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Genitourinary Flashcards

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1
Q

What is the role of the kidneys in regulating fluid and electrolyte balance?

A

Regulating fluid, electrolyte and acid-base balances, remove waste, provides hormones involved in RBC production, bone metabolism, BP control

The kidneys filter blood, reabsorb essential substances, and excrete waste.

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2
Q

What structures are involved in the urinary system?

A

Kidneys, Ureters, Bladder, Urethra

Each structure plays a critical role in urine formation and transport.

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3
Q

What substances are filtered during urine formation?

A
  • Sodium
  • Chloride
  • Bicarbonate
  • Potassium
  • Glucose
  • Urea
  • Creatinine
  • Uric acid

These substances are crucial for maintaining homeostasis.

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4
Q

What substances are reabsorbed during urine formation?

A
  • Amino acids
  • Glucose

These substances are crucial for maintaining homeostasis.

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5
Q

What is osmolality?

A

Concentration of a solution in terms of osmoles of solutes per kg of solution

Osmoles are the standard unit of osmotic pressure.

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6
Q

What is osmolarity?

A

Ratio of solute to water; concentration of a solution in terms of osmoles of solutes per liter of solution

Osmoles are the standard unit of osmotic pressure.

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7
Q

How do the kidneys control water balance?

A

Absorption/secretion of H2O regulated by antidiuretic hormone (ADH)

ADH plays a significant role in conserving water in the body.

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8
Q

What do the kidneys excrete?

A

urea, creatinine, phosphates, sulfates, uric acid, drug metabolites

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9
Q

How do the kidneys regulate electrolytes?

A

Absorption/secretion K+, Na+, Mg;
↑NA = ↓Aldosterone

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10
Q

How do the kidneys regulate acid-base balance?

A

Reabsorption of bicarbonate
Excrete or reabsorb acids
Synthesize ammonia, and
Excrete ammonium chloride

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11
Q

How do the kidneys regulate blood pressure?

A

Vasa recta (blood vessels of the kidney) detect ↓in BP and cause secretion of renin which initiates RAAS (renin-angiotensin-aldosterone system) activation

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12
Q

How does the RAAS system increase blood pressure?

A

Renin converts Angiotensin I into
Angiotensin II which causes vasoconstriction and aldosterone increases Na+ and water reabsorption

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13
Q

What are common risk factors for kidney disorders?

A
  • Benign prostatic hyperplasia (enlarged prostate)
  • Diabetes
  • Hypertension
  • Immobilization
  • Exposure to chemicals
  • Pregnancy
  • Sickle cell disease
  • Spinal cord injury

These factors can contribute to the development of various kidney-related issues.

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14
Q

What are common symptoms of kidney dysfunction?

A
  • Pain
  • Changes in voiding
  • Urinary frequency
  • Urgency
  • Dysuria (burning)
  • Oliguria (output < 400 mL/day)
  • Anuria (no urine production)
  • GI symptoms

Symptoms can vary widely depending on the underlying condition.

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15
Q

What is the normal urine production rate?

A

0.5ml/kg/hr or >90 ml/hr

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16
Q

What diagnostic evaluations are used for kidney disorders?

A
  • Urinalysis/urine culture
  • Renal function tests
  • Ultrasonography
  • CT and MRI
  • IV Urography
  • Retrograde pyelography
  • Cystography
  • Renal angiography
  • Endoscopic procedures
  • Biopsies

Each test provides critical information about kidney function and health.

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17
Q

What is the significance of GFR in kidney assessment?

A

GFR < 90 mL/min/1.73 m² indicates chronic kidney damage; < 60 mL/min/1.73 m² indicates irreversible kidney damage

Glomerular Filtration Rate (GFR) is a measure of how well the kidneys are filtering waste products from the blood

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18
Q

What are the clinical manifestations of nephrotic syndrome?

A
  • Increased permeability leading to massive proteinuria
  • Hypoalbuminemia
  • Diffuse edema
  • Hyperlipidemia/High serum cholesterol

Nephrotic syndrome is excessive protein leaked into urine and can lead to significant complications if not managed properly.

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19
Q

What is the primary treatment for chronic glomerulonephritis?

A

Reduce blood pressure and manage symptoms

This condition often requires ongoing management and monitoring.

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20
Q

What are the common causes of renal cancer?

A
  • Smoking
  • Obesity
  • Genetic factors
  • Hypertension
  • Occupational exposure to chemicals

These factors significantly increase the risk of developing renal cancer.

