URINARY SYSTEM Flashcards
Magnesium
1.5-2.5 meq/l
Phosporus
2.5-3.5 meq/l
Potassium
3.5-4.5 meq/l
Calcium
4.5- 5.5 meq/l
Sodium
135-145 mg/dl
Chloride
95-105
UO per hour
40-60 ml
UO per day
1500 ml
Normal BUN
10-20 dl
Serum Creatinine
0.4-1.2
Serum Uric
2.2. - 5.5
Serum Albumin
3.2 - 5.5
Normal Urine Odor
Aromatic
bean shaped
kidneys
Wt. of kidney
120-130g
Length of Kidney
5-6 inches
Width of kidney
2-3 inches
Thickness
2-3 cm
a kidney that is slightly lower than the left.
Right kidney; due to presence of liver
kidneys are located at
CV angle; retroperitoneally; 3rd and 12th lumbar
top of kidney
Adrenal gland
3 INTERNAL DISTINCT REGIONS
CORTEX, MEDULLA, RENAL PELVIS
CORTEX
Outer part; Light in color and granular in appearance
wide of renal cortex
1cm wide
waste filtration
glomerulus
surrounded by Bowman’s capsule
Glomerulus
Renal Medulla
Inner; contains loop of henle, vasarecta, renal pyramid
wide of medulla
5cm
loop of Henle
where loop diuretics work; water reabsorption
Vasarecta
regulates renal blood flow
Renal pyramid
collection of urine; urine flows out
Renal pelvis
Transports urine that forms in urine calices
total C02 receive of kidney
20-25%
Basic structural unit of kidney
nephrons
Nephrons
Responsible for urine formation
2 kinds of nephrons
Cortical
Juxtamedullary
Cortical
production of urine
Juxtamedullary
secrete renin
GFR
125 mL/min
Oliguria
Decreased UO
Polyuria
Increased UO
Anuria
No UO
Dysuria
Painful urination
Pyuria
Pus on urine
Presence of blood on urine
Hematuria
Painful sexual intercourse
Dyspareunia
FUNCTION OF KIDNEYS
UERRCRSS
Renal Failure; ABG?
metabolic acidosis
DOC of metabolic acidosis
sodium bicarbonate
Pt. with Renal failure is prone to-
Renal osteodystrophy
DOC OF Hyperkalemia
CBIGKD
Glucose is always with?
Potassium
Kayexalate
It exchanges for sodium ions of body and eliminates excess potassium
Nitrogen waste
Urea
produce RBC
Erythropoietin
cannot be improved by dialysis
anemia
Activate by liver then followed by kidney
vitamin D
Maintain renal blood circulation even with regulation of sodium
prostaglandins
RAAS
Renin-Angiotensin Aldosterone System
This hormone inhibits ADH secretion
ATRIAL NATRIURETIC PEPTIDE
ANP released and inhibit ADH production -> ↓Water Reabsorption -> ↑UO -> dilute urine -> ↓SG
Renal Failure
Urine that forms in the nephrons flow into the renal pelvis and then into these
Ureters
ureters length
12-20 inches
terminate end of the ureter
Trigone wall
Posterior to the symphysis pubis
and a Muscular hollow sac located just behind the pubic bone
URINARY BLADDER
UB in Males: lies immediately in front of the_______
rectum
UB in Females: lies in front of the__________
vagina
Amount of urine holds
500-800 ml
Smooth triangular portion of the base of the bladder outlined by these openings
Trigone wall
Detrusol
allows the bladder to expand or contract
Thin-walled muscular tube that channels urine to the outside of the body
URETHRA
Female urethra
0.5 – 2.5 inches (3-5 cm)
Male urethra
5-6 inches (20cm)
Red, Dark, Smoky Color
bleeding
Cloudy
infection
Colorless
FVE
Very dark yellow
FVD
Red/ Red brown
due to: Thoracin and Rifampicin
Orange
Severe DHN
Blue/green
Elavil (anti-depressant)
Brown/Black
Lysol poisoning
Milky
Fats
pH
4.5-8
Specific Gravity
1.010 – 1.025
Protein
(AGN)
Acute Glomerulonephritis
What cause Glucose?
