Urine Elimination Flashcards
What is the functional unit of the kidney?
nephron
What are the 6 parts of the nephron?
- glomerulus
- Bowman’s capsule
- proximal convoluted tubule
- loop of Henle
- distal tubule
- collecting duct
Where is the initial site of filtration of the blood and the beginning of urine formation?
glomerulus
What is the term for large proteins in the urine? What does this indicate?
proteinuria; sign of glomerular injury
What is the normal adult average output?
1200-1500mL/day
How do the kidneys maintain a normal RBC volume?
produce erythropoietin
Why are patients with chronic kidney disease prone to anemia?
They cannot produce sufficient quantities of erythropoietin
Which hormone is released from juxtaglomerular cells in times of renal ischemia?
Renin
What is the function of the hormone renin?
Converts angiotensinogen into angiotensin I
Where is angiotensin I converted into angiotensin II?
Lungs
What is the function of angiotensin II?
causes vasoconstriction and stimulates aldosterone release from the adrenal cortex
What is the function of aldosterone?
causes water retention in order to increase blood volume
What is the term for the pain caused by the strong peristaltic waves produced by the ureters in order to move an obstruction such as a kidney stone?
renal colic
What is the name of the primary bladder muscle?
detrusor muscle
What is the name of the part of urethra through which the urine passes out of the body?
urethral meatus
What are the three sections of the male urethra?
- prostatic
- membranous
- penile
Which brain structures influence bladder function?(4)
- cerebral cortex
- thalamus
- hypothalamus
- brainstem
What is the average bladder capacity?
600-1000mL
How often does an adult normally void?
2-4 hours
At what age do children have enough neurological development to be toilet trained?
24-36 months
What urinary problem can occur with damage to the spinal cord above the sacral region.
reflex incontinence
What are the symptoms of reflex incontinence?
Causes loss of voluntary control of urination, but the micturation reflex pathway remains intact which allows urination to occur without the sensation of the need to void.
What urinary problem can occur when a bladder is overly full and bladder pressure exceeds sphincter pressure?
overflow incontinence
What can occur if a chronic obstruction caused by neurological damage hinders bladder emptying?
Over time the micturation reflex changes, causing bladder overactivity and possibly causing the bladder not to empty completely.
What are the three categories of conditions that affect urine volume and quality?
- prerenal (bloodflow to and through the kidney)
- renal (disease of renal tissue)
- postrenal (obstruction in lower urinary tract)
What is the condition characterized by an increase in nitrogenous wastes in the blood, marked fluid and electrolyte abnormalities, nausea, vomiting, headache, coma, and convulsions?
uremic syndrome
List 3 major indicators for dialysis:
- Renal failure
- Worsening of uremic syndrome with ESRD
- Severe electrolyte and/or fluid abnormalities
What is the condition characterized by awaking to void one or more times at night?
nocturia
What is the condition characterized by an excessive output of urine?
polyuria
What is the condition characterized by decreased urine output despite normal intake?
oliguria
What is the condition characterized by a lack of urine output?
anuria
How does stress affect fluid balance?
- increased ADH increases fluid retention
- increased aldosterone increases Na and H20 retention
How do anesthetics and narcotic analgesics affect fluid balance?
- slows GFR which reduces urine output
- impair sensory and motor impulses traveling among the bladder, spinal cord, and brain.
What is the term for the surgical diversion of the drainage of urine?
urinary diversion (ie ureterostomy)
What is the term for the artificially created opening between a body cavity and the surface of the body?
stoma
Urinary retention occurs as a result of which conditions? (5)
- urethral obstruction
- surgical or childbirth trauma
- alterations tin motor/sensory innervation
- removal of indwelling catheter
- medication side effects
What must be done if a patient cannot void or completely empty the bladder? Why?
Patient must be catheterized. UTI, kidney stones and hyperreflexia can occur
What is the term for the volume of urine remaining in the bladder after a normal voiding?
residual volume aka postvoid residual (PVR)
How soon after voiding should PVR be assessed?
10-15 minutes
What does the acronym CAUTIs stand for?
Catheter-associated UTIs
What is the most common source of CAUTIs?
- the patient’s own flora
- Escherichia coli
What is the term for pain or burning during urination?
dysuria
What is the term for an irritated bladder?
cystitis
What is the term for blood-tinged urine?
hematuria
What is the term for an infection that spreads to the upper urinary tract and into the kidneys?
pyelonephritis
What is the term for the involuntary leakage of urine that is sufficient to be a problem?
urinary incontinence
What is the condition that results from sudden, involuntary contraction of the muscles of the urinary bladder, resulting in an urge to urinate?
Overactive bladder (OAB)
What are common abnormalities that cause OAB?
- CVA
- head injuries
- spinal cord injury
- diabetic neuropathy
- UTI
- anxiety
What are the two types of urinary diversions?
- continent urinary reservoir
- orthotopic neobladder
How do cranberry juice and vitamin C decrease bacterial infections of the bladder?
they acidify the urine
How does aging affect micturation in men?
prostate enlargement usually begins in the 40s and continues throughout the life
How does aging affect micturation in women?
changes in the urethral mucosa associated with loss of estrogen during and after menopause contribute to increased susceptibility to UTIs
Why does residual urine in the bladder increase the risk for a UTI?
residual urine becomes more alkaline and is an ideal site for microorganism growth
What are the 3 common risks of an indwelling catheter?
- infection
- catheter blockage
- skin care problems
What should be used to measure urine output if precise hourly measurements are necessary?
urimeter
An hourly output of less than _____________mL for more than _________ consecutive hours is cause for concern.
30mL
2
How much daily volume is considered polyuria?
over 2000 to 2500 mL
What are the 3 characteristics of urine that need to be inspected?
- color
- clarity
- odor
What is the normal color range for urine?
pale, straw color to amber
When is urine usually more concentrated?
in the morning or with fluid volume deficits
Bleeding from which 2 locations causes dark red urine?
- kidneys
- ureters
Bleeding from which 2 locations causes bright red urine?
- bladder
- urethra
What does cloudy or foamy urine from a patient with renal disease indicate?
high protein concentration
What can thick and cloudy urine indicate?
bacteria and WBCs in urine
List two tests that can be used to test urine concentration:
- specific gravity
