q

Urine

A

95% water, the rest is nitrogenous wastes and salts.

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5
Q

Urochrome

A

Causes urine to be yellow; a pigment resulting from the body’s destruction of hemoglobin.

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6
Q

Albumin

A

Albuminuria indicates possible renal disease, increased blood pressure, or toxicity of the kidney cells from heavy metals

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7
Q

Glucose

A

Sugar in the urine(glycosuria) most often indicates a high blood glucose level.

When the blood glucose level rises above the renal threshold(the point at which the renal tubules can no longer reabsorb), and the glucose spills into the urine

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8
Q

Erythrocytes

A

Hematuria may indicate infection, tumors, or renal disease.

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9
Q

Ketone bodies

A

Ketonuria. It occurs when too many fatty acids are oxidized.

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10
Q

Leukocytes

A

Are found in urine when there is an infection in the urinary tract.

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11
Q

Bladder

A

Can hold 750-1000mL

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12
Q

When the individual has the desire to urinate

A

250-300mL

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13
Q

Most common urinary diagnostic study

A

Urine Analysis

Completed on a clean-catch or catheterized specimen

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14
Q

Urine culture and sensitivity

A

Done to confirm suspected infections, to identify causative organisms, and to determine appropriate antimicrobial therapy.

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15
Q

Blood Urea Nitrogen(BUN)

A

A lab test used to determine the kidney’s ability to rid the blood of non-protein(NPN) waste and urea, which result from protein breakdown(catabolism)

10-20mg/dL

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16
Q

Creatinine

A

A catabolic product of creatine, which is used in skeletal muscle contraction.

As with BUN is excreted entirely by the kidneys and is therefore directly proportional to renal excretory function.

  1. 5-1.1mg/dL Female
  2. 6-1.2mg/dL Male
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17
Q

KUB

A

Kidney-ureter-bladder radiograph assesses the general status of the abdomen and the size, structure, and position of the urinary tract structures.

Tumors, calculi, glomerulonephritis, cysts, and etc

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18
Q

IVP, IVU

A

Intravenous pyelogram or intravenous urography evaluates structures of the urinary tract, filling of the renal pelvis with urine, and transport of urine via the ureters to the bladder.

Assess for Iodine allergy

structural deviations, hydronephrosis, calculi with the urinary tract, polycystic renal(kidney)disease(PKD), tumors, and other conditions.

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19
Q

Endoscopic Procedure

A

Visual examinations of hollow organs using an instrument with a scope and light source.

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20
Q

Cystoscopy

A

Visual exam. to inspect, treat or diagnose disorders of the urinary bladder and proximal structures.

Lithotomy position

Urologist can perform a brush biopsy via a ureteral catheter during a cystoscopy.

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21
Q

Renal angiography

A

Aids in evaluating blood supply to the kidneys, evaluates masses, and detects possible complications after kidney transplantation.

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22
Q

Urinary retention

A

The inability to void even with an urge to void

Causes
Stress
Surgery
Occlusion of the urethra by calculi
Infection
Tumor
Medication side effects
Perineal trauma-Vaginal delivery
S/s
bladder distention
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23
Q

Urinary Incontinence

A

May be the most common health problem in women

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24
Q

Stress Incontinence

A

Involuntary loss of urine during physical exertion or when coughing, sneezing, or laughing

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25
Q

UTI

A

The presence of microorganisms in any urinary system structure.

***Bacteriuria(bacteria in the urine) is the most common of all nosocomial infection

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26
Q

Chronic health problems predispose the pt to a UTI

A 
DM
MS
Spinal cord injuries 
HTN
renal diseases
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27
Q

Pyuria

A

Pus in the urine

28
Q

Pyridium

A

Phenazopyridine-urinary analgesic

Will make urine bright orange and stain underwear

29
Q

Urethritis

A

Inflammation of the urethra, is classified by the presence or absence of gonorrhea

Usually occurs when a catheter is in place or trauma has occurred

30
Q

Diagnostic test for Urethritis

A

Gram stain of the exudate to identify the pathogen

31
Q

Prostatitis

A

An Inflammation and/or infection of the prostate gland, is actually a group of diseases

Caused by Pseudomonas and S.faecalis traveling up the urethra

32
Q

Prostatodynia

A

Pain in the prostate gland

33
Q

Pyelonephritis

A

An inflammation of the structures of the kidney-renal pelvis, renal tubules, and interstitial tissue.

Caused by E.Coli

34
Q

Health problems associated with Pyelonephritis

A

Pregnancy, DM, polycystic or hypertensive renal disease, insult to the urinary tract from catheterization, or infection, obstruction, or trauma.

35
Q

Azotemia

A

The retention of excessive amounts of nitrogenous compounds in the blood

36
Q

Signs of infection

A

Elevated temp
vomiting and chills
elevated blood pressure and GI irritation such as vomiting and diarrhea.

