Renal and Urological Systems Flashcards
What structures does waste product pass through to eliminate through urination
- Kidneys
- Renal pelvis
- Ureter
- Bladder
- Urethra
Functions of the kidneys
- Regulates composition and pH of body fluids
- Eliminates metabolic waste
- Assists BP regulation through rennin-angiotension-aldosterone mechanisms and salt/water elimination
- Controls production of RBC in bone marrow
What is the glomerular filtration rate (GFR)
- The amount of filtrate that is formed each minute as blood moves through the glomeruli and serves as an important gauge of renal function
- Measured clinically by obtaining creatinine levels in blood and urine
- Normal creatinine clearance is 115-125 mL/min
What is BUN
- Blood urea nitrogen is urea produced in the liver as a by-product of protein metabolism that is eliminated by the kidneys
- BUN levels are elevated with increased protein intake, GI bleeding, and dehydration
Normal UA findings
- Color: yellow-amber
- Clarity: clear
- Specific gravity: 1.010-1.025 with normal fluid intake
- pH: 4.6-8.0; average is 6 (acid)
- Protein: 0-8 mg/dL
- Sugar: 0
Signs and symptoms of dehydration
- Poor skin turgor (rigidity)
- Dry mucous membranes
- HA
- Irritability
- Postural hypotension
- Incoordination
- Lethargy
- Disorientation
Define edema
- An excess of body fluids with expansion of interstitial fluid volume
What should you look for/observe with edema
- Swelling of ankles and feet
- Weight gain
- HA
- Blurred vision
- Muscle cramps and twitches
Signs and symptoms of hypokalemia
- Potassium <3.5
- Muscle weakness
- Aches
- Fatigue
- Abdominal distention
- Nausea and vomiting
- Life threatening arrhythmias
- Flattened or inverted T-wave
- ST depression
Signs and symptoms of hyperkalemia
- Potassium >5.5
- Often symptomless until very high levels
- Observe for muscle weakness
Signs and symptoms of hyponatremia
- Sodium <135
- Confusion
- Decreased mental alertness can progress to convulsions
- Signs of increased intracerebral pressure
- Poor motor coordination
- Sleepiness
- Anorexia
Signs and symptoms of hypernatremia
- Sodium >146
- Circulatory congestion (pitting edema, excessive weight gain)
- Pulmonary edema with dyspnea
- HTN
- Tachycardia
- Agitation
- Restlessness
- Convulsions
Signs and symptoms of hypocalcemia
- Calcium <8.4
- Muscle cramps
- Tetany
- Spasms
- Paresthesias
- Anxiety
- Irritability
- Twitching convulsion
- Arrhythmias
- Hypotension
Signs and symptoms of hypercalcemia
- Calcium >10.4
- Fatigue
- Depression
- Mental confusion
- Nausea and vomiting
- Increased urination
- Occasional cardiac arrhythmias
Signs and symptoms of hypomagnesemia
- Magnesium <1.8
- Hyperirritability
- Confusion
- Leg and foot cramps
Signs and symptoms of hypermagnesemia
- Magnesium >2.4
- Hyporeflexia
- Muscle weakness
- Drowsiness
- Lethargy
- Confusion
- Bradycardia
- Hypotension
What are the normal value ranges for pH, CO2, and HCO for acid-vase relationships
- pH: 7.35-7.45
- CO2: 35-45 (inverse relationship with pH; CO2 high pH low)
- HCO: 23-27 (direct relationship with pH; HCO high pH high)
Signs and symptoms of metabolic acidosis
- Hyperventilation
- Deep respirations
- Weakness
- Muscular twitching
- Malaise
- Nausea and vomiting
- Diarrhea
- HA
- Dry skin and mucous membranes
- Poor skin turgor
Signs and symptoms of metabolic alkalosis
- Hypoventilation
- Depressed respirations
- Dysrhythmias
- Prolonged vomiting
- Diarrhea
- Weakness
- Muscle twitching
- Irritability
- Agitation
- Convulsions and coma (death)
Signs and symptoms of respiratory acidosis
- Dyspnea
- Hyperventilation cyanosis
- Restlessness
- HA
Signs and symptoms of respiratory alkalosis
- Tachypnea
- Dizziness
- Anxiety
- Difficulty concentrating
- Numbness and tingling
- Blurred vision
- Diaphoresis
- Muscle cramps
- Twitching or tetany
- Weakness
- Arrhythmias
- Convulsions
Symptoms of urinary frequency, urgency, burning sensation during urination, urine may be cloudy and foul smelling, pain noted in suprapubic, lower abdominal, or groin areas
- Lower UTI
- Cystitis: inflammation and infection of the bladder
- Urethritis: inflammation and infection of the urethra
Symptoms of systemic involvement such as fever, chills, malaise, HA, tenderness and pain over kidneys, tenderness over costovertebral angle (Murphy’s sign), frequent and burning urination, nausea and vomiting may occur
- Upper UTI
- Pyelonephritis: inflammation and infection of one of both kidneys
Fluid filled cavities that form along the nephron and can lead to renal degeneration or obstruction; symptoms include pain, hematuria, and HTN
- Renal cysts
Crystalline structures formed from normal components of urine
- Renal calculi (kidney stones)
Sudden loss of kidney function with resulting elevation in serum urea and creatinine
- Acute renal failure
Progressive loss of kidney function leading to end-stage failure
- Chronic renal failure
End-stage toxic condition resulting from renal insufficiency and retention of nitrogenous wastes in blood; symptoms include anorexia, nausea, and mental confusion
- Uremia
Describe the purpose of dialysis
- Process of diffusing blood across a semipermeable membrane for the purposes of removal of toxic substances; maintains fluid, electrolyte and acid-base balance in presence of renal failure
Symptoms of dialysis disequilibrium
- Nausea and vomiting
- Drowsiness
- HA
- Seizures
- Result of rapid changes after beginning dialysis
Symptoms of dialysis dementia
- Signs of cerebral dysfunction: speech difficulties, mental confusion, myoclonus, seizures, eventually death
- Result of long standing years of dialysis treatment
Risk factors for renal cancer
- Smoking
- High BP
- Males
- African Americans
- Family history of renal CA
- Advanced kidney disease
Risk factors for bladder cancer
- Smoking
- Work place exposures (textiles, rubber, leather, paint)
- Not drinking enough fluid
- Age >55
- Males
- Previous radiation/chemotherapy
- Family history
Define stress incontinence
- Sudden release of urine due to increases in intra-abdominal pressure (coughing, laughing, etc.), weakness and laxity of pelvic floor musculature, sphincter weakness
Define urge incontinence
- Bladder begins contracting and urine is leaked after sensation of bladder fullness is perceived; inability to delay voiding to reach toilet due to detrusor muscle instability or hyperreflexia or sensory instability/hypersensitive bladder
Define overflow incontinence
- Bladder continuously leaks secondary to urinary retention (an over distended bladder or incomplete emptying of bladder)
Define functional incontinence
- Leakage associated with inability or unwillingness to toilet due to impaired cognition, impaired physical functioning, and/or environmental barriers
Parameters for Kegel exercises
- Type 1: works on holding contractions, progressing to 10sec holds, rest 10sec between contractions
- Type 2: works on quick contractions, 10-80 reps a day, avoid squeezing buttocks or contracting abdominals (bearing down)
