November 29 Review Quiz Flashcards
Increased ADH is a characteristic of _______
SIADH
Decreased ADH is a characteristic of _______
Diabetes insipidus
BUN normal lab range
10-20 mg/dL
Cr normal lab range
0.6-1.2 mg/dL
Protein in urine, normal and abnormal lab values
1-2 mg
Abnl >30 mg
pH of urine normal lab range
4.5-8
Specific gravity of urine normal lab range
1.003-1.030
Structure that filters blood into Bowman’s capsule
Glomerulus
Structure that reabsorbs most electrolytes
Proximal tubule
Structure that reabsorbs water without ADH
Loop of henle
Structures that reabsorb H20 with ADH
Distal tubule and collecting duct
Natriuretic peptides (increase, decrease) renal excretion of sodium and water; ADH (increases, decrease) renal excretion of water, which (increases, decrease) urine specific gravity
Increase; decrease; increases
What do BNP/ANP do in the kidney?
Inhibit water/sodium absorption
Elimination of substances in the urine is called _____
Excretion
The amount of plasma filtered per unit time is the _____
Glomerular filtration rate
All of the glomeruli are located in the renal (medulla, cortex)
Cortex
Write the letters here in the correct order of the steps: glomerular capillaries proximal convoluted tubule bladder renal pelvis filtration slits loop of henle bowman’s space distal convoluted tubule Ureter Collecting duct
Glomerular capillaries Filtration slits Bowman's space Proximal convoluted tubule Loop of henle Distal convoluted tubule Collecting duct Renal pelvis Ureter Bladder
Composition of mineral salts that cause kidney stones (nephrolithiasis or urolithiasis)
Calcium oxalate and calcium phosphate: 70% to 80%
Struvite (magnesium, ammonium, phosphate): 15%
Uric acid: 7%
Cystine: 1%
Salts that cause alkaline urine
Ca ox, Ca phos, struvite
salts that cause acidic urine
Uric acid, cystine
Staghorn calculi
Are large and fill the minor and major calyces.
Medications that create renal stones
Antacids, vit D, laxatives, aspirins
Kidney stones clinical manifestations
Renal colic pain, nausea, dysuria, CVA tenderness
Diagnostic tests for kidney stones
KUB, UA, 24 hour urine collection, IV pyelogram, US
Kidney stone treatment
Pain relief, hydration, strain urine,
>1cm= Extracorporeal shock wave lithotripsy
Cystitis
Bladder inflammation
Pyelonephritis
Inflammation of upper urinary tract/kidneys
Glomerulonephritis pathophys
Formation of immune complexes (antigen/antibody) in the circulation with subsequent deposition in glomerulus
Antibodies produced against the organism that cross-react with the glomerular endothelial cells
Activation of complement
Recruitment and activation of immune cells and mediators
Glomerulonephritis treatment
Steroids, cytotoxic agent
Structure that facilitates reabsorption of bicarbonate
Distal tubule
In addition to relieving pain, rapid removal of an urinary tract obstruction is important, because the accumulating urine cause back pressure that (kills, hyperstimulates) renal cells.
Kills
When one kidney develops irreversible damage, the other kidney (makes additional nephrons, undergoes hypertrophy of existing glomeruli and tubules)
Undergoes hypertrophy of existing glomeruli and tubules
Obstruction to urine flow in the lower urinary tract include obstruction of the _____ in men and prolapse of the _____ in women.
Prostate; bladder
An alkaline urinary pH significantly increases the risk for (calcium phosphate, uric acid) stone formation, where as acidic urine increases the risk for a (calcium phosphate, uric acid) stone
Calcium phosphate; uric acid
Urinary stones, also called _____, most commonly are composed of _____ salts, but may have a different composition depending on the person’s risk factors and the characteristics of the urine
Uroliathisis; calcium
The sites where urinary stones are most likely to obstruct the urinary system are at the _____ and _____
Pelvic ureter junction (aka ureteropelvic junction) and vesicoureter junction (aka vesico-uretic junction)
The most common type of urinary stone
Calcium oxalate
Associated with gout
Uric acid
Mineral associated with staghorn formation in kidney pelvis
Struvite
On assessment of the patient with renal calculi passing down the renal ureter, the nurse would expect the patient to report?
Severe, colicky back pain radiating to the groin
True or false: Acute pyelonephritis causes progressive destruction of nephrons resulting in chronic renal insufficiency
False
True or false: In a patient with acute pyelonephritis, an IVP may be performed after the infection is resolved to evaluate the urinary system for abnormalities
True
True or false: Diagnosis of acute pyelonephritis always requires a urine culture and sensitivity test
True
True or false: Following initial treatment of acute pyelonephritis, the patient must have a follow-up CBC
False, also need to include culture
The process of urination
Micturition
Red blood cells in the urine
Hematuria
The bladder wall muscle
Detrusor
Accumulations of precipitated material in the urine that have a cylindrical shape like a mold of a section of tubule
Casts
Precipitated material in the urine that increase as urine cools
Crystals
The area of the bladder between the openings of the ureters and the urethra
Trigone
White blood cells in the urine
Pyuria
Small openings in the glomerular endothelium called _____ are maintained by vascular endothelial growth factor secreted by the _____
Fenestrae; podocytes
The (internal, external) urethral sphincter is under voluntary control and is innervated by the (pudendal, phrenic) somatic nerve.
External; pudendal
Urea is a product of (carbohydrate, protein) breakdown; recycling of urea within the renal medulla is necessary to (concentrate, filter) urine.
Protein; concentrate
Blood entering the peritubular capillaries has (low, high) hydrostatic pressure and (low, high) oncotic pressure, which facilitates (secretion, reabsorption) of fluid from the proximal convoluted tubules.
Low; high; reabsorption
Dilation of a ureter by accumulated urine
Hydroureter
Enlargement of the renal pelvis and calyces by accumulated urine
Hydronephrosis
Narrowing of the lumen of a urethra
Urethral stricture
Large urinary stone that has assumed the shape of the renal pelvis and calyces
Staghorn calculus
The technical term for bladder dysfunction due to neurologic problems is _____
Neurogenic bladder
Cigarette smoking, arsenic in drinking water, and exposure to aniline dyes are risk factors for (renal, bladder) cancer, which is characterized by (painless, pain and) hematuria.
Bladder; painless
The most common route by which bacteria reach the bladder is (through the blood, retrograde up the urethra); the most common route by which bacteria reach the kidney is (through the blood, retrograde up the ureter)
Retrograde up the urethra; retrograde up the ureter
The only manifestations of cystitis in an older adult may be development of _____
Confusion
Acute pyelonephritis primarily affects the _____ and is associated with sudden onset of fever, chills and flank or groin pain; chronic pyelonephritis primarily involves inflammation and fibrosis of the renal _____
Renal tubules; interstitium
In IgA nephropathy, the bone marrow makes antibodies against _____ that trigger glomerular injury, often after a _____ infection
Abnormal IgA; viral
Proteinuria and angiotensin II contribute to (reversible, irreversible) renal damage in (acute kidney injury, chronic kidney disease).
Irreversible; chronic kidney disease