Week 3: Renal Assessment Flashcards
Define
Urobilinogen
A substance in urine that can indicate liver function or disease.
Define
Chronic Kidney Disease (CKD)
A long-term condition where the kidneys gradually lose function over time.
What is
A measure of urine concentration, reflecting kidney function and hydration status.
Define
Specific Gravity
What is
The part of the nervous system that regulates involuntary bodily functions, including bladder control.
Define
Autonomic Nervous System
What is
A tool used to monitor and record bladder function and urine output.
Define
Bladder Chart
What is
Urinary incontinence resulting from medical treatments or conditions, such as medications or surgical procedures.
Define
Iatrogenic Incontinence
Define
Acute Kidney Injury (AKI)
A sudden decline in kidney function, leading to the accumulation of waste products in the blood.
What is
A waste product from muscle metabolism, used as a marker of kidney function.
Define
Creatinine
What is
Compounds found in urine that can suggest the presence of a bacterial infection.
Define
Nitrites
What is
The need to wake up multiple times during the night to urinate.
Define
Nocturia
Define
Catheterization
An imaging test that measures the amount of urine in the bladder to assess bladder function.
Define
Anticholinergic Agents
Medications that block muscarinic receptors, reducing bladder contractions and potentially causing urinary retention (e.g., Oxybutynin).
Define
Pelvic Floor Muscles
Muscles that support and stabilize the pelvic organs, including the bladder and uterus, helping to maintain urinary continence.
What is
A kidney disorder characterized by high protein levels in urine, low protein levels in blood, and swelling.
Define
Nephrotic Syndrome
Define
Body Fluids
Liquids within the body, including blood and urine, regulated by the renal system.
Define
Post-Void Residual Volume
The amount of urine remaining in the bladder after urination, which can indicate bladder function issues.
Define
Escherichia coli (E. coli)
A type of bacteria commonly responsible for urinary tract infections.
What is
Swelling caused by fluid retention, which can be related to kidney or heart problems.
Define
Edema
What is
Diagnostic tests that assess bladder function and efficiency, including how well the bladder stores and releases urine.
Define
Urodynamic Testing
What is
Medications that block muscarinic receptors, reducing bladder contractions and potentially causing urinary retention (e.g., Oxybutynin).
Define
Anticholinergic Agents
What is
A waste product formed in the liver from the breakdown of proteins, excreted in urine.
Define
Urea
What is
A medication used to relax the urethra and improve urine flow in cases of overflow incontinence, especially related to an enlarged prostate.
Define
Tamsulosin
Define
ACE Inhibitors (Angiotensin-Converting Enzyme Inhibitors)
Medications used to treat high blood pressure and heart failure, which can impact kidney function.
Define
Hemodialysis
A type of dialysis that filters blood through a machine to remove waste products and excess fluids.
Define
Fluid Balance
The equilibrium between fluid intake and output, crucial for maintaining kidney function and overall health.
What is
Narrowing of the renal arteries, which can lead to high blood pressure and kidney damage.
Define
Renal Artery Stenosis
What is
An imaging test that measures the amount of urine in the bladder to assess bladder function.
Define
Catheterization
Define
Selective Serotonin Reuptake Inhibitors (SSRIs)
Antidepressants that may affect bladder function and contribute to urinary incontinence (e.g., Amitriptyline).
What is
Medications that reduce inflammation and pain but can affect kidney function.
Define
NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)
What is
The presence of blood in the urine, indicating potential issues with the urinary tract.
Define
Hematuria
Define
Iatrogenic Incontinence
Urinary incontinence resulting from medical treatments or conditions, such as medications or surgical procedures.
What is
Antidepressants that may affect bladder function and contribute to urinary incontinence (e.g., Amitriptyline).
Define
Selective Serotonin Reuptake Inhibitors (SSRIs)
What is
A type of dialysis that filters blood through a machine to remove waste products and excess fluids.
Define
Hemodialysis
What is
Leakage that occurs when the bladder overfills due to an inability to completely empty, often associated with bladder outlet obstruction.
Define
Overflow Incontinence
Define
Continence Aids
Products designed to manage and contain urinary leakage, such as pads, briefs, and other absorbent materials.
Define
Overflow Incontinence
Leakage that occurs when the bladder overfills due to an inability to completely empty, often associated with bladder outlet obstruction.
What is
A catheter inserted into the bladder for long-term urine drainage.
Define
Indwelling Catheter (IDC)
Define
Radical Prostatectomy
Surgical removal of the prostate gland, which can affect urinary function.
What is
A tube inserted into the abdominal cavity for peritoneal dialysis.
Define
Peritoneal Catheter
Define
AV Graft
A synthetic tube used to connect an artery and vein for dialysis access when an AV fistula is not possible.
What is
The backward flow of urine from the bladder into the ureters, which can lead to infections and kidney damage.
Define
Ureteral Reflux
Define
Fistula Bruit
A sound heard through a stethoscope over an AV fistula, indicating blood flow and function.
Define
Polycystic Kidney Disease
A genetic disorder characterized by the growth of numerous cysts in the kidneys.
Define
Urethral Meatus
The opening at the end of the urethra where urine exits the body.
Define
Bladder
A hollow organ that stores urine before it is excreted from the body.
