Genitourinary/Reproductive System (Exam One) Flashcards
(149 cards)
1
Q
What is the last major organ system that is perfused from the abdominal aorta?
A
Renal system
2
Q
How much blood should circulate to the kidneys every minute?
A
1200 mL per minute
3
Q
What is the uretropelvic junction (UPJ)?
A
Narrow point where each ureter joins the kidney
4
Q
What is the ureterovesical junction (UVJ)?
A
Point where each ureter inserts the side of the bladder
5
Q
What does proper anatomy of the UVJ help prevent?
A
- Urine reflux
- Infection
6
Q
What is the detrusor?
A
Bladder muscle responsible for filling and emptying the bladder
7
Q
True or False: The pelvic cavity can hold a large amount of fluid or bleeding before signs and symptoms appear.
A
True
8
Q
What is the length of the urethra for a male?
A
8 to 10 inches
9
Q
What is the length of the urethra for a female?
A
1 to 2 inches
10
Q
What is hypospadias and epispadias?
A
Congenital malformation of male urethra
11
Q
Where is the urethral meatus positioned with hypospadias?
A
Urethral meatus is abnormally placed on ventral (underside) of penis
12
Q
Where is the urethral meatus positioned with epispadias?
A
Urethral meatus is abnormally placed on dorsal (topside) of penis
13
Q
Are babies born with hypospadias or epispadias circumcised at birth? Why or why not?
A
- No
- The foreskin is used during reconstruction surgery
14
Q
What is the functional unit of the kidney?
A
Nephron
15
Q
What are the functions of the kidneys? Which is the primary function?
A
- Filtration of blood (primary)
- Create urine
- Rid the body of waste in the form of urine: urea, bacterial toxins, water-soluble drugs, drug metabolites
- Excrete or conserve fluid
- Keep electrolytes balance
- Acid-base balance
- Activate vitamin D
- Produce erythropoietin
- Produce renin (for RAAS)
- Regulates blood pressure
16
Q
What is the normal blood pH?
A
7.35 - 7.45
17
Q
What organ regulates the Renin-Angiotensin-Aldosterone System?
A
- Kidneys
- The kidneys will release renin to activate RAAS
18
Q
What conditions would cause the kidneys to activate the Renin-Angiotensin-Aldosterone System?
A
- Decreased blood flow to the kidneys (decreased renal perfusion/renal ischemia)
- Decreased arterial blood pressure (i.e. hypotension)
- Decreased blood volume
- Decreased serum sodium (hyponatremia)
- Increased urine sodium
19
Q
What is the purpose of the Renin-Angiotensin-Aldosterone System?
A
- To retain sodium, thus retaining fluid
- Increasing blood volume & increasing blood pressure
- Increasing serum sodium levels
- Increase renal perfusion
20
Q
What are the steps of the Renin-Angiotensin-Aldosterone System?
A
- Kidneys release Renin
- Renin meets up with Angiotensinogen (which comes from the liver)
- Chemical reaction occurs between Renin & Angiotensinogen –> Angiotensin I is created
- Angiotensin Converting Enzyme (which comes from the lungs) converts Angiotensin I to Angiotensin II
- Angiotensin II promotes vasoconstriction of the arteries/arterioles
- Angiotensin II acts on the adrenal cortex, releasing aldosterone
- Aldosterone acts on the kidneys to retain sodium
- Retention of sodium causes fluid to be retained & potassium to be excreted
- Blood volume increases, blood pressure increases, renal perfusion increases, serum sodium levels increases
- When blood pressure is an appropriate level, the kidneys will stop releasing Renin and will stop RAAS
21
Q
What is a normal GFR?
A
120 mL/min
22
Q
What is a normal eGFR?
A
> 60 mL/min
23
Q
What substances can be reabsorbed into the blood after filtration?
A
- Water
- Sodium
- Chloride
- Calcium
- Bicarbonate
24
Q
What substances filter out into the urine?
A
- Potassium
- Hydrogen ions
- Ammonia
25
What substances should not cross into the renal tubules?
- Blood cells
- Platelets
- Protein
26
What is the most common laboratory test for urine?
Urinalysis
27
What laboratory test is used to identify specific organisms present in the urine?
Urine culture
28
Describe the process of a clean catch specimen? What must females do specifically regarding a clean catch?
- Clean urethral area
- Void small amount in toilet
- Void in sterile cup
- Women must keep labia open during entire process
29
The average adult and child should have how much urine output per hour?
30 mL
30
What is the normal protein value?
