Unit 7 - B Flashcards

1
Q

What are the structors of the kidneys?

A

-Nephron
-Glomerulus
-Bowman’s capsule
-Tubular system (PCT, loop of Henle, DCT, and collecting tubules)

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2
Q

Explain the kidney artery supply system.

A

-Renal arteries rise from the abdominal aorta then divide into afferent arterioles that then divide into the glomerulus.

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3
Q

How is blood filtered?
What is the filteration rate?

A

-Blood is filtered by hydrostatic pressure
-It passes from the glomerulus into Bowman’s Capsule, then into the PCT duct.
-Glomerular filtration rate (GFR): 125mL/min.

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4
Q

What do the PCT, Loop of Henle, Descending & Ascending loops, and DCT absorb?

A

-Proximal convoluted tubule: Absorption of electrolytes, glucose, amino acids, small proteins.

-Loop of Henle: Absorption of Na+, Cl-, and H2O.

-Descending loop: Absorption of H2O, some Na+, and urea.

-Ascending loop: Absorption of Cl- and Na+.

-Distal convoluted tube: Reabsorption and balance of water.

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5
Q

What does Antidiuretic hormone (ADH) do?
What regulates it?

A
  • It increases water reabsorption resulting in less urine produced.
  • It is regulated by the posterior pituitary gland.
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6
Q

What does the hormone aldosterone do?
What regulates it?

A
  • It helps regulate B/P by managing the absorption of Na+, K+, and water, and maintaining the acid-base balance in the blood.
  • It is regulated by the adrenal cortex.
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7
Q

Explain the Renin-angiotensin-aldosterone system (RAAS).

A

-Juxtaglomerular cells produce prorenin which then converts to renin into the blood when B/P drops.
-Renin then converts angiotensinogen (made by liver) into angiotensin I.
-Angiotensin converting enzyme (ACE) convert angiotensin I into angiotensin II.
-Angiotensin II then increases water/sodium retention, vasoconstriction, and the release of aldosterone, all leading to an increase in blood pressure.

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8
Q

Explain the process of Prostaglandin Synthesis.
What does it do?
What is it managed by?

A
  • Increases blood flow to the kidneys resulting in increased Na+ excretion.
  • Causes vasodilation.
  • Released by medulla.
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9
Q

What do ureters and the bladder do?

A

-Ureters: Carry urine from the renal pelvis into the bladder.
-Bladder: Stores urine, it can hold 600-1000mLs.

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10
Q

What is the function of the urethra?
Male vs. Female

A

-It is a channel for urine during voiding.
- Male: 8-10 inches.
-Female: 1-2 inches.

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11
Q

How would you subjectively and assess urinary problems?

A

-Ask about their voiding patterns.
-Assess past history of problems.
-Note any medications that could cause problems.

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12
Q

How would you objectively assess urinary problems?

A

Assess their bladder, urethral meatus, skin integrity, their hydration, and urine output.

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13
Q

How would you assess the Costovertebral Angle (CVA)?

What does CVA tenderness indicate?

A

-Assess by placing one hand over the twelfth rib on the CVA, then thump your hand with the ulnar edge of your other hand.

-CVA tenderness could indicate kidney problems.

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14
Q

What are the normal findings of the GU system?

A

-No CVA tenderness.
-Nonpalpable kidneys and bladder, and masses.

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15
Q

What is specific gravity of urine?
What are the normal values?
What does a low/high value indicate?

A

It is a measure of the dissolved particles in the urine.
Normal values: 1.010-1.025
Low indicates less concentrated urine.
High indicates more concentrated urine.

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16
Q

What is Blood Urea Nitrogen (BUN)?
What do high levels indicate?
What are the normal values?

A

Urea is a waste product of protein metabolism.
High levels indicate impaired kidney function.
Normal values: 10-20mg/dL.

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17
Q

What are some factors that affect micturition (urinating)?
DFA-PM

A

-Developmental considerations.
-Food/fluid intake.
-Activity and muscle tone.
-Pathologic conditions.
-Medications.

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18
Q

What are the types of urinary incontinence?
TSU-OFRT

A

-Transient incontinence (from infection/medication).
-Stress incontinence.
-Urge incontinence.
-Overflow.
-Functional (can’t get to the toilet in time).
-Reflex.
-Total.

19
Q

What medications can you give for urinary incontinence?

A

-You can give anticholinergics such as oxybutynin.

20
Q

What does oxybutynin do? What are the side effects?

S/E: D - B - S

A

-It relaxes the bladder muscle and inhibits overactive detrusor muscle contractions.
S/E: Dry mouth & eyes. Blurred vision, sleepiness.

21
Q

What is urinary retention?
What is the normal post-void residue inside the bladder?