Define
Urinalysis
A test that examines urine for signs of infection, disease, or other conditions.
Define
Glomerular Filtration Rate (GFR)
A measure of kidney function, indicating how well the kidneys filter blood.
What is
The duct through which urine exits the bladder and is expelled from the body.
Define
Urethra
What is
The inability to completely empty the bladder, leading to discomfort and potential complications.
Define
Urinary Retention
What is
A condition characterized by a sudden, intense urge to urinate followed by involuntary leakage, often due to overactivity of the detrusor muscle.
Define
Urge Incontinence
What is
A condition caused by the accumulation of waste products in the blood due to kidney dysfunction.
Define
Uremia
Define
Uremia
A condition caused by the accumulation of waste products in the blood due to kidney dysfunction.
What is
A measure of kidney function, indicating how well the kidneys filter blood.
Define
Glomerular Filtration Rate (GFR)
Define
Renal Artery Stenosis
Narrowing of the renal arteries, which can lead to high blood pressure and kidney damage.
Define
TURP (Transurethral Resection of the Prostate)
A procedure to remove part of the prostate gland to relieve urinary obstruction.
What is
A type of bacteria that can cause urinary tract infections and other infections.
Define
Klebsiella
What is
A metabolic state characterized by elevated ketones in the blood, often due to low carbohydrate intake.
Define
Ketosis
What is
A waste product from the breakdown of purines in food, excreted in urine.
Define
Uric Acid
Define
Ureteral Reflux
The backward flow of urine from the bladder into the ureters, which can lead to infections and kidney damage.
Define
Klebsiella
A type of bacteria that can cause urinary tract infections and other infections.
What is
The liquid component of blood that carries cells, hormones, and nutrients, filtered by the kidneys.
Define
Blood Plasma
Define
Tamsulosin
A medication used to relax the urethra and improve urine flow in cases of overflow incontinence, especially related to an enlarged prostate.
What is
The functional units of the kidneys responsible for filtering blood and forming urine.
Define
Nephrons
Define
Urinary Tract Infection (UTI)
An infection affecting any part of the urinary system, including the bladder and kidneys.
What is
An infection affecting any part of the urinary system, including the bladder and kidneys.
Define
Urinary Tract Infection (UTI)
What is
White blood cells that may indicate infection when found in urine.
Define
Leukocytes
Define
Furosemide
A diuretic medication that increases urine production, potentially leading to more frequent urination and incontinence.
Define
Urodynamic Testing
Diagnostic tests that assess bladder function and efficiency, including how well the bladder stores and releases urine.
What is
A surgically implanted device that helps control urinary retention by mimicking the function of the natural bladder sphincter.
Define
Artificial Bladder Sphincter
What is
Organs that filter blood to produce urine, remove waste products, and balance fluids and electrolytes.
Define
Kidneys
What is
Accumulation of fluid in the abdominal cavity, which can be related to liver or kidney disease.
Define
Ascites
Define
Uric Acid
A waste product from the breakdown of purines in food, excreted in urine.
What is
The presence of glucose in urine, often associated with diabetes.
Define
Glucosuria
What is
A connection created surgically between an artery and vein for dialysis access.
Define
AV Fistula
What is
A procedure involving the injection of material around the urethra to provide support and reduce involuntary leakage.
Define
Periurethral Bulking
Define
Urea
A waste product formed in the liver from the breakdown of proteins, excreted in urine.
Define
Ketones
Compounds produced from fat metabolism, which can be detected in urine in cases of uncontrolled diabetes or starvation.
Define
Stress Incontinence
Leakage of urine during activities that increase abdominal pressure, such as coughing, sneezing, or exercise.
What is
The opening at the end of the urethra where urine exits the body.
Define
Urethral Meatus
Define
Glucosuria
The presence of glucose in urine, often associated with diabetes.
Define
Hematuria
The presence of blood in the urine, indicating potential issues with the urinary tract.
Define
Urinary Retention
The inability to completely empty the bladder, leading to discomfort and potential complications.
Define
Involuntary Sphincter
A muscle that controls the release of urine without conscious control, located at the bladder neck.
What is
A sudden decline in kidney function, leading to the accumulation of waste products in the blood.
Define
Acute Kidney Injury (AKI)
What is
The system responsible for removing waste products from the body, including the kidneys and urinary tract.
Define
Excretory System
What is
The invasion of uroepithelial cells, potentially related to infections or tumors.
Uroepithelial Penetration
Define
Bilirubin
A substance in urine that can indicate liver dysfunction or bile duct obstruction.
What is
A method of collecting urine to minimize contamination for accurate testing.
Define
Clean-Catch Midstream Sample (MSU)
What is
Liquids within the body, including blood and urine, regulated by the renal system.
Define
Body Fluids
Define
Nephrotic Syndrome
A kidney disorder characterized by high protein levels in urine, low protein levels in blood, and swelling.
What is
Medications used to lower blood pressure that may contribute to urinary incontinence (e.g., Perindopril).
Define
Angiotensin-Converting Enzyme (ACE) Inhibitors
Define
Voiding Diary
A record kept by patients to track urination patterns and symptoms, aiding in diagnosis and management.
What is
A type of bacteria commonly responsible for urinary tract infections.