0 - 18 mg/dL
31
What is the normal value for red blood cells?
0 - 4
32
Should glucose, ketones, bilirubin, nitrates, and leukocytes be present in the urine?
No
33
What is a normal serum creatinine level?
0.6 - 1.2
34
What is a normal BUN level?
10 - 20
35
What is a normal creatinine clearance test?
85 - 135
36
What is known about the urinary system and aging?
Function and muscle tone decreases
37
Men have more problems with their urinary system due to what?
Enlarged prostate
38
In pediatrics, if an infection or rash is not being caused by an anatomical issue, the nurse should look at what?
- Type of diapers
- Bubble bath
- Baby powder
- External irritants
39
What is included in the physical assessment for all patients?
- Vital signs
- Lung sounds
- Costovertebral angle (CVA)
- Edema
- Daily weights
- Intake and output
40
What is a costovertebral angle (CVA) test?
- Press on kidneys using fist to asses for pain
| - If pain is present, patient will have acute pyelonephritis
41
What test is used to determine if a patient has acute pyelonephritis?
Costovertebral angle (CVA)
42
What does a KUB x-ray show?
- Tumors
- Swollen kidneys
- Kidney stones
- Ureters
- Bladder
43
What should the nurse assess for before doing an intravenous pyelogram (IVP)?
- Contrast dye allergies
- Creatinine levels
- Hydration (before and after)
44
What is contrast-induced nephropathy? What causes it?
- Toxicity in the kidneys
- Decline in renal function and rise in serum creatinine
- Caused by IV or oral contrast dye for CT scan or MRI
45
What are the nursing priorities regarding contrast-induced nephropathy?
- Hydration protocols
| - Encourage PO fluids
46
List renal diagnostic tests?
- Cytoscopy
- Renal ultrasound
- Renal biopsy
47
What is a cytoscopy?
Endoscopy through urethra to visualize bladder or collect specimens
48
What is stress incontinence?
- Involuntary urinary loss from increased abdominal pressure
| - Sneezing, coughing, laughing
49
Who is most at risk for stress incontinence?
Women after childbirth
50
What is urge incontinence?
Involuntary urinary loss with abrupt and strong desire to void
51
Urge incontinence is most common in what population?
Older adults
52
What is functional incontinence?
Can not make it to bathroom due to physical or mental function
53
What is overflow incontinence?
- Involuntary loss of urine associated with bladder overdistention
- Dribbling
54
What is total incontinence?
- Continuous
| - Unpredictable loss of urine
55
What are the causes of acute urinary retention?
- Anesthesia
- Medications
- Local trauma
56
What are the causes of chronic urinary retention?
- BPH
- Medications
- Strictures
- Tumors
57
What is the normal residual volume on a bladder scan?
<50 mL
58
What population usually benefit from intermittent catheterization?
Those unable to void due to retention or neurological condition
59
What is a suprapubic catheter?
- Permanent catheter
| - Can only be inserted by a physician
60
What is a priority nursing intervention if a patient present with a UTI?
- Antibiotic
| - Education
61
What are the risk factors for UTI?
- Stasis of urine
- Contamination
- Instrumentation
- Urinary reflux
- Previous UTI's
- Injury
- Old age
- Use of brief
- Dehydration
- Sepsis
- Poor hygiene
- Neurological conditions
- Immunosuppression
62
What are the signs and symptoms of UTI?
- Dysuria
- Urgency
- Frequency
- Cloudy urine
- Foul smelling
- Dark urine
- Flank pain
- Fever, chills, malaise, N/V
- Confusion
63
What is the most common symptom of a UTI in older adults?
Confusion
64
What are conditions related to UTI's?
- Urethritis
- Cystitis
- Pyelonephritis
65
What is urethritis?
Inflammation of urethra
66
What is cystitis?
Inflammation or infection of bladder wall
67
What is pyelonephritis? What are these patients at an increased risk for?
- Infection of the kidneys
| - High risk of developing sepsis
68
How does the nurse manage a patient with a UTI?
- Monitor vital signs
- Monitor I&O's
- Pain control
- Education
69
What education should you provide to a patient with a UTI?
- Finish all of antibiotics
- Void every 3-4 hours
- Void before and after sex
70
What is enuresis? Is it a disease or symptom?
- Bed wetting
| - Symptom
71
What are organic causes of enuresis?
- UTI
- Neurological deficits
- Excessive production of urine
- Biological causes
72
What are inorganic causes of enuresis?
