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Module 4 > UNIT 3- GU OVERVIEW AND ASSESSMENT > Flashcards

UNIT 3- GU OVERVIEW AND ASSESSMENT Flashcards

1
Q

What are the functions of the kidney?

A
  1. Regulate the volume and composition of extracellular fluid (EFC)
  2. Excrete waste products from the body
  3. Control BP
  4. Erythropoietin production
  5. Vitamin D Activation
  6. Acid-Base Balance regulation
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2
Q

What do we need to know about urine formation?

A

Urine formation is the outcome of a complex, multistep process of filtration, reabsorption, secretion and excretion of water, electrolyte and metabolic waste products.

  1. Glomerular filtration
  2. Tubular reabsorption
  3. Tubular secretion
  4. Urine concertation.
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3
Q

What is the function of the Glomerular?

A
  1. Blood is filtered by hydrostatic pressure
  2. Passes through bowman’s capsule
  3. Glomerular filtrate passes down tubule
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4
Q

What is the normal Glomerular filtration rate (GFR)?

A

125mL/min (this results in about 48 gallons filtered per day)

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5
Q

What should we know about tubular reabsorption?

A

Proximal convoluted tubule (PCT)–>most reabsorption will occur here (amino acids, sodium, chloride, and other essential nutrients)

Loop of Henle–> descending limb and ascending limb——–>located in the renal medulla (this is a VERY salty area—hypertonic (the interstitial fluid is hypertonic)– this is where a lot of your water absorption will occur (where the urine will get concentrated)

Nephron function: Note——->small amounts of waste products (ex: urea and creatinine) are okay to remain in the blood, but too much can be harmful. (This will be important when we discuss renal failure!)
 Urine contains water, urea, sodium, potassium, chloride, creatinine and more! When a patient is not excreting these substances, it can be harmful.

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6
Q

How does ADH play a role in urine formation?

A
  1. Important in water balance/water reabsorption in the kidney
  2. Regulated by posterior pituitary gland
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7
Q

How is aldosterone important in the urine formation?

A
  1. Reabsorption of sodium and water
  2. Released from adrenal cortex
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8
Q

What is the function of Ureters?

A
  1. Carry urine from renal pelvis to the bladder
  2. Ureteral lumens are narrow
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9
Q

What should we know about the bladder?

A
  1. Reservoir for urine
  2. Capacity 600-1000mL
  3. Bladder muscle (detrusor)
  4. Urination Micturition, voiding
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10
Q

How long is a female urethra?

A

1-2 in (3-5cm)

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11
Q

How long is a males urethra?

A

8-10in (20-25cm)

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12
Q

What should we know about the Ureterovesical unit?

A

Formed by the bladder, urethra, and pelvic floor muscle

  1. Voluntary control of this unit is defined as continence
    -Distention of bladder stimulates stretch receptors
    -Impulses sent to brain.
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13
Q

Why is medication use important GU history?

A

To rule of contraindicated medications either due to reactions w/each other or potential side nephrotoxic agents

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14
Q

What are 4 examples of nephrotoxic agents

A
  1. Vancomycin
  2. Ampoterycin
  3. Cephalosporin
  4. Gentamycin
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15
Q

What is anuria?

A

Inability to pee

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16
Q

What is olguira?

A

Small amounts of urine

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17
Q

What is polyuria?

A

Lots of urine/frequent use

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18
Q

What functional health patterns are important in a GU assessement?

A
  1. Health Perception-health management pattern
  2. Nutritional-metabolic pattern
  3. Elimination pattern
  4. Activity-excercise pattern
  5. Sleep-rest pattern
  6. Sexuality-reproductive pattern
19
Q

What dx blood studies are important with GU assessments?

A
  1. Serum cr (increases more than or equal to 50% renal function loss)
  2. BUN
    3.BUN/CR ratio
  3. Estimated GFR
20
Q

What is a normal BUN level?

A
  1. 7-24
21
Q

What is a normal CR level?