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21
Q

What are the nursing management strategies for a patient undergoing hemodialysis?

A
  • Monitor dialyzer for complications
  • Protect vascular access
  • Monitor for hypotension, cramping, and blood leaks

Patient safety and comfort are paramount during dialysis.

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22
Q

What are the signs of kidney transplant rejection?

A
  • Oliguria
  • Edema
  • Fever
  • Increasing blood pressure
  • Weight gain
  • Swelling or tenderness over the transplanted kidney

Early detection of rejection is crucial for patient outcomes.

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23
Q

What is the role of the RAAS system in kidney function?

A

Regulates blood pressure and fluid balance through secretion of renin, angiotensin II, and aldosterone

RAAS activation leads to vasoconstriction and increased sodium and water reabsorption.

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24
Q

What is the typical urine output for a healthy adult?

A

0.5ml/kg/hr or >90 ml/hr

This output is essential for assessing kidney function.

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25
What is the primary treatment for acute nephritic syndrome?
* Corticosteroids * Managing hypertension * Controlling proteinuria ## Footnote Treatment focuses on reducing inflammation and managing symptoms.
26
What is the definition of bacterial cystitis?
Inflammation of the urinary bladder ## Footnote A common type of lower UTI.
27
What are the types of upper urinary tract infections?
* Pyelonephritis (acute & chronic) * Interstitial nephritis * Renal abscess * Perirenal abscess ## Footnote Upper UTIs are less common than lower UTIs.
28
What are common risk factors for lower UTIs?
* Female anatomy * Menopause * Urethrovesical/reflux * Diabetes * Pregnancy * Neurologic disorders * Gout * Immunosuppression * Incomplete bladder emptying * Catheterization * Inflammation of urethral mucosa ## Footnote These factors increase the likelihood of developing a lower UTI.
29
What are the clinical manifestations of lower UTIs?
* Burning with urination * Urinary frequency * Urgency * Nocturia * Incontinence * Suprapubic or pelvic pain * Hematuria * Back pain * Can be asymptomatic ## Footnote These symptoms can vary in intensity and presence.
30
What are potential complications of lower UTIs?
* Bacteriuria & septic shock * AKI or CKD ## Footnote Early recognition and treatment are essential to prevent these complications.
31
What are gerontologic considerations for lower UTIs?
* Most common infection in older adults * Increases with age * More common in women, but gap narrows * Higher incidence of obstruction from enlarged prostate * Structural abnormalities like decreased bladder tone * Increased risk in postmenopausal women ## Footnote Older adults may present with atypical symptoms.
32
What are the key diagnostic methods for lower UTIs?
* Urine cultures (clean-catch midstream, straight catheterization) * Cellular studies (WBCs) * Multiple-test dipstick * STI testing ## Footnote These tests help confirm the presence of a UTI.
33
What is the typical medical management for lower UTIs?
* Antibiotics (usually short course) * Longer courses for complicated cases (men, pregnant women, pyelonephritis) ## Footnote Treatment duration and type depend on severity and patient factors.
34
Fill in the blank: Encourage fluid intake of _______ for lower UTI prevention.
[water & cranberry juice]
35
What are common nursing interventions for lower UTIs?
* Encourage fluid intake * Discourage urinary tract irritants * Frequent voiding * Administer antibiotics * Manage pain with analgesics and antispasmodics * Patient education on prevention ## Footnote These interventions help manage symptoms and prevent recurrence.
36
What are the prevention strategies for lower UTIs?
* Hygiene practices (shower instead of bathe, proper wiping) * Fluid intake (cranberry juice) * Frequent voiding * Voiding after intercourse * Regular urination (every 2-3 hours) * Taking antibiotics as prescribed ## Footnote Preventative measures are crucial for at-risk populations.
37
What is acute pyelonephritis?
Bacterial infection of the renal pelvis, tubules, and interstitial tissue of the kidney(s) ## Footnote Typically caused by bacteria from the bladder or systemic sources.
38
What are the clinical manifestations of acute pyelonephritis?
* Fever * Chills * Leukocytosis * Bacteriuria * Pyuria * Lower back & flank pain * N/V * Headache * Malaise * Painful urination ## Footnote Symptoms may overlap with those of a lower UTI.
39
What diagnostic tests are used for acute pyelonephritis?
* Ultrasound or CT scan * IV pyelogram (X-ray w/ contrast) * Radionuclide imaging * Urine cultures and sensitivity ## Footnote These tests help identify obstructions and assess kidney function.
40
What is the medical management for uncomplicated acute pyelonephritis?