Define
Escherichia coli (E. coli)
What is
The inability to control urination, leading to involuntary leakage of urine.
Define
Urinary Incontinence
Define
Smooth Muscle
Muscle tissue found in the walls of the bladder and urethra, which helps in the involuntary control of urination.
What is
A procedure to remove part of the prostate gland to relieve urinary obstruction.
Define
TURP (Transurethral Resection of the Prostate)
Define
Artificial Bladder Sphincter
A surgically implanted device that helps control urinary retention by mimicking the function of the natural bladder sphincter.
What is
The involuntary loss of urine, which can result from various conditions affecting the urinary system.
Define
Incontinence
Define
Chronic Renal Failure
Severe, long-term reduction in kidney function, often leading to the need for dialysis.
Define
Peritoneal Catheter
A tube inserted into the abdominal cavity for peritoneal dialysis.
What is
A genetic disorder characterized by the growth of numerous cysts in the kidneys.
Define
Polycystic Kidney Disease
Define
Dysuria
Painful or difficult urination, often associated with urinary tract infections or other disorders.
Define
Diuretics
Medications that increase urine production to manage conditions like hypertension or edema.
Define
Dialysis
A treatment that performs the function of the kidneys by removing waste products from the blood.
What is
A muscle that controls the release of urine without conscious control, located at the bladder neck.
Define
Involuntary Sphincter
Define
NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)
Medications that reduce inflammation and pain but can affect kidney function.
What is
A diuretic medication that increases urine production, potentially leading to more frequent urination and incontinence.
Define
Furosemide
Define
Leukocytes
White blood cells that may indicate infection when found in urine.
What is
Medications used to treat high blood pressure and heart failure, which can impact kidney function.
Define
ACE Inhibitors (Angiotensin-Converting Enzyme Inhibitors)
What is
The equilibrium between fluid intake and output, crucial for maintaining kidney function and overall health.
Define
Fluid Balance
Define
Detrusor Muscle
The muscle in the bladder wall that contracts to facilitate urination.
What is
Products designed to manage and contain urinary leakage, such as pads, briefs, and other absorbent materials.
Define
Continence Aids
What is
Medications that increase urine production to manage conditions like hypertension or edema.
Define
Diuretics
What is
A type of dialysis that uses the lining of the abdominal cavity to filter blood.
Define
Peritoneal Dialysis (PD)
What is
Muscle tissue found in the walls of the bladder and urethra, which helps in the involuntary control of urination.
Define
Smooth Muscle
Define
Creatinine
A waste product from muscle metabolism, used as a marker of kidney function.
Define
Urethra
The duct through which urine exits the bladder and is expelled from the body.
What is
Medications that block alpha-adrenergic receptors and can affect the bladder neck, potentially leading to incontinence (e.g., Prazosin).
Define
Alpha-Adrenergic Blockers
What is
Surgical removal of the prostate gland, which can affect urinary function.
Define
Radical Prostatectomy
Define
Periurethral Bulking
A procedure involving the injection of material around the urethra to provide support and reduce involuntary leakage.
Define
Nitrites
Compounds found in urine that can suggest the presence of a bacterial infection.
Define
Bladder Chart
A tool used to monitor and record bladder function and urine output.
What is
A record kept by patients to track urination patterns and symptoms, aiding in diagnosis and management.
Define
Voiding Diary
What is
Compounds produced from fat metabolism, which can be detected in urine in cases of uncontrolled diabetes or starvation.
Define
Ketones
Define
Excretory System
The system responsible for removing waste products from the body, including the kidneys and urinary tract.
Define
Indwelling Catheter (IDC)
A catheter inserted into the bladder for long-term urine drainage.
What is
Leakage of urine during activities that increase abdominal pressure, such as coughing, sneezing, or exercise.
Define
Stress Incontinence
Define
Candida
A type of yeast that can cause infections in the urinary tract and other areas of the body.
Define
Nephrons
The functional units of the kidneys responsible for filtering blood and forming urine.
Define
Ascites
Accumulation of fluid in the abdominal cavity, which can be related to liver or kidney disease.
What is
The presence of excess protein in urine, often a sign of kidney dysfunction.
Define
Proteinuria
What is
Muscles that support and stabilize the pelvic organs, including the bladder and uterus, helping to maintain urinary continence.
Define
Pelvic Floor Muscles
What is
A test that examines urine for signs of infection, disease, or other conditions.
Define
Urinalysis
Define
Angiotensin-Converting Enzyme (ACE) Inhibitors
Medications used to lower blood pressure that may contribute to urinary incontinence (e.g., Perindopril).
Define
Residual Urine Volume
The amount of urine left in the bladder after urination, which can indicate urinary retention.
What is
A sound heard through a stethoscope over an AV fistula, indicating blood flow and function.
Define
Fistula Bruit
What is
The amount of urine remaining in the bladder after urination, which can indicate bladder function issues.
Define
Post-Void Residual Volume
What is
Severe, long-term reduction in kidney function, often leading to the need for dialysis.
Define
Chronic Renal Failure
What is
A hollow organ that stores urine before it is excreted from the body.
Define
Bladder
Define
Intravenous Pyelogram (IVP)
An imaging test using contrast dye to visualize the urinary tract and assess kidney function.
