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patho > urinary function ch.7 > Flashcards

urinary function ch.7 Flashcards

1
Q

altered eliminations

A
  • incontience
  • neurogeniic bladder
  • UTI
  • nephrolithiasis
  • hydronephrosis
  • cancers: renal cell carcinoma & bladder
  • benign prostatic hyperplasia
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2
Q

impaired renal function

A
  • acute kidney injury

- chronic kidney disease

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3
Q

Incontinence

A

loss of urinary control

- affects 25-35% of population

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4
Q

types of incontinecne

A

children

  • enuresis
  • nocturnal enuresis

adults

  • stress
  • urge
  • reflex
  • overflow
  • functional
  • treatment
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5
Q

incontinence children enuresis

A

involuntary urination by a child after 4-5 years of age

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6
Q

incontinence children nocturnal enuresis

A
  • bed wetting

types

  • primary: child never developed normal bladder control @ night. might bc bladder too small
  • secondary: normal urinary control. physiological causes changes it

causes:

  • psychological
  • structural
  • underlying condition
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7
Q

incontinence adulthood stress

A
  • combined process of weakening of bladder sphincter and intra-abdominal pressure

contributing factors:

  • pregnancy
  • child birth
  • menopause
  • prostate removal and obesity
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8
Q

incontinence adulthood urge

A
  • sudden, intense urge to urinate and involuntary loss of urine
  • overacting bladder
  • few second warning

causes

  • parkinson
  • alzheimer disease
  • stroke
  • injury to nervous system
  • frequent uti
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9
Q

incontinence adulthood reflex

A

trauma or damage to nervous system

  • detrusor hyperreflexiaxia
  • increased detrusor muscle contractility
  • urine is released bladder cant relax and fill
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10
Q

incontinence adulthood overflow

A
  • inabilty to empty bladde ror retention
  • chronic distention
  • “nursing/teaching bladder”

causes:

  • bladder damage
  • urethral blockage
  • nerve damage
  • prostate conditons
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11
Q

incontinence adulthood functional

A
  • physical or mental impairment that prevents toileting in time
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12
Q

incontinence transient

A
  • resulting from underlying cause
  • temporary

causes

  • delirium
  • infection
  • use of diuretics and sedatives
  • high urine output
  • alcohol and caffeine consumption
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13
Q

risk factors for incontinence

A
  • female gender- pelvic floor muscle and vaginal wall weakening
  • advancing age- both muscle weaken and urine storage
  • obesity
  • smoking
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14
Q

complications inconteince

A
  • impaired skin integrity
  • recurrent utis
  • impaired body image/ sexual disfunction
  • interruption of usual activities
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15
Q

neurogenic bladder

A

bladder dysfunction caused by an interruption of normal bladder nerve innervation
- results in flaccid or spastic bladder

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16
Q

etiology of neurogenic bladder

A

neurologic

  • brain/spinal cord injury/ infections
  • dementia
  • parkinsons
  • stroke
  • ms

other

  • medications
  • alcoholism
  • herpes zoster
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17
Q

UTI

  • urethritis
  • cystitis
  • pyelonephritis
A

infection within the urinary tract

  • urethritis- urethra
  • cystitis- bladder
  • pyelonephritis- kidneys
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18
Q

uti etiology

A

bacterial invasion

- 75%-95% caused by E.coli (normal intestinal flora)

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19
Q

patho of uti

A
  • bacteria resists normal defenses: urination and acidity
  • adherers to urothelial lining
  • inflammation/redness of wall of urethra/bladder
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20
Q

UTI risk factors

A
  • female
  • immobility
  • bowel/bladder inconteninence
  • urinary obstruction- pooling of urine
  • indwelling urinary catheters- follys
  • antibiotic use- overuse- kills good bacteria
  • improper personal hygiene
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21
Q

uti clinical manifestation

A
  • asymptomatic
  • urgency/ frequency
  • dysuria- burning
  • hematuria- blood in urine
  • cloudy/ foul-smelling urine- more bacteria
  • fever, chills, fatigue
  • back/flank pain- progress to kidneys
  • confusion or sudden change in mental status- do urinalysis
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22
Q

nephrolithiasis

A

presence of renal calculi (kidney stones)