* 2-week course of antibiotics * Hydration * Pain management ## Footnote Patients may require longer courses if symptoms persist.
41
What is nephrolithiasis?
Calculi (hard, mineral deposits) in the kidney (kidney stones) ## Footnote Urolithiasis refers to calculi in the urinary tract.
42
What are the common types of stones found in nephrolithiasis?
* Calcium oxalate * Calcium phosphate * Struvite * Cystine * Uric acid ## Footnote The composition of stones can influence treatment and dietary recommendations.
43
What are the clinical manifestations of urolithiasis/nephrolithiasis (stones in the urinary tract)?
* Severe pain (renal colic) * Hematuria * N/V * Urinary frequency * Inability to void ## Footnote Symptoms can vary based on the location and size of the stones.
44
Fill in the blank: Bladder cancer is the _______ leading cause of death among cancers.
[6th most common cancer]
45
What are the leading risk factors for bladder cancer?
* Tobacco use * Age * Gender (more common in men) ## Footnote Risk factors can vary based on environmental and genetic factors.
46
What is the most common clinical manifestation of bladder cancer?
Painless hematuria ## Footnote Early detection is crucial for effective treatment.
47
What is the typical treatment approach for bladder cancer?
* Medical management (chemotherapy, BCG therapy) * Surgical management (TUR, cystectomy) ## Footnote Treatment depends on tumor grade and stage.
48
What is benign prostatic hyperplasia (BPH)?
Noncancerous enlargement or hypertrophy of the prostate ## Footnote BPH can lead to urinary obstruction.
49
What are common clinical manifestations of BPH?
* Frequent or urgent need to urinate * Nocturia * Difficulty starting urination * Weak stream * Dribbling after urination * Straining with urination * Incomplete bladder emptying ## Footnote Symptoms can significantly impact quality of life.
50
What are the risk factors for prostate cancer?
* African American race * Increasing age * Family history * Genes (HPC1, BRCA1, BRCA2 mutations) * High fat/red meat diet ## Footnote Awareness of risk factors can aid in early screening.
51
What is the primary treatment for localized prostate cancer?
Radical prostatectomy ## Footnote Other options include radiation and hormone therapy.
52
What is continuous bladder irrigation (CBI)?
A method providing a continuous infusion of sterile solution into the urinary bladder to remove tissue and blood clots ## Footnote CBI is often used post-surgery to prevent clot formation.
53
What is the purpose of assessing lung and heart sounds in patients?
To evaluate for pulmonary edema and heart failure ## Footnote This assessment helps in identifying complications related to fluid overload.
54
What should be maintained to ensure patient safety post-surgery?
Fluid/electrolyte balance ## Footnote This is crucial to prevent complications such as dehydration or electrolyte imbalances.
55
What complications should be monitored for in patients?
Hemorrhage, infection, venous thromboembolism (VTE), catheter problems ## Footnote Early detection can significantly improve patient outcomes.
56
What is a recommended practice for post-surgical recovery?
Early ambulation ## Footnote This helps reduce the risk of complications such as VTE.
57
What is the goal of pain control in post-operative patients?
To ensure comfort and facilitate recovery ## Footnote Effective pain management can enhance patient mobility and participation in care.
58
What does Continuous Bladder Irrigation (CBI) involve?
Continuous infusion of sterile solution into the urinary bladder using a three-way irrigation system with a triple-lumen catheter ## Footnote CBI is used to remove loose tissue, blood clots, and mucous shreds from the bladder.
59
What must the amount of fluid recovered in the drainage bag equal for a CBI?
The amount of fluid instilled ## Footnote This balance is critical for monitoring the effectiveness of CBI.
60
What should be done if bright red drainage is observed during CBI?
Increase infusion rate until clear; if not clear, leave wide open and notify provider ## Footnote Bright red drainage may indicate active bleeding.
61
What action is recommended for pink or tea-colored drainage?
Continue infusion at moderate rate ## Footnote This indicates that some bleeding may still be present but is not severe.
62
What should be done when clear drainage is achieved during CBI?
Slow infusion rate ## Footnote This indicates that the bladder is clearing and less irrigation is needed.
63
What should be monitored during CBI, besides the drainage bag?
Tubing ## Footnote Ensuring the tubing is not obstructed is critical for effective irrigation.
64
Fill in the blank: CBI provides a continuous infusion of _______ into the urinary bladder.
sterile solution ## Footnote This is essential for flushing out the bladder contents.

MedSurg (16 decks)

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