- Environmental causes
- Sleep disturbances
- Psychological stress
- Inappropriate toilet training
73
What is always significant and destroys kidney tissue?
Obstruction/backup of urine
74
What are renal calculi?
- Kidney stones
- Made of urinary salt precipitate
- Urethra lumen is blocked due to small stones
75
What are urethral strictures?
Urethra lumen becomes narrow due to scar tissue
76
What are the causes of renal calculi?
- Hereditary
- Chronic dehydration
- Infection
- Immobility
77
Who is most at risk for renal calculi?
Men
78
What are the signs and symptoms of renal calculi?
- Flank pain
- Costovertebral tenderness
- GI upset
- N/V
- Dark, scanty urine
- Pain radiating to genitalia
79
What is used to diagnose renal calculi?
- KUB x-ray
| - Intravenous pyleogram (IVP)
80
What are the nursing interventions for renal calculi?
- Strain all urine
- Monitor symptoms
- Monitor I&Os
- IV fluids
- Pain control
- Education
81
What medications are administered for renal calculi?
- Flomax
- Narcotics
- Toradol
- Thiazide diuretics
- Allopurinol
82
What is the priority nursing concern with a ureteroscopy?
Infection
83
What can prevent renal calculi?
- Avoid calcium and acidic foods
- Hydration
- Exercise
84
What are the complications of renal calculi?
- UTI's
| - Hydronephrosis
85
What is hydronephrosis?
Swelling of kidneys due to urine buildup
86
What is a hydroureter? What causes this?
- Dilation of ureters due to urinary backup
| - Caused by renal calculi
87
Who is at an increased risk for developing bladder cancer?
- Men ages 50 to 70 years old
- Smokers
- Patients exposed to industrial pollution
88
What are the signs and symptoms of bladder cancer?
- Painless
- Hematuria
- Pelvic pain
- Lower back pain
- Dysuria
- Inability to void
89
How is bladder cancer diagnosed?
- Urinalysis
- Cystoscopy
- Transurethral biopsy
- Intravenous pyelogram (IVP)
90
What are the treatment options for bladder cancer?
- Chemotherapy
| - Surgery
91
What is an ileal conduit?
Incontinent urinary diversion
92
What is a kock pouch?
- Continent urinary diversion
- Suture bladder and create stoma outside of abdominal wall
- Intermittently catheterize to drain urine
93
What are the risk factors associated with kidney cancer?
- Smoking
- Obesity
- Hypertension
- Long-term kidney dialysis
- Radiation exposure
- Asbestos
- Industrial pollution
94
What are the signs and symptoms of kidney cancer?
- Hematuria
- Dull flank pain
- Palpable mass
95
What tests are used to diagnose kidney cancer?
- Cystoscopy
- Pyelogram
- Ultrasound
- CT
- MRI
- Renal biopsy
96
What are the treatment options for kidney cancer?
- Radical nephrectomy
- Radiation
- Immunotherapy
- Chemotherapy
97
What nursing management should be done for a patient with kidney cancer?
- Monitor urinary output
- Education
- Pre-op and post-op care
98
The nurse should never insert a catheter if...
Blood is present in the meatus
99
What are the signs and symptoms of renal trauma?
- Flank pain
- Grey Turner's sign
- Hematuria
- Pelvic pain
100
What nursing management should be provided for a patient with renal trauma?
- Vital signs
- I&Os
- IVF
- Pain management
101
What are the priority nursing concerns with renal trauma?
- Urinalysis
| - Vital signs
102
What is polycystic kidney disease?
Presence of multiple cysts in kidneys
103
What are the signs and symptoms of polycystic kidney disease?
- Dull heaviness in flank/back
- Hematuria
- Hypertension
- UTI's
104
What are the treatment options for polycystic kidney disease?
No treatment
105
Polycystic kidney disease is _____ and _____.
Hereditary and progressive
106
What is diabetic nephrophathy?
- Diabetes complication
| - Damage to renal vascular system by prolonged high glucose levels
107
What is the most common cause of chronic kidney disease?
Diabetic nephropathy
108
Patients will need _____ doses of insulin if they have diabetic nephropathy.
Smaller
109
Why is less insulin needed in patients with diabetic nephropathy?
Kidneys lose the ability to break down insulin and excrete it
110
What is nephrosclerosis? What causes it?
- Thickening and hardening of renal blood vessels
| - Caused by uncontrolled hypertension
111
What are the treatment options for nephrosclerosis?
- Controlling hypertension
- Medication compliance
- Low sodium diet
112
What is the nursing priority for patients with nephrosclerosis?