(DM)
Ketones
(DKA)
WBC, RBC, if present?
infection
↑BUN
= renal failure
RBC
4.5-5
HcT F
26 – 44
HcT M
40 – 50
Creatinine Clearance F
85-135
Creatinine Clearance M
97 – 127
ONCOTIC PRESSURE
Pulley force for water to contain in ECF ; protein leaves
CYSTOSCOPY
invasive or not?
INVASIVE
for clearer visualization and maintain sterility of area
Laxatives
Sedation
to relax = diazepam or valium
CYSTOSCOPY
done with anesthesia or not?
Anesthesia
In local anesthesia?
Force fluids
Force fluids in local anesthesia
prevent ascending Urinary Tract Infection
Force fluids; amount?
3000 mL
In general anesthesia
NPO 6-8 hours
NPO 6-8 hours
to prevent aspiration – temporarily relax peristaltic movement
desire to void is? normal or abnormal
NORMAL
Cystoscopy Position:
Lithotomy
Cystoscopy takes about:
15 mins – 1 hour
Bed rest and Don’t attempt to stand without assistance- after cystoscopy to-
Prevent orthostatic hypotension or supine hypertensive syndrome
Expected burning on urination for a__________
day or two
AFTER cystoscopy : Monitor vital signs
for suspected bleeding = hypo, tachy, tachy
AFTER cystoscopy: Observe for
-retention or low UO
-bright bleeding or hematuria
-abdominal or flank pain
-chills or fever
-signs of tissue irritation
-signs of infection
Pink-tinged urine is________
normal
Normal Pink-tinged urine is due to
irritation of mucous membrane of urinary tracts
BLOOD after cystoscopy?
report to physician (prevent hypovolemia)
Hot sitz bath to?
relieve pelvic or perineal discomfort
Warm moist soaks to?
prevent leg cramps
IV pyelogram- “GRAM”
make use of contrast medium (iodinated)
Most common used contrast medium
hypaque
Check iodine allergy to?
prevent hypersensitivity
readily available at bedside to prevent delayed hypersensitivity reaction
EPINEPHRINE
Hypersensitivity reaction
- Itching/rashes
- Bronchospasm
- Anaphylactic shock
Intravenous Pyelogram - Invasive or not?
Invasive
Evacuate feces for clearer visualization
Bowel preparation (laxative or enema)
CARE AFTER: IV Pyelogram
-Monitor VS
-NPO 6-8 hours
-Increase Fluid Intake
-Burning Sensation on voiding may be experienced
-Observe for delayed allergic reaction
Increase Fluid Intake
to flow out contrast medium =nephrotoxic
KUB
Painless and No usual special preparation done
RENAL BIOPSY
Suspected renal Ca
kidney is highly?
vascularized
Renal Biopsy: NPO Status
from midnight; 6-8 hours
RENAL BIOPSY: Check pro-time, hemoglobin, hematocrit
since kidney is highly vascularized
Renal Biopsy Position:
Prone
Apply pressure dressing:
prevent bleeding
Hold breath and remain still during needle insertion for?
(5-15 secs)
AFTER RENALBIOPSY: Bed rest for 24 hours?
prone to bleeding
RENAL BIOPSY: Monitor_______ and notify in case of _____________, ________________or other signs ________________
Monitor vital signs and notify in case of tachycardia, hypotension or other signs (oliguria, ↓LOC)
Monitor biopsy site for?
bleeding
Obtain hematocrit and hemoglobin in
8 hours (detect internal bleeding)
Force fluids
prevent ascending UTI
RENALBIOPSY: Avoid strenuous exercise for?
2 weeks (to prevent bleeding)
Signs of bleeding after cystoscopy
low bp, high RR and PR, restlessness
Signs of infection
Ab. pain, tenderness, chills, fever
