Med Surg-Urinary

Question 1

Kidneys

Answer 1

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

Question 2

Nephrons slow down

Answer 2

Age 40

Question 3

Urine Formation daily

Answer 3

1000-2000mL

Question 4

Urine

Answer 4

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

Question 5

Urochrome

Answer 5

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

Question 6

Albumin

Answer 6

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

Question 7

Glucose

Answer 7

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

Question 8

Erythrocytes

Answer 8

Hematuria may indicate infection, tumors, or renal disease.

Question 9

Ketone bodies

Answer 9

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

Question 10

Leukocytes

Answer 10

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

Question 11

Bladder

Answer 11

Can hold 750-1000mL

Question 12

When the individual has the desire to urinate

Answer 12

250-300mL

Question 13

Most common urinary diagnostic study

Answer 13

Urine Analysis

Completed on a clean-catch or catheterized specimen

Question 14

Urine culture and sensitivity

Answer 14

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

Question 15

Blood Urea Nitrogen(BUN)

Answer 15

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

Question 16

Creatinine

Answer 16

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.

0. 5-1.1mg/dL Female
1. 6-1.2mg/dL Male

Question 17

KUB

Answer 17

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

Question 18

IVP, IVU

Answer 18

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.

Question 19

Endoscopic Procedure

Answer 19

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

Question 20

Cystoscopy

Answer 20

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.

Question 21

Renal angiography

Answer 21

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

Question 22

Urinary retention

Answer 22

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

Question 23

Urinary Incontinence

Answer 23

May be the most common health problem in women

Question 24

Stress Incontinence

Answer 24

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

Question 25

UTI

Answer 25

The presence of microorganisms in any urinary system structure. ***Bacteriuria(bacteria in the urine) is the most common of all nosocomial infection

Question 26

Chronic health problems predispose the pt to a UTI

Answer 26

``` DM MS Spinal cord injuries HTN renal diseases ```

Question 27

Pyuria

Answer 27

Pus in the urine

Question 28

Pyridium

Answer 28

Phenazopyridine-urinary analgesic | Will make urine bright orange and stain underwear

Question 29

Urethritis

Answer 29

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

Question 30

Diagnostic test for Urethritis

Answer 30

Gram stain of the exudate to identify the pathogen

Question 31

Prostatitis

Answer 31

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

Question 32

Prostatodynia

Answer 32

Pain in the prostate gland

Question 33

Pyelonephritis

Answer 33

An inflammation of the structures of the kidney-renal pelvis, renal tubules, and interstitial tissue. Caused by E.Coli

Question 34

Health problems associated with Pyelonephritis

Answer 34

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

Question 35

Azotemia

Answer 35

The retention of excessive amounts of nitrogenous compounds in the blood

Question 36

Signs of infection

Answer 36

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

Question 37

Antibiotic therapy

Answer 37

14-21 days

Question 38

Hydronephrosis

Answer 38

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.

Question 39

Micturition

Answer 39

Voiding

Question 40

Urolithiasis

Answer 40

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

Question 41

People prone to urolithiasis

Answer 41

``` Immobile hyperparathyroid recurrent UTIs some foods and nutrients Medications ```

Question 42

Lithotripsy

Answer 42

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

Question 43

Foods to avoid with Kidney stones

Answer 43

``` Cheese Greens Whole grains Carbonated beverages Nuts Chocolate Shellfish Organ meat ```

Question 44

Benign Prostatic Hypertrophy

Answer 44

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.

Question 45

Diagnosic tests BPH

Answer 45

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

Question 46

Prostatectomy

Answer 46

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

Question 47

TURP

Answer 47

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)

Question 48

Suprapubic prostatectomy

Answer 48

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

Question 49

Radical perineal prostatectomy

Answer 49

An incision through the perineum between the scrotum and the rectum

Question 50

Retropubic prostatectomy

Answer 50

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

Question 51

Renal Failure

Answer 51

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

Question 52

etiology of renal failure

Answer 52

``` Diabetes Burns Trauma Heart Failure Volume depletion Renal disease ```

Question 53

Acute Renal Failure

Answer 53

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

Question 54

Etiology ARF

Answer 54

Hemorrhage Trauma Infection decreased cardiac output

Question 55

Oliguric

Answer 55

BUN, serum creatinine levels rise while urine output decreases

Question 56

Diuretic

Answer 56

Chemistries return to normal and output increases

Question 57

Recovery

Answer 57

near normal function returns

Question 58

S/S ARF

Answer 58

``` 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. ```

Question 59

Diagnostic tests that confirm ArF

Answer 59

BUN, creatinine.

Question 60

Medical Mngmt

Answer 60

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

Question 61

Diet

Answer 61

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

Question 62

Chronic renal failure

Answer 62

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

Question 63

Common causes

Answer 63

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

Question 64

S/S

Answer 64

``` 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 ```

Question 65

Dialysis

Answer 65

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.

Question 66

Hemodialysis

Answer 66

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

Question 67

Peritoneal Dialysis

Answer 67

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.