What is
A long-term condition where the kidneys gradually lose function over time.
Define
Chronic Kidney Disease (CKD)
Define
Alpha-Adrenergic Blockers
Medications that block alpha-adrenergic receptors and can affect the bladder neck, potentially leading to incontinence (e.g., Prazosin).
Define
AV Fistula
A connection created surgically between an artery and vein for dialysis access.
Define
Urinary Tract Infection (UTI)
An infection affecting any part of the urinary system, including the bladder, urethra, ureters, or kidneys.
Define
Incontinence
The involuntary loss of urine, which can result from various conditions affecting the urinary system.
Define
Blood Plasma
The liquid component of blood that carries cells, hormones, and nutrients, filtered by the kidneys.
Define
Uroepithelial Penetration
The invasion of uroepithelial cells, potentially related to infections or tumors.
Define
Urinary Incontinence
The inability to control urination, leading to involuntary leakage of urine.
What is
The amount of urine left in the bladder after urination, which can indicate urinary retention.
Define
Residual Urine Volume
Define
Peritoneal Dialysis (PD)
A type of dialysis that uses the lining of the abdominal cavity to filter blood.
What is
The muscle in the bladder wall that contracts to facilitate urination.
Define
Detrusor Muscle
Define
Autonomic Nervous System
The part of the nervous system that regulates involuntary bodily functions, including bladder control.
What is
A synthetic tube used to connect an artery and vein for dialysis access when an AV fistula is not possible.
Define
AV Graft
Define
Specific Gravity
A measure of urine concentration, reflecting kidney function and hydration status.
What is
An infection affecting any part of the urinary system, including the bladder, urethra, ureters, or kidneys.
Define
Urinary Tract Infection (UTI)
What is
A treatment that performs the function of the kidneys by removing waste products from the blood.
Define
Dialysis
Define
Nocturia
The need to wake up multiple times during the night to urinate.
What is
An imaging test using contrast dye to visualize the urinary tract and assess kidney function.
Define
Intravenous Pyelogram (IVP)
Define
Edema
Swelling caused by fluid retention, which can be related to kidney or heart problems.
What is
A type of yeast that can cause infections in the urinary tract and other areas of the body.
Define
Candida
Define
Proteinuria
The presence of excess protein in urine, often a sign of kidney dysfunction.
Define
Urge Incontinence
A condition characterized by a sudden, intense urge to urinate followed by involuntary leakage, often due to overactivity of the detrusor muscle.
What is
A substance in urine that can indicate liver dysfunction or bile duct obstruction.
Define
Bilirubin
Define
Kidneys
Organs that filter blood to produce urine, remove waste products, and balance fluids and electrolytes.
Define
Clean-Catch Midstream Sample (MSU)
A method of collecting urine to minimize contamination for accurate testing.
What is
A substance in urine that can indicate liver function or disease.
Define
Urobilinogen
Define
Ketosis
A metabolic state characterized by elevated ketones in the blood, often due to low carbohydrate intake.
What is
Painful or difficult urination, often associated with urinary tract infections or other disorders.
Define
Dysuria
Where are the kidneys located in the body?
On either side of the vertebral column.
What is the primary function of the kidneys?
To maintain the composition and volume of body fluids.
How many nephrons are typically found in each kidney?
About a million.
Name three substances that nephrons help to remove from the blood plasma.
Urea, creatinine, and uric acid.
What indicates that the kidneys are functioning well?
Stable body fluid levels.
How many layers of smooth muscle are there in the bladder?
Three
What does the middle layer of smooth muscle in the bladder form?
The involuntary sphincter.
What role does the involuntary sphincter play?
It controls the opening between the bladder and the urethra.
How is the bladder innervated?
By the autonomic nervous system.
When is the need to pass urine typically felt?
When the bladder stretches and nerves are stimulated.
What is the primary function of the urethra?
To convey urine from the bladder to the exterior of the body.
How does the male urethra differ from the female urethra in terms of length and function?
The male urethra is longer and part of both the excretory and reproductive systems, while the female urethra is shorter and has no portion external to the body.
Why might the difference in urethra length between males and females be significant for patient presentations?
It may influence the presentation and management of urinary tract infections and other urinary conditions.
What key symptoms should be described in the health history related to urinary issues?
Urgency to void, hematuria, dysuria, abdominal pain, and incontinence.
What is significant about the appearance and smell of urine?
Urine should be clear, straw-colored, and have a mild odor; changes may indicate a UTI.
Why is it important to ask about urinary continence history and elimination patterns?
To understand the presence of incontinence, retention, and changes in urinary appearance or smell.
What past medical history is relevant for renal assessment?
Renal or urinary cancers, infections, prostate enlargement, hypertension, diabetes, trauma, and signs of infection.
Why is medication history important in renal assessment?
Certain medications, like NSAIDs, diuretics, and ACE inhibitors, can cause acute renal failure.
What types of surgeries are important to know during a renal assessment?
Radical prostatectomy, TURP, endometrial removal, and pelvic floor surgery.
How can smoking affect renal health?
Carcinogenic chemicals in smoke can lead to bladder cancer.
What impact can fluid intake and the use of diuretics have on renal health?
Excessive diuretics can affect fluid balance and renal function.
Why are protein shakes and supplements a concern for renal health?
