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NPTE Other Systems > Renal and Urological Systems > Flashcards

Renal and Urological Systems Flashcards

1
Q

Kidneys are located

A

outside peritoneal cavity in post upper abdomen on each side of vertebral column at level T12 to L2

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2
Q

The renal pelvis is what

A

a wide, funnel shaped structure at the upper end of the urethra that drains the kidney into the lower urinary tract (bladder and urethra)

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3
Q

Bladder is

A

membranous sac that collects urine

located behind symphysis pubis

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4
Q

Ureter extends from

A

renal pelvis to bladder and moves urine via peristaltic action

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5
Q

Urethra extends from

A

bladder to an external orifice for elimination of urine from the body

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6
Q

Function of kidneys

A 
Regulate composition and pH of body fluids 
Controls mineral and water balance
Eliminates metabolic waste
Assists in BP regulation 
Contributes to bone metabolic function 
Controls production of RBCs
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7
Q

Glomerular filtration rate (GFR) is what

A

the amount of filtrate that is formed each minute as blood moves through the glomeruli and serves as an important gauge of renal function

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8
Q

Glomerular filtration rate is regulated by

A

arterial blood pressure and renal blood flow

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9
Q

Glomerular filtration rate is measured clinically by

A

obtaining creatinine levels in blood and urine samples

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10
Q

Normal creatinine is

A

115-125

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11
Q

Blood urea nitrogen (BUN) is what

A

urea produced in the liver as a by-product of protein metabolism that is eliminated by the kidneys

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12
Q

BUN levels are elevated with

A

increase protein intake, GI bleeding, dehydration

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13
Q

Normal values for urinanalysis

A

Yellow amber color
pH 4.6-8 (should be acid)
0-8 protein
0 sugar

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14
Q

Urinary regulation of fluids and electrolytes - homeostasis is regulated through

A

thirst mechanisms and renal function via circulating antidiuretic hormone (ADH)

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15
Q

Urinary regulation of fluids and electrolytes - fluid imbalances - causes for edema

A

inc capillary pressure
dec colloidal osmotic pressure
inc capillary permeability
obstruction of lymphatic flow

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16
Q

Urinary regulation of fluids and electrolytes - Potassium - normal serum level

A

3.5-5.5

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17
Q

Urinary regulation of fluids and electrolytes - K - Hypo causes

A

deficient K or excessive loss due to diarrhea, vomit
metabolic acidosis
renal tubular disease
alkalosis

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18
Q

Urinary regulation of fluids and electrolytes - K - hypo observe for

A

mm weakness, aches, fatigue, cardiac arrythmias, abdominal distention, n/v

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19
Q

Urinary regulation of fluids and electrolytes - K - hyper causes

A 
inadequate secretion with acute renal failure
kidney disease
metabolic acidodis
diabetic ketoacidosis
sickle cell anemia
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20
Q

Urinary regulation of fluids and electrolytes - Na - Hypo causes

A

water intoxication associated with excess intake or excess ADH

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21
Q

Urinary regulation of fluids and electrolytes - Na - Hypo - observe for

A 
confusion
dec mental alertness
signs of inc intracerebral pressure
poor motor coordination
sleepy
anorexia
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22
Q

Urinary regulation of fluids and electrolytes - Na - hyper causes

A 
water deficits (NOT SALT EXCESS)
dehydration
insufficient water intake
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23
Q

Urinary regulation of fluids and electrolytes - Na - hyper - observe for

A 
circulatory congestion
pulmonary edema with dyspnea
hyeprtension
tachycardia
agitation
restless
convulsions
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24
Q

Urinary regulation of fluids and electrolytes - Ca - normal

A

8.4-10.4

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25
Q

Urinary regulation of fluids and electrolytes - Ca - hypo causes

A 
reduced albumin levels
hyperphosphatemia
hypoparathyroidism
malabsorption of Ca and vit D
alkalosis 
acute pancreatitis
Vit D deficiency
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26
Q

Urinary regulation of fluids and electrolytes - Ca - hypo = observe for

A 
mm cramps
tetany
spasms
convulsions
paresthesias
anxiety, irritability
arrythmias
hypotension
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27
Q

