Unit 7 - B Flashcards
What are the structors of the kidneys?
-Nephron
-Glomerulus
-Bowman’s capsule
-Tubular system (PCT, loop of Henle, DCT, and collecting tubules)
Explain the kidney artery supply system.
-Renal arteries rise from the abdominal aorta then divide into afferent arterioles that then divide into the glomerulus.
How is blood filtered?
What is the filteration rate?
-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.
What do the PCT, Loop of Henle, Descending & Ascending loops, and DCT absorb?
-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.
What does Antidiuretic hormone (ADH) do?
What regulates it?
- It increases water reabsorption resulting in less urine produced.
- It is regulated by the posterior pituitary gland.
What does the hormone aldosterone do?
What regulates it?
- 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.
Explain the Renin-angiotensin-aldosterone system (RAAS).
-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.
Explain the process of Prostaglandin Synthesis.
What does it do?
What is it managed by?
- Increases blood flow to the kidneys resulting in increased Na+ excretion.
- Causes vasodilation.
- Released by medulla.
What do ureters and the bladder do?
-Ureters: Carry urine from the renal pelvis into the bladder.
-Bladder: Stores urine, it can hold 600-1000mLs.
What is the function of the urethra?
Male vs. Female
-It is a channel for urine during voiding.
- Male: 8-10 inches.
-Female: 1-2 inches.
How would you subjectively and assess urinary problems?
-Ask about their voiding patterns.
-Assess past history of problems.
-Note any medications that could cause problems.
How would you objectively assess urinary problems?
Assess their bladder, urethral meatus, skin integrity, their hydration, and urine output.
How would you assess the Costovertebral Angle (CVA)?
What does CVA tenderness indicate?
-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.
What are the normal findings of the GU system?
-No CVA tenderness.
-Nonpalpable kidneys and bladder, and masses.
What is specific gravity of urine?
What are the normal values?
What does a low/high value indicate?
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.
What is Blood Urea Nitrogen (BUN)?
What do high levels indicate?
What are the normal values?
Urea is a waste product of protein metabolism.
High levels indicate impaired kidney function.
Normal values: 10-20mg/dL.
What are some factors that affect micturition (urinating)?
DFA-PM
-Developmental considerations.
-Food/fluid intake.
-Activity and muscle tone.
-Pathologic conditions.
-Medications.
What are the types of urinary incontinence?
TSU-OFRT
-Transient incontinence (from infection/medication).
-Stress incontinence.
-Urge incontinence.
-Overflow.
-Functional (can’t get to the toilet in time).
-Reflex.
-Total.
What medications can you give for urinary incontinence?
-You can give anticholinergics such as oxybutynin.
What does oxybutynin do? What are the side effects?
S/E: D - B - S
-It relaxes the bladder muscle and inhibits overactive detrusor muscle contractions.
S/E: Dry mouth & eyes. Blurred vision, sleepiness.
What is urinary retention?
What is the normal post-void residue inside the bladder?
-It is the inability to fully empty the bladder.
-Post void residue: 50-75mL.
What causes urinary retention?
E- N - B - W - A
-Enlarged prostate.
-Neurologic impairment.
-Bladder outlet obstruction.
-Weak detrusor muscle.
-Alcoholism.
What are the nursing interventions for urinary retention?
D- I - D - W - D
-Double-voiding.
-Intermittent catheter.
-Drink small amounts of water.
-Warm bathe.
-Drink caffeine.
What medications would you give for urinary retention?
What is the action of the medication?
Any side effects?
alpha(a)-adrenergic blockers.
Action: Relaxes smooth muscle of bladder and urethera.
S/E: dizziness, weakness, stuffy nose.