A

-It is the inability to fully empty the bladder.
-Post void residue: 50-75mL.

22
Q

What causes urinary retention?

E- N - B - W - A

A

-Enlarged prostate.
-Neurologic impairment.
-Bladder outlet obstruction.
-Weak detrusor muscle.
-Alcoholism.

23
Q

What are the nursing interventions for urinary retention?

D- I - D - W - D

A

-Double-voiding.
-Intermittent catheter.
-Drink small amounts of water.
-Warm bathe.
-Drink caffeine.

24
Q

What medications would you give for urinary retention?
What is the action of the medication?
Any side effects?

A

alpha(a)-adrenergic blockers.
Action: Relaxes smooth muscle of bladder and urethera.
S/E: dizziness, weakness, stuffy nose.

25
Q

What kind of urinary catheters can you do?

A

-Straight.
-Indwelling w/balloon.
-Indwelling w/coudé tip.
-3-way indwelling.

26
Q

How would you prevent catheter-associated urinary tract infections (CAUTI)?

A

-Teach catheter care to pt.
-Use closed drainage system.
-Only disconnect for irrigation.
-Remove catheter as early as possible.

27
Q

What is a urinary tract infection (UTI)? Which gender experiences it more commonly?
What is the most common bacteria that causes it?

A

-It is an infection of the upper & lower urinary tract.
-It is more common in women.
-E.Coli is the most common pathogen.

28
Q

What are the clinical manifestations of upper & lower UTI’s?

A

Upper:
-Fever, chills, flank pain, N/V, anorexia, fatigue.
Lower:
-Pain/burning.
-Urgency to urinate.
-Incontinence.
-Hematuria & cloudiness.

29
Q

How would you assess a person with a UTI?

A

-Assess for fever, foul-smelling urine, tender/enlarged kidney, leukocytosis, WBC/RBC.

30
Q

What diagnostic studies can be done for urinary problems?
What can you use to temporarily treat?

A

-Urinalysis
-Urine culture
-CT scan of bladder

-Use broad spectrum abx until culture returns.

31
Q

What first-choice medications will you use for pt. with uncomplicated UTI?

A

-Trimethoprim/sulfamethoxazole.
-nitrofurantoin.

32
Q

What are the side effects of trimethoprim and sulfamethoxazole?

H - A - N - R - P - C

A

-Headache, abd pain, N/V/D, rash, pruritus, C. Diff.

33
Q

What are the side effects of nitrofurantoin?

H- A - N - U - C

A

-Headache, abd pain, N/V/D, urine discoloration, C. Diff.

34
Q

What other medications can you give for UTI’s?

A

-cephalexin
-ceftriaxone

35
Q

What are the side effects of cephalexin and ceftriaxone?

R- N - P - C

A

-Rashes, N/V/D, phlebitis at IV site, C. Diff.

36
Q

What medications will you use for complicated UTI’s?
Any side effects?

HIDNCN

A

-Fluoroquinolone. It treats resistant bacteria.
S/E: headache, insomnia, dizziness, nausea, C.Diff, neuropathy.

37
Q

What does phenazopyridine do?
What are its side effects?

R-H-N-R

A

-It numbs the lining of the urinary tract mucosa using dye.
S/E: red urine, headache, nausea, rash.

38
Q

What does nortriptyline do?
What are its side effects?

H - D - C - D

A

-Reduces burning and urinating frequency.
S/E: hypotension, dry mouth/eyes, constipation, drowsiness.

39
Q

What are the aging effects on the urinary system?

D - L - P - N - I

A

-Decreased blood flow.
-Loss of elasticity.
-Prostate enlargement.
-Nocturia.
-Increased frequency & retention.

40
Q

What happens to the urinary system as a person grows up?

A

-Kidneys decrease in size & weight by 10% each decade starting at 30.
-Glomerulus begins declining at 40.
-Decreased ability to concentrate urine.

41
Q

What is pyelonephritis? What bacteria causes it? Risk factors?

I - C

B - D - C

A

-Inflammation of renal parenchyma.
-Caused by bacteria, mainly E.Coli.

-Risk factors:
-Backflow of urine.
-Dysfunction of lower urinary tract.
-CAUTI.

42
Q

What are the clinical manifestations of pyelonephritis?

F - M - C - F - C

A

Fatigue.
-Malaise.
-Chills.
-Fever.
-CVA tenderness.

43
Q

What are some patient teachings for pyelonephritis?

F - R - I - V

A

-Finish all abx.
-Routine bladder emptying.
-Increase fluid intake.
-Void after intercourse.

44
Q

What are risk factors for UTIs?

S - U - P - I

A

-Sexually active women.
-Urinary stasis.
-Postmenopausal women.
-Indwelling catheter.