- composed of: calcium, uric acid and magnesium

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23
Q

patho of nephrolithiasis

A

minerals build up forming crystals that grow in size

24
Q

etiology nephrolithiasis

A
  • ph changes
  • increase Na concentration
  • stasis of urine
25
Q

risk factors nephrolithiasis

A
  • obesity
  • HTN
  • diet ( increased protein, increased an, decrease calcium)
26
Q

hydronephrosis

A

abnormal dilation of the renal pelvis of one or both kidneys

  • unilateral renal involvement: indicates an obstruction in one of the ureters
  • bilateral renal involvement indicates an obstruction in the urethra
27
Q

hydronephrosis patho

A
  • obstruction of urine flow leads to fluid buildup within kidneys
  • dilation results in obstruction or pressure and compression on surrounding tissues and blood vessels
  • resulting in decreased glomerular filtration and potentially atrophy/ necrosis
28
Q

hydronephrosis etiology

A
  • urinary obstruction

- stones, tumors, strictures, stenosis, congenital defects

29
Q

renal cell carcinoma

A

most freqently occurring kidney cancer in adults

  • increase incidence in men
  • 50-70 years old

5 year survival rate

  • localized 93%
  • distant spread 13%
  • metastasis to the liver, lungs, bone, or nervous system is common
  • does not typically respond well to chemo
  • preferred tx partial or total nephrectomy
30
Q

bladder cancer

A

cancer that forms in the tissue of the bladder

  • incidence rates
  • increase age, increase male, increase Caucasians

types: categorized by tissue of origin
- recurrence common

31
Q

bladder cancer risk factors

A
  • smoking
  • chemical exposure
  • recurrent uti. chronic bladder irritation
  • chemo/radiation
32
Q

benign prostatic hyperplasia (BPH)

A

nonmalignant enlargement of the prostate gland

33
Q

benign prostatic hyperplasia (BPH) etiology

A
  • unknown –> decreased testosterone

- common over age 50

34
Q

benign prostatic hyperplasia (BPH) patho

A
  • abnormal proliferation –> enlargement of prostate
  • compression of urethra –> obstruction of urine flow
  • urine collects in bladder causing uti and thickening of bladder
35
Q

benign prostatic hyperplasia (BPH) risk factors

A 
obesity
cardiovascular disease
DM2
inactivity 
ED
36
Q

acute kidney injury

A

sudden loss of renal function

  • days to weeks
  • generally reversible
37
Q

acute kidney injury etiology

A

inadequate renal perfusion

  • prerenal (before kidney)- decrease bp, HF
  • intrarenal (within kidney)- inflammation of glomerulus/ compression on internal structures
  • postrenal (after kidney)- urethral/ bladder obstruction- interfere with the ability to secrete urine
38
Q

acute kidney injury patho

A
  • abrupt onset

- 4 phase process

39
Q

acute kidney injury lab values

A

creatinine increase

  • decreased urinary excretion
  • waste product produced by muscle

BUN increase
- decreased urinary excretion

40
Q

acute kidney injury phases

A
  • prodromal
  • oliguric
  • diuretic
  • recovery
41
Q

acute kidney injury phases: prodromal

A
  • damage occurs

- pt. asyomptomatic

42
Q

acute kidney injury phases: oliguric

A
  • nephrons are damaged
  • decreased glomerular filtration
  • decreased urine output
  • less than 400 ml/day
43
Q

acute kidney injury phases: diuretic

A
  • renal function begins to improve
  • tubular damage continues to impair ability to concentrate urine appropriately
  • leads to diuresis- excess urine output (depletes fluids and electrolytes)
  • up to 5l
44
Q

acute kidney injury phases: recovery

A
  • can take 3-12 months

- glomerular filtration returns to normal

45
Q

chronic kidney disease

A

gradual, irreversible loss of renal function

  • nephrons become injured
  • replacement by scar tissue
  • affects 30 million adults
46
Q

chronic kidney disease etiology

A
  • DM- diabetes #1 cause
  • HTN- affects glomelura
  • urinary obstruction- increase pressure on kidneys
  • renal artery stenosis- not good blood flow
  • nephrotoxic medications- kidney toxic (NSAIDS)
  • sickle cell disease
  • SLE- sickle cell attacks cells in nephron
  • smoking- harden Bu- small Bu in kidneys
  • aging- less effective
47
Q

chronic kidney disease patho

A

damaged nephrons –> impaired kidney function

  • decrease regulation and ability to eliminate waste products and drug exretion
  • increase bp
48
Q

chronic kidney disease stage 1

A

kidney damage present by GFR > 90

49
Q

chronic kidney disease stage 2

A

kidney damage worsens as the GFR falls (60-89)

50
Q

chronic kidney disease stage 3

A

kidney function is signficantly impaired as GFR is between 30 and 59

51
Q

chronic kidney disease stage 4

A

kidney function is barley present with GFR dropping between 15 and 29

52
Q

chronic kidney disease stage 5

A

kidney failure as the GFR drops to less than 15

53
Q

prerenal

A

(before kidney)

decrease bp, HF

54
Q

intrarenal

A

(within kidney)

inflammation of glomerulus/ compression on internal structures

55
Q

postrenal

A

(after kidney)

urethral/ bladder obstruction- interfere with the ability to secrete urine

patho (24 decks)

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