High protein and creatinine levels can lead to end-stage renal disease.
What should be assessed in the physical examination before focusing on renal-specific aspects?
Vision, smell, and hearing.
What signs of uremia might be observed in the skin, hair, and nails?
A sallow complexion, greyish skin, and uremic frost.
Where should edema be assessed in a renal examination?
Around the eyes, legs, and sacral area.
What should be checked for in a patient with a history of dialysis or kidney surgery?
Dialysis access devices like AV fistulas and signs of previous kidney removal or transplantation.
What is ascites and why is it important to assess for it in the abdominal examination?
Ascites is fluid build-up in the peritoneum, and its presence can indicate renal failure.
What should be assessed in the abdominal examination to evaluate renal artery health?
Auscultation for renal artery blood flow and signs of stenosis.
Why is monitoring blood pressure crucial in renal assessment?
Because hypertension is common in kidney disease and controlling it can help preserve renal function.
How is bladder distension assessed during a physical examination?
By palpating gently just below the umbilicus to check for urinary retention.
At birth, how do the kidneys of infants compare in proportion to the abdomen?
The kidneys occupy a large proportion of the abdomen.
When does kidney formation occur during fetal development?
At the third month of fetal development.
At what age do children begin to become aware of their bladder filling and start toilet training?
Around two to three years old.
Why is regular testing for proteinuria important during pregnancy?
To monitor for preeclampsia and potential distress in the baby.
What should be done if the fundus is above the level of the pubic symphysis in a postpartum woman?
Midwives need to measure each void individually, as urine output cannot be accurately measured with a bladder scan.
By age 70, what percentage of renal function may be lost?
About 30 to 50%.
How do decreased estrogen levels affect the urinary system in aging individuals?
They result in increased dryness in the urethra, bladder, pelvic floor, and vagina.
What issue might prostate enlargement cause in older men?
It can obstruct the flow of urine through the urethra, leading to difficulty voiding.
What has contributed to the recent 130% increase in chronic kidney disease?
Diabetes and obesity.
How does elevated glucose in diabetes affect the kidneys?
It damages the basement membrane of capillaries, causing them to thicken and reducing glomerular filtration.
Which populations are at a higher risk for chronic kidney disease due to familial risk?
Māori and Pacific Islander populations.
How common is urinary incontinence in women over 50?
It affects about 30% of women over 50.
What are two common causes of urinary incontinence in women and men?
In women, decreased estrogen and changes in the pelvic floor; in men, prostate enlargement leading to urinary retention and overflow incontinence.
Why is accurate measurement of fluid intake and output crucial for patients with renal or cardiac disease?
To ensure proper management and avoid complications related to fluid overload or deficit.
What fluids should be included in fluid balance measurements?
All fluids, including water, lemonade, jelly, and ice cream.
What should patients record in a voiding diary?
Voiding patterns, amount of urine, incontinence episodes, pain, and other symptoms.
What is the normal urine output for an adult?
About 0.5 mL per kilogram per hour, or roughly 30 to 40 mL per hour.
What does a normal urine color indicate?
Straw-colored urine is normal and indicates proper hydration.
What does the presence of leukocytes in urine suggest?
An infection.
What is the significance of nitrites in a urinalysis?
They indicate bacterial infection, as nitrites are produced by bacterial conversion of nitrates.
What can elevated urobilinogen levels indicate?
Hemolytic states or increased red blood cell destruction.
What is the typical urine pH range?
About 6, though it can vary.
What might blood in the urine indicate?
Infection, bladder cancer, or contamination from menstruation.
What does a specific gravity of 1.025 usually indicate?
Dehydration.
Why are ketones important to assess in urine?
They indicate fasting, hypoglycemia, or uncontrolled diabetes.
What does the presence of glucose in urine usually indicate?
High blood sugar levels, potentially due to diabetes.
What is the purpose of collecting a midstream urine sample?
To avoid contamination from bacteria in the urethra.
How should a midstream urine sample be collected?
Start voiding, stop midstream to collect the sample, and then continue voiding into the toilet.
How should urine be collected from a catheter for culture and sensitivity testing?
Using sterile procedures to avoid contamination.
How long can urine samples be stored in a fridge?
Up to an hour, but not in a fridge where food is stored.
What is the purpose of a 24-hour urine collection?
To assess levels of hormones, steroids, creatinine, and protein over a full day.
How should the collection container be managed?
Properly labeled to avoid mix-ups.
What is the purpose of a bladder scan?
To measure the volume of urine in the bladder and assess for urinary retention.
What does a bladder scanner provide?
A non-invasive way to assess residual urine volume, with settings for male and female patients.
What does elevated creatinine in the blood indicate?
Potential renal dysfunction, as creatinine is a byproduct of muscle metabolism excreted by the kidneys.
Why are sodium and potassium levels important in renal function assessment?
The kidneys regulate these levels, so abnormalities can indicate renal issues.
What is an intravenous pyelogram (IVP) used for?
To visualize the urinary system and identify issues such as narrowing or strictures in the renal pelvis, ureters, bladder, or urethra.
What are the two types of dialysis?
Hemodialysis and peritoneal dialysis.
What is the purpose of hemodialysis?
To mechanically filter blood in patients with severely decreased or total loss of kidney function.