Urinary regulation of fluids and electrolytes - Ca - hyper - causes

A

hyperparathyroidism
tumors
hyperthyroidism
vit a intoxication

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28
Q

Urinary regulation of fluids and electrolytes - Ca - hyper - observe for

A

fatigue, depression, mental confusion
n/v, inc urination
occasional arrythmias

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29
Q

Urinary regulation of fluids and electrolytes - Mg - norm

A

1.8 to 2.4

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30
Q

Urinary regulation of fluids and electrolytes - Mg - hypo - causes

A 
hemodialysis
blood transfusions
chronic renal disease
hepatic cirrhosis 
chronic pancreatitis
hypoparathyroidism
excess loss of body fluiids
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31
Q

Urinary regulation of fluids and electrolytes - Mg - hypo - observe for

A

hyperirritability
confusion
leg and foot cramps

32
Q

Urinary regulation of fluids and electrolytes - Mg - hyper - causes

A 
renal failure
diabetic acidosis
hypothyroidism
addisons 
dehydration and use of antacids
33
Q

Urinary regulation of fluids and electrolytes - Mg - hyper - observe for

A

hyporeflexia, mm weakness, drowsy

lethargy, confusion, bradycardia, hypotension

34
Q

Acid base balance

A

Balance of acids and bases in the body (normally a ratio of 20 base to 1 acid)
normal serum pH is 7.35-7.45

35
Q

Metabolic acidosis is what

A

a depletion of bases or an accumulation of acids

blood pH below 7.35

36
Q

Metabolic acidosis causes

A

diabetes
renal insufficiency
diarrhea

37
Q

Metabolic acidosis observe for

A 
hyperventilation
deep respirations
weakness
mm twitch
malaise
n/v, diarrhea, HA, dry skin and mucus 
can lead to stupor and come/death
38
Q

Metabolic alkalosis is what

A

an increase in bases or a reduction of acids

pH rises above 7.45

39
Q

Metabolic alkalosis causes

A 
excess vomit
excess diuretics
hypokalemia
peptic ulcer
excessive intake of antacids
40
Q

Metabolic alkalosis observe for

A 
hypoventilation 
depressed respirations
dysrhythmias
prolonged vomit, diarrhea
weakness
mm twitch
irritability
agitation
convulsions
coma/death
41
Q

Respiratory acidosis is what

A

CO2 retention, imapired alveolar ventilation

42
Q

Respiratory acidosis causes

A

hypoventilation
drugs/over sedation
chronic pulmonary disease
hypermetablism (sepsis, burns)

43
Q

Respiratory acidosis observe for

A 
dyspnea
hyperventilation
cyanosis
resltessness
HA
May lead to stupor, coma/death
44
Q

Respiratory alkalosis is what

A

diminished CO2

alveolar hyperventilation

45
Q

Respiratory alkalosis - causes

A 
anxiety attack with hyperventilation
hypoxia
impaired lung expansion
CHF
PE
diffuse liver or CNS disease 
salicylate poisoning
extremem stress
46
Q

Respiratory alkalosis - observe for

A

tachypnea, dizziness, anxiety, difficulty concentrating
numb/ting
blurred vision
diaphoresis, mm cramps
twitching, tetany, weakness, arrhythmias, convulsions

47
Q

Renal and Urological Disorders - UTI is what

A

infection of urinary tract with microorganisms

48
Q

Renal and Urological Disorders - UTI - lower UTI

A

cysitis (inflammation and infection of the bladder)
or urethritis (inflammation and infection of the urethra)
Usually secondary to ascending urinary tract infections - may invovle kidneys and ureters
Symptoms of urinary frequency, burning with urination, pain

49
Q

Renal and Urological Disorders - UTI - upper UTI

A

pyelonephritis (inflammation and infection of one or both kidneys)
Symptoms of systemic involvement - back pain, pain over costovertebral angle (murphy’s sign) burning urination

50
Q

Renal and Urological Disorders - UTI - increased risk in those with

A

autoimmunity, urinary obstruction and reflus, neurogenic bladder and catheterization, diabetes, kidney transplant
older adults and women at inc risk

51
Q

Renal and Urological Disorders - Renal cystic disease - renal cysts are what

A

fluid filled cavities that form along the nephron and can lead to renal degeneration or obstruction