37
Q

Antibiotic therapy

A

14-21 days

38
Q

Hydronephrosis

A

The dilation of the renal pelvis and calyces may be congenital or may develop at any time.

Can occur unilateral or bilaterally

Caused by obstructions in the lower urinary tract, ureters, or the kidneys.

39
Q

Micturition

A

Voiding

40
Q

Urolithiasis

A

Formation of urinary calculi
Lithiasis”formation of stones”

Form from minerals that have precipitated out of solution and adhere, forming stones that vary in size and shape

41
Q

People prone to urolithiasis

A 
Immobile
hyperparathyroid
recurrent UTIs
some foods and nutrients
Medications
42
Q

Lithotripsy

A

Pt submerged in a tank of water, and ultrasonic shock waves are used to pulverize the stone

43
Q

Foods to avoid with Kidney stones

A 
Cheese
Greens
Whole grains
Carbonated beverages
Nuts
Chocolate
Shellfish
Organ meat
44
Q

Benign Prostatic Hypertrophy

A

Enlargement of the prostate gland, is common in men older than 50yrs old

The prostate enlarges, exerting pressure on the urethra and vesicle neck of the urinary bladder, which prevent complete emptying.

45
Q

Diagnosic tests BPH

A

Palpatation of the enlarged prostate gland
Blood chemistry
measuring residual urine
cystoscopy or IVP
cytologic evaluation determines whether its benign or malignant.

46
Q

Prostatectomy

A

Removal of the prostate gland is indicated to relieve or prevent further obstruction of the urethra

47
Q

TURP

A

Less invasive and less stressful for the pt

Approaching the gland through the penis and bladder using a resectoscope(surgical instrument with an electric cutting wire for resection and cautery to resect the lobes away from the capsule)

48
Q

Suprapubic prostatectomy

A

Incision through the abdomen; the bladder is oppened, and the gland is removed from above the finger

49
Q

Radical perineal prostatectomy

A

An incision through the perineum between the scrotum and the rectum

50
Q

Retropubic prostatectomy

A

Low abdominal incision, but the bladder is not opened. The gland is removed by making an incision into the capsule encasing the prostate gland

51
Q

Renal Failure

A

Inability of the kidneys to remove wastes, concentrate urine, and conserve or eliminate electrolytes.

52
Q

etiology of renal failure

A 
Diabetes
Burns
Trauma
Heart Failure
Volume depletion
Renal disease
53
Q

Acute Renal Failure

A

Kidney function altered by interference with kidney’s ability to be selective in filtering blood or by decrease in blood flow to kidneys

54
Q

Etiology ARF

A

Hemorrhage
Trauma
Infection
decreased cardiac output

55
Q

Oliguric

A

BUN, serum creatinine levels rise while urine output decreases

56
Q

Diuretic

A

Chemistries return to normal and output increases

57
Q

Recovery

A

near normal function returns

58
Q

S/S ARF

A 
Anorexia
Nausea
Vomiting
Edema
Lethargy
headaches
dry mucus membranes
poor turgor
output less than 400mL/24hr
CNS manifestations such as drowsiness, muscle twitching, and seizures.
59
Q

Diagnostic tests that confirm ArF

A

BUN, creatinine.

60
Q

Medical Mngmt

A

Fluids and osmotic preparations to prevent decrease renal perfusion, manage fluid volume and treat electrolyte imbalances

Renal dialysis if need

61
Q

Diet

A

Protein sparing, hi carb, low K+ and Na+
Diuretics
K+ lowering agents

62
Q

Chronic renal failure

A

Exists when the kidneys are unable to regain normal function.

As of 80% of nephrons may be severely impaired before loss of kidney function is detected

63
Q

Common causes

A

pyelonephritis, chronic glomerulonephritis, glomerulosclerosis, chronic urinary obstruction, severe hypertension, diabetes mellitus, gout and PKD.

64
Q

S/S

A 
headache
lethargy
asthenia(decreased energy)
anorexia
pruritus
anuria
muscle cramps/twitching(electrolyte imbalance)
dusky yellow-tan or gray skin color from retained uruochrome pigments
disorientation and mental lapses
65
Q

Dialysis

A

Medical procedure for the removal of certain elements from the body by virtue of the difference in their rates of diffusion through an external semipermeable membrane or peritoneum.

Mimics kidney function

Involves either the diffusion of wastes, drugs, lytes OR osmosis of water into a dialysate fluids.

66
Q

Hemodialysis

A

Requires an access to pts circulatory system to route blood thru the artificial kidney(dialyzer)to remove wastes, fluids & lytes and then return the “cleaned” blood to the pts body.

Usually achieved via an arteriiovenous fistula(AV)

Schedule 3X a week, 3-6 hours

67
Q

Peritoneal Dialysis

A

The peritoneum becomes of the semipermeable membrane instead of artificial kidney for osmosis and diffusion of wastes, fluids and lytes

Catheter is placed in peritoneal space, then dialyzing fluid is instilled for a period of time, then drained.

Med Surg (2 decks)

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