How is peritoneal dialysis performed?
Using the blood vessels in the peritoneum and a dialysate solution to filter waste products.
What should be monitored in a patient with a peritoneal catheter?
Signs of infection, such as cloudy dialysate with white flecks or blood.
Why should blood pressure not be taken on the arm with a fistula or graft?
To avoid compromising the vascular access.
What should be done if the sound of a fistula or graft becomes faint or stops?
It needs immediate attention, as it may indicate an obstruction.
What is acute kidney injury (AKI)?
A sudden loss of kidney function with the inability to filter waste products, often with rapid onset.
What is the typical onset of AKI?
Rapid
What are some common causes of AKI?
Injury, dehydration, severe infections, or medications that affect kidney function.
What defines chronic kidney disease (CKD)?
Irreversible kidney damage lasting for at least three months.
What are some common causes of CKD?
Genetics, infections, immune disorders, diabetes, and high blood pressure.
How does CKD differ from AKI in terms of duration?
CKD is long-term and persistent, while AKI is sudden and short-term.
What are the two main types of urinary tract infections (UTIs)?
Lower urinary tract infections (urethra and bladder) and upper urinary tract infections (ureters and kidneys).
What is the most common pathogen causing UTIs in hospital settings?
Escherichia coli (E. coli).
What pathogens (other than E. coli) might cause UTIs?
Klebsiella and Candida species.
What anatomical factors can increase the risk of UTIs?
Ureteral reflux, pregnancy, and anatomical abnormalities.
What are some common risk factors for developing UTIs?
Indwelling catheters, certain medications, behavioral factors, and genetic predispositions.
What are common signs and symptoms of a UTI?
Dysuria (painful urination), urgency and frequency, painful intercourse, and foul-smelling urine.
How is a UTI typically managed?
With antibiotics, ample fluid intake, proper hygiene, and wearing cotton, well-fitting underwear.
What role does cranberry juice play in managing UTIs?
While some believe it helps, the primary recommendation is to ensure adequate fluid intake.
Why are urinary tract infections common in hospital settings?
The use of indwelling catheters and the presence of hospital-acquired pathogens increase the risk.
Where might Candida species be found as a pathogen?
In the vaginal flora or as part of a broader fungal infection.
How can voiding dysfunction contribute to UTIs?
It can lead to incomplete bladder emptying and increased risk of bacterial growth.
How many hospital-acquired UTIs occur annually in Australia?
Approximately 20,500.
What is cystitis?
A type of lower urinary tract infection specifically referring to bladder infections.
What are the two types of upper urinary tract infections?
Pyelonephritis and glomerulonephritis.
What is pyelonephritis?
An infection of the renal pelvis.
What is glomerulonephritis?
An infection involving the nephrons and glomeruli.
What microorganisms commonly cause UTIs?
E. coli and Staphylococcus, but viruses, fungi, and other bacteria can also be involved.
How do microorganisms adhere to the urinary tract?
Using fimbriae and sometimes forming biofilms.
What effects do biofilms have on UTIs?
They protect microorganisms from being washed out by urine, leading to persistent infections.
What is inflammatory edema in the context of UTIs?
Swelling of the uroepithelial tissue due to increased blood flow and immune response.
What are common symptoms of UTIs?
Pain, frequent urination, dysuria, hematuria, and pain during intercourse.
What is dysuria?
Painful urination.
Why might elderly patients or those with dementia have a challenging UTI diagnosis?
They may not exhibit typical symptoms.
What risk factor involves the insertion of a catheter?
It can introduce microorganisms and disrupt natural defenses.
How can antibiotic use contribute to UTIs?
It can disrupt normal flora and allow opportunistic infections like Candida.
What role does spermicide use play in UTIs?
It can cause irritation and increase the risk of infection.
How does frequent or recent sexual intercourse impact UTI risk?
It increases the risk, especially with new partners.
Why does female anatomy increase UTI risk?
A shorter urethra and proximity to the anus increase the risk.
How does pregnancy affect UTI risk?
Hormonal changes during pregnancy can impair immune response.
What is a key management strategy for UTIs?
Hydration to promote urinary flushing.
Why is hygiene important in managing UTIs?
Preferring showers over baths reduces the risk of reinfection.
What type of underwear is recommended to reduce UTI risk?
Cotton underwear, which reduces moisture and supports airflow.
When are antibiotics used in UTI management?
For severe or persistent cases, due to concerns about antimicrobial resistance.
What clinical tests are used to diagnose UTIs?
Urinalysis, midstream urine culture, and possibly pelvic examination.
What additional investigation might be needed for recurrent UTIs?
Assessment for anatomical abnormalities.
How does urinary incontinence relate to UTIs?
UTIs can exacerbate urinary incontinence, creating a cycle where incontinence can also lead to UTIs.
Is urinary incontinence a normal part of aging?
No, it is not a normal part of aging and should be investigated.
What percentage of nursing home residents have urinary incontinence?
About 80%.
Why are women more susceptible to urinary incontinence compared to men?
Women have a shorter, more vertical urethra and may experience pressure from the uterus or hormonal changes.
How long is the female urethra?
5-6 cm.
How long is the male urethra?
20-25 cm.
What role does the uterus play in urinary incontinence for women?