52
Q

Renal and Urological Disorders - Renal cystic disease - types

A

polycystic
medullary sponge
Acquired
Simple renal cysts

53
Q

Renal and Urological Disorders - Renal cystic disease - symptoms

A 
Pain
Hematuria
Hypertension
Maybe fever if infection
Cysts can rupture and produce hematuria
54
Q

Renal and Urological Disorders - Obstructive disorders are what

A

developmental defects, renal calculi, prostatic hyperplasia or cancer, scar tisue from inlammation, tumors and infection

55
Q

Renal and Urological Disorders - Obstructive disorders - Renal Calculi (kidney stones) are what

A

crystalline structures formed from normal components of urine

56
Q

Renal and Urological Disorders - Obstructive disorders - Renal Calculi (kidney stones) - etiologic influences

A

concentration of stone components in urine and a urinary environemnt conductive to stone formation

57
Q

Renal and Urological Disorders - Obstructive disorders - Renal Calculi (kidney stones) - s/s

A

Renal colic pain
Pain might radiate to lower abdominal quadrant, bladder area
N/v common with clamy skin

58
Q

Renal and Urological Disorders - Obstructive disorders - Renal Calculi (kidney stones) - how are stones broken up

A

extracorporeal shock wave lithotripsy (ESWL) breaks up stones into fragments to allow for easy passage

59
Q

Renal and Urological Disorders - Renal failure - Acute

A

Acute renal failure - sudden loss of kidney function with resulting elevation in serum urea and creatnine

60
Q

Renal and Urological Disorders - Acute renal failure - etiology

A

can be due to circulatory disruption to kidneys, toxic substances, bacterial toxins, acute obstruction, or trauma

61
Q

Renal and Urological Disorders - chronic renal failure

A

progressive loss of kidney function leading to end stage failure

62
Q

Renal and Urological Disorders - chronic renal failure - etiology

A

may result from prolonged acute UT obstruction and infection, diabetes, SLE, uncontrolled hypertension

63
Q

Renal and Urological Disorders - chronic renal falure - uremia

A

an end stage toxic condition resulting from renal insufficiency and retention of nitrogenous wastes in blood - symptoms can include anorexia, nausea, mental confusion

64
Q

Renal and Urological Disorders - Renal failure - RED FLAGS

A

May lead to multisystem abnormalities and failure

65
Q

Renal and Urological Disorders - Renal failure - dialysis

A

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

66
Q

Renal and Urological Disorders - Renal failure - Dialysis disequilibrium

A

symptoms of nausea, vomit, drowsy, HA, seizures

result of rapid changes after beginnin dialyssi

67
Q

Renal and Urological Disorders - renal failure - dialysis dimentia

A

signs of cerebral dysfunction - result of long standing years of dialysis treatment

68
Q

Renal and Urological Disorders - renal failure - locate dialysis shunt - why?

A

taking BP at the site of shunt is CONTRAINDICATED!

69
Q

Renal and Urological Disorders - Urinary incontinence is what

A

Inability to retain urine
REsult of loss of sphincter control
may be acute or persistent

70
Q

Renal and Urological Disorders - Urinary incontinence- Types - stress incontinence

A

Sudden release of urine due to
inc in abdominal pressure
weakness and laxity of pelvic floor mm, sphincter weakness

71
Q

Renal and Urological Disorders - Urinary incontinence- types - urge incontinence

A

bladder begins contracting and urine is leaked after sensation of bladder fullness is perceived, an inability to delay voiding to reach toilet due to
detrusor mm instability or hyperreflexia
sensory instability - hypersensitive bladder

72
Q

Renal and Urological Disorders - Urinary incontinence- types - Overflow incontinence

A

bladder continuously leaks secondary to urinary retention due to
anatomical obstruction
acontractile bladder
neurogenic bladder

73
Q

Renal and Urological Disorders - Urinary incontinence - types - functional incontinence

A

leakage associated with inability or unwillingness to toilet due to
impaired cognition
impaired physical functioning
environmental barriers

74
Q

Renal and Urological Disorders - Urinary incontinence - management

A

dietary
medications
surgery
Bladder training

75
Q

Renal and Urological Disorders - Urinary incontinence - PT

A 
Teach pelvic floor mm exercises 
Provide behavioral training
Functional mobility training as needed
Environmental mod
Maintain good skin condition
Emotional support

NPTE Other Systems (10 decks)

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