A

0.7-1.4

22
Q

If BUN is high but Cr is normal this could indicate?

A

Dehydration

23
Q

If BUN is decreased this could indicate

A

Over hydration

24
Q

When is the best time to collect a UA?

A

1st morning void– make sure to examine within an hour

25
Q

Within a urine study what test can be done?

A
  1. Urine c/s
  2. Composite urine collection
26
Q

What should we know about Creatinine clearance?

A
  1. Discard 1st urination
  2. Collect for 24 hours in large collection container placed on ice
  3. Save urine from ALL subsequent urinations for 24 hours
  4. Have patient urinate at end of 24 hour and add specimen to collection
27
Q

True or false: Small amounts of waste products in the blood are okay but large amounts can be harmful?

A

True

28
Q

True or false: If the body is not excreting creatine though the urine properly, the value of urinary cr will decrease and we will see a rise in serum cr.

A

True

29
Q

What radiology studies might we get for a GU assessment?

A
  1. KUB
  2. IVP (intravenous pyelogram)
  3. CT
    4.Cystography/cystourethrography
  4. Renal ultrasound
30
Q

What surgical procedure might we see with GU?

A
  1. Renal biopsy
  2. Cystoscopy
  3. Renal arteriogram (angiogram)
31
Q

What is a renal biopsy?

A
  1. Obtains tissue for examination to determine type of kidney disease
  2. Usually done as a skin biopsy through needle insertion into lower lobe of kidney under CT or Ultrasound guildance
32
Q

What are absolute contraindications to a renal biopsy?

A
  1. Bleeding disorders
  2. Single Kidney
  3. Uncontrolled hypertension
33
Q

What steps should we take before a renal biopsy?

A
  1. Type and crossmatch patient for blood
  2. Ensure consent is signed
  3. Assess coagulation status
    4.Pt hx and med hx
  4. Review labs- cbc, h&h, clotting factors
34
Q

What should we as nurses do after a renal biopsy of our patient.

A
  1. Apply pressure dressing
  2. Keep patient positioned on affected side for 30-60mins,
  3. Bed rest for 24 hours
  4. Vs q5-10mins for the 1st hour
  5. Assess frequently for signs of bleeding or infection
35
Q

What is the purpose of a renal arteriogram?

A
  1. Visualizes renal blood vessels. Can aid in dx renal artery stenosis, extra or missing renal blood vessels, and renovascular hypertension. Can aid in distinguishing between a renal cyst and tumor.
36
Q

As the nurse what should you do prior to a renal anteriogram (angiogram)

A
  1. Cathartic or enema may be used the night before
  2. Before injection of contrast material, assess for iodine sensitivity
  3. Prior to contrast medial injection, notify patient of possible transient warm feeling along the course of blood vessels.
37
Q

As the nurse what should you do after a renal arteriogram (angiogram)

A
  1. Place a pressure dressing over femoral artery inj. site
  2. Observe site for bleeding and inflammation.
  3. Have patient maintain bed rest with affected leg straight.
    Take peripheral pulses in involved leg every 30-60mins to detect occlusion of blood flow (from thrombus or emboli)
38
Q

Age related changes GU… decreased elasticity and muscle tone leads to….

A

Palpable bladder after urination because of retention

39
Q

Age related changes in GU… weakening of urinary sphincter leads to

A

Stress incontinence (esp. during Valsalva maneuver), dribbling of urine after urination.

40
Q

Age related changes in GU… decreased bladder capacity and sensory receptors leads too

A

frequency, urgency, nocturia, overflow incontinence

41
Q

Age related changes in GU…. estrogen deficiency leading to thin, dry virginal tissue leads to

A

Stress or overactive bladder,dysuria

42
Q

Age related changes in GU… Increased prevalence of unstable bladder contractions leads too

A

Overactive bladder

43
Q

Age related changes in GU… prostatic enlargement leads…

A

Hesitancy, frequency, urgency, nocturia, straining to urinate, retention, dribbling.

Module 4 (29 decks)

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