It can exert pressure on the bladder, especially during pregnancy.
How do hormonal changes affect urinary incontinence in women?
Hormonal changes, such as those during menopause, can contribute to incontinence.
What is the role of pelvic floor muscles in urinary continence?
They support the bladder and urethra, preventing involuntary leakage.
What factors can weaken pelvic floor muscles?
Pregnancy, increased abdominal fat, and menopause.
What is stress incontinence?
Leakage of urine due to external pressure on the bladder neck, such as from coughing or sneezing.
Which type of incontinence is more common in women due to anatomical and hormonal changes?
Stress incontinence.
What is urge incontinence?
A sudden, strong urge to urinate that is difficult to delay, often due to an overactive bladder.
What are common signs of urge incontinence?
Frequency, urgency, nocturia, and small voiding patterns.
What causes overflow incontinence?
Obstruction preventing urine flow or increased pressure in the bladder leading to involuntary leakage.
What are common symptoms of overflow incontinence?
Dribbling, poor urine stream, suprapubic ache, and straining to initiate urine flow.
What is functional incontinence?
Incontinence due to cognitive impairment, impaired mobility, or environmental barriers.
What factors contribute to iatrogenic incontinence?
Medical interventions or conditions related to treatments and medications.
How do alpha-adrenergic blockers contribute to urinary incontinence?
They interfere with receptors on the bladder neck, which can increase incontinence.
What effect do diuretics have on urinary incontinence?
They increase urine production, leading to frequent bathroom trips and potential incontinence.
How do ACE inhibitors contribute to urinary incontinence?
They can contribute to incontinence by affecting bladder function.
What impact do opioids have on urinary incontinence?
They obstruct the sensation of needing to urinate and can block the spinal reflex responsible for urination.
What is a common behavioral therapy for managing urinary incontinence?
Pelvic floor exercises (Kegel exercises).
What role does a voiding diary play in managing urinary incontinence?
It helps track triggers and patterns of incontinence.
What type of medication is used to manage urge incontinence?
Anticholinergic medications, such as oxybutynin.
How can hormone replacement therapy help with urinary incontinence?
It may restore mucosal and muscular integrity of the genitourinary system.
What is the purpose of Botox injections in urinary incontinence management?
To reduce detrusor muscle spasms in the bladder.
What are some surgical interventions for urinary incontinence?
Bladder lift and stabilization, periurethral bulking, artificial bladder sphincter, and transurethral resection of the prostate.
What are some challenges in managing urinary incontinence?
Invasive interventions, patient preferences, and managing incontinence in social situations.
What are some complications of urinary incontinence?
Embarrassment, social isolation, loss of employment, falls, perineal breakdown, cost of continence aids, urinary tract infections, anxiety, and soiling of mattresses.
What can cause perineal breakdown in urinary incontinence patients?
Frequent incontinence leading to skin breakdown in the perineum, similar to nappy rash.
What is the financial burden of managing urinary incontinence?
The cost of continence aids can be expensive and prohibitive for some patients.
How effective is urethral bulking with collagen?
Effectiveness can vary, and tolerance may build over time requiring dosage adjustments.
What is a potential issue with Botox injections for urinary incontinence?
Botox is effective in small amounts but toxic in large quantities, requiring careful dosage and frequency adjustments.
What is medication resistance in the context of urinary incontinence?
Resistance to medications like tamsulosin or oxybutynin can develop, requiring dosage adjustments or alternative treatments.
How does obesity affect stress incontinence?
Increased abdominal pressure from obesity can contribute to stress incontinence.
What factors can trigger urge incontinence?
Urinary tract infections, medications, or neurological conditions affecting the detrusor muscle.
What is nocturia and how is it related to urge incontinence?
Nocturia is the need to urinate frequently during the night and is a common symptom of urge incontinence.
How does an enlarged prostate contribute to overflow incontinence in men?
An enlarged prostate can obstruct the urethra, leading to difficulty in urine flow and overflow incontinence.
How does cognitive impairment contribute to functional incontinence?
Issues with brain function affect the ability to recognize the need to urinate and perform the necessary tasks.
What role does impaired mobility play in functional incontinence?
Difficulty moving, such as due to severe osteoarthritis, can delay reaching the toilet, leading to incontinence.
How can environmental barriers contribute to functional incontinence in hospital settings?
Barriers such as heavy doors, unclear signage, and inadequate equipment can impede timely access to the toilet.
How do diuretics contribute to iatrogenic incontinence?
Diuretics increase urine production, leading to frequent trips to the bathroom and potential incontinence.
What role do opioids play in iatrogenic incontinence?
Opioids can obstruct the sensation of needing to urinate and affect the spinal cord reflex responsible for urination.
What impact do anticholinergic agents have on urinary incontinence?
They inhibit muscarinic receptors in the detrusor muscle, leading to excessive relaxation and potential overflow incontinence.
Which component is not typically included in a renal assessment?
A) Inspection
B) Palpation
C) Auscultation
D) Fundoscopy
D) Fundoscopy
During a renal assessment, which method is used to evaluate kidney tenderness?
A) Inspection
B) Palpation
C) Percussion
D) Auscultation
B) Palpation
What is the primary purpose of auscultating the renal arteries?