Controlling hypertension
113
What is acute kidney injury?
- Rapid onset of decreased kidney function
- Kidneys are unable to filter waste products
- Usually reversible
114
What are the prerenal causes of acute kidney injury?
- Dehydration
- Hypovolemia
- Shock
- Bradycardia
115
What are the intrarenal causes of acute kidney injury?
- Trauma
- Diabetes Type II
- Hypertension
- Toxins
- Drugs
- Inflammation
- Infection
116
What are the postrenal causes of acute kidney injury?
- Kidney stone
- Bladder stone
- Mass
- Tumor
117
What are considered nephrotoxins?
- Diagnostic contrast media
- Medications
- Chemicals
- Waste products
118
What are the phases of acute kidney injury?
- Oliguric
- Diuretic
- Recovery
119
Azotemia leads to an increase in what lab values?
- BUN
| - Creatinine
120
What is the priority nursing intervention for acute kidney injury?
Treat cause
121
What is CRRT?
Continuous dialysis in smaller volumes
122
If a patient is admitted with acute kidney injury what will the nurse assess for?
- Hyperkalemia
| - Cardiac monitor!
123
What is chronic kidney disease?
- Gradual decrease in kidney function
- Not usually diagnosed until 75% of kidney function is lost
- Progressive and irreversible
124
What is uremic frost?
- Caused by chronically elevated BUN and creatinine levels
| - Emergency!
125
A patient will reach end stage renal disease when they lost what percentage of kidney function?
90%
126
What are signs and symptoms of chronic kidney disease?
- Fluid overload
- Electrolyte imbalance
- Retained waste in blood
- Acid-base imbalance
- Anemia
- Peripheral neuropathy
127
What medications are used to treat chronic kidney disease?
- Kayexalate
- Calcium gluconate
- Insulin
- Sodium bicarb
- Lasix
- Albuterol
- Calcium
- Vitamin D supplements
128
What should the nurse do if a patient present with hyerkalemia?
- Notify HCP
| - Cardiac monitor
129
What kind of diet will a patient with chronic kidney disease be placed on?
- High calorie, low fat
- Protein restriction unless on dialysis
- Fluid restriction
- Restrict sodium, potassium, phosphorus
130
Hemodialysis is the definitive treatment for what diseases?
- Chronic kidney disease
- End stage renal disease
- Uncontrolled hyperkalemia
131
What medication is commonly seen taken in patients who do hemodialysis? What does it do?
- Sevelamer hydrochloride (Renagel)
| - Prevents bone damage from high phosphorus levels
132
Why would a fistula be used in a dialysis patient?
Less likely to clot than a graft
133
What is a thrill?
Palpable tremor
134
What is a bruit?
Swishing sound when auscultating
135
What is the nursing priority regarding vascular access sites in hemodialysis patients?
- Protect the site
| - Maintain site patency
136
What is peritoneal dialysis? How often is it performed?
- Continuous dialysis done by patient
| - Exchange occurs 3 to 4 times per day
137
What is a possible side effect of peritoneal dialysis?
Peritonitis
138
Why are diseased kidneys left in body after a kidney transplant?
Less manipulation of organs
139
What is nephrotic syndrome?
Massive loss of protein through urine
140
What is the main cause of nephrotic syndrome in children?
Autoimmune or inflammatory response
141
What are the signs and symptoms of nephrotic syndrome?
- Anasarca
- Ascites
- Low serum total protein and albumin
- Elevated serum cholesterol
- Foamy urine
- Elevated BP
142
What is anasarca?
Widespread edema
143
What is glomerulonephritis?
- Inflammation of the glomerulus
| - Alters filtration
144
What is the cause of glomerulonephritis?
- Post-streptococcal infection
- Goodpasture's Syndrome
- Chronic Glomerulonephritis
145
What is the main diagnostic test regarding glomerulonephritis?
- Urinalysis (shows hematuria and proteinuria)
| - Cola colored urine
146
What nursing management should you provide for glomerulonephritis?
- Promote rest
- Treat edema
- Sodium restriction
- Education focused on prevention
147
What is the first thing the nurse should ask a patient who presents with glomerulonephritis?
Have you had strep throat recently?
148
What is hemolytic uremic syndrome?
- Caused by E. coli
- Most common in acute renal failure in children
- Manifests as severe glomerulonephritis
149
What are the most common signs and symptoms of hemolytic uremic syndrome?
- Acute renal failure
- Thrombocytopenia
- Anemia