A) To detect kidney stones
B) To assess for abnormal sounds such as bruits
C) To evaluate urine flow
D) To check for bladder distension
B) To assess for abnormal sounds such as bruits
Which test is commonly used to evaluate the function of the renal vascular system?
A) Urinalysis
B) Renal ultrasound
C) CT scan
D) Electrocardiogram (ECG)
B) Renal ultrasound
In a renal assessment, what does a decreased blood pressure indicate?
A) Increased renal function
B) Renal artery stenosis
C) Normal renal function
D) Decreased bladder volume
B) Renal artery stenosis
Which factor should be considered when performing a renal assessment on an elderly patient?
A) Increased muscle mass
B) Decreased skin elasticity
C) Increased renal function
D) High metabolic rate
B) Decreased skin elasticity
When assessing a patient from a different cultural background, which practice is essential?
A) Avoiding all physical contact
B) Asking for specific dietary preferences
C) Ignoring cultural health practices
D) Assuming all cultural practices are the same
B) Asking for specific dietary preferences
What should a nurse consider when assessing renal health in a pregnant woman?
A) The increase in glomerular filtration rate
B) The decrease in blood volume
C) The impact of fetal movements
D) The reduced risk of urinary tract infections
A) The increase in glomerular filtration rate
How might social factors impact renal health assessments?
A) Increased risk of kidney stones
B) Variations in access to healthcare resources
C) Decreased need for hydration
D) Increased likelihood of hereditary conditions
B) Variations in access to healthcare resources
Which developmental consideration is important when assessing renal function in children?
A) Larger kidney size compared to adults
B) Higher incidence of renal failure
C) Immature renal function leading to different normal values
D) Increased renal reserve
C) Immature renal function leading to different normal values
Which test is used to measure the renal clearance of creatinine?
A) Urinalysis
B) CT scan
C) Serum creatinine test
D) Creatinine clearance test
D) Creatinine clearance test
What is the purpose of a renal biopsy?
A) To evaluate kidney function
B) To assess for infections
C) To obtain a tissue sample for pathological examination
D) To measure blood pressure in the kidneys
C) To obtain a tissue sample for pathological examination
Which imaging study is best for visualizing kidney stones?
A) MRI
B) X-ray
C) Ultrasound
D) PET scan
C) Ultrasound
Which diagnostic test is used to evaluate the presence of blood or protein in the urine?
A) Urinalysis
B) Electrolyte panel
C) Serum albumin test
D) CT scan
A) Urinalysis
Which test is commonly performed to assess the size and structure of the kidneys?
A) MRI
B) Ultrasound
C) Electrocardiogram
D) X-ray
B) Ultrasound
Which condition is characterized by the formation of stones in the kidney?
A) Pyelonephritis
B) Nephritis
C) Renal colic
D) Cystitis
C) Renal colic
What is a common symptom of chronic kidney disease?
A) Decreased appetite
B) Frequent headaches
C) Increased thirst
D) Itchy skin
D) Itchy skin
Which condition involves inflammation of the renal pelvis and kidney?
A) Glomerulonephritis
B) Pyelonephritis
C) Renal artery stenosis
D) Urinary tract infection
B) Pyelonephritis
Which of the following is a common cause of acute kidney injury?
A) Prolonged dehydration
B) Increased fluid intake
C) Frequent urination
D) Decreased blood pressure
A) Prolonged dehydration
Which condition is often associated with hypertension and diabetes?
A) Polycystic kidney disease
B) Acute glomerulonephritis
C) Chronic kidney disease
D) Renal artery stenosis
C) Chronic kidney disease
What is a primary characteristic of stress incontinence?
A) Sudden, overwhelming urge to urinate
B) Involuntary leakage during physical activity
C) Continuous dribbling of urine
D) Difficulty initiating urine flow
B) Involuntary leakage during physical activity
Which type of incontinence is most likely to be managed with pelvic floor exercises?
A) Urge incontinence
B) Overflow incontinence
C) Functional incontinence
D) Stress incontinence
D) Stress incontinence
What is a common complication of urinary incontinence?
A) Increased risk of bladder cancer
B) Frequent urinary tract infections
C) Renal failure
D) High blood pressure
B) Frequent urinary tract infections
Which medication class is used to manage urge incontinence?
A) Anticholinergics
B) Alpha-adrenergic blockers
C) Diuretics
D) SSRIs
A) Anticholinergics
What is a common nursing intervention for managing functional incontinence?
A) Pelvic floor exercises
B) Scheduled toileting
C) Medication adjustment
D) Surgical intervention
B) Scheduled toileting
Which symptom is most commonly associated with a UTI?
A) Lower back pain
B) Cloudy or foul-smelling urine
C) Weight loss
D) Chest pain
B) Cloudy or foul-smelling urine
Which diagnostic test is used to confirm a UTI?
A) Serum creatinine test
B) Urinalysis
C) Renal ultrasound
D) CT scan
B) Urinalysis
What is a common complication of untreated UTIs?
A) Renal colic
B) Pyelonephritis
C) Stress incontinence
D) Chronic kidney disease
B) Pyelonephritis
Which medication class is commonly prescribed to treat UTIs?
A) Antihistamines
B) Antibiotics
C) Antidepressants
D) Antifungals
B) Antibiotics
