GU Assessments Flashcards by Madison North

Kidney Function

Regulate the volume and composition of extracellular fluid (ECF)
Excrete waste products from the body
Control BP
Erythropoietin production
Vitamin D activation
Acid-Base balance regulation

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How many nephrons are in one kidney?

1 million

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What gender gets more UTIs? Why?

female
the urethra is shorter and closer to the rectum where E. coli is

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Where are the kidneys and what do they look like?

bean shaped behind the peritoneum
right is slightly lower than left
adrenal gland on top of each

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Why is the right kidney lower than the left?

liver placement on the right

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Where is the entrance of the renal artery and nerves + exit of the renal vein?

Hilus -medial side of kidney

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What is the parenchyma?

tissue of the kidney
outer = cortex
inner = medulla

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What is a nephron?

the functional unit of the kidney

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Each nephron contains what

glomerulus
Bowman’s capsule
tubular system

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What is located in the cortex of the kidney?

loop of Henle
collecting tubules

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About how many mL/min of blood flow to the kidneys?

1200

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Blood flow to the kidneys accounts for what percentage of cardiac output?

20-25

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How does blood filter through the kidneys?

Renal artery
glomerulus
capillaries
venous system

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Urine formation

Glomerular filtration
Tubular reabsorption
Tubular secretion
Urine concentration

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Glomerular filtration

blood being filtered by hypostatic pressure through the glomerulus
Through Bowman’s capsule to tubule

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Glomerular filtration Rate normal value

125 mL/min

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How many gallons of water a day in filtered by healthy kidneys?

47.6

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Tubular reabsorption

Where the necessary fluids and nutrients are reabsorbed into the body

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Where does water absorption occur in the kidney process?

renal medulla

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Nephron function can contain small amounts of waste products that are okay in the blood but large amounts

are harmful and renal failure
bc of toxin build up

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PVT means

Proximal convoluted tubule

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Where does most of the reabsorption occur in the tubular reabsorption (amino acids, Na, Cl, and others)?

PCT

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What is the order of tubular reabsorption?

PCT (reabsorbs essential nutrients)
Loop of Henle
Descending (hypertonic)
Ascending
DCT
Collecting tubule or Bloodstream

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What analogy does Mrs.Moreno use when discussing tubular reabsorption?

Coffee filter

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What is the entire pathology of the healthy kidney?

Renal artery Glomerulus Bowman's capsule

Tubular secretion

secreted bad stuff out of the bloodstream and to be excreted

Urine concentration

water, urea, Na, k, Cl, Creatinine, and more

A damaged kidney has what type of pores? Allowing for?

large; allow larger molecules to exit (protein)

ADH

water balance regulated by the posterior pituitary gland

Aldosterone

reabsorption of Na and water released from the adrenal cortex through the RAAS system

What hormones maintain homeostasis with each other?

ADH and Aldosterone

Ureters

carry urine from the renal pelvis to the bladder lumens narrow ease for occlusion and kidney stones

Bladder

reservoir for urine detrusor muscle urination, micturition, voiding

Bladder Capacity

600-1000 mL

Urethra lengths for females and males

Fem: 1-2 inches Male: 8-10 inches

Continence

voluntary control of the ureterovesical unit

Bladder distention stimulates

stretch receptors = damage impulses to the brain

What conditions could affect the continence of the bladder?

DM MS Paralysis

What would you use to strengthen the bladder detrusor muscle?

Kegel Exercises

Who is more susceptible to infection?

old females postpartum females (hormone changes with natural flora) homeless occupation (nurses)

Hx Collection for GU assessment

*gender age* socioeco occupation dietary surgeries health hx

What should you ask a pt about GU?

Probiotics, bathtub, douching, perfumes in peri-area Meds, immobility Hx kidney stones, UTIs, CA, Cath use

Medication Use for GU

Rx, OTC, illegal, antibiotics Vitamins supplements Potential nephrotoxic agents

Anuria

– inability to urinate

Oliguria

– small amounts

Polyuria

frequent or large

Hematuria

blood in urine

What are some nephrotoxic antibiotics?

Vancomycin Gentamycin Amphotericin - illegal drugs, chemotherapy

Smoking causes what

vasoconstriction

What health perception question would you ask a GU pt?

visual changes smoked energy level

What nutrition question would you ask a GU pt?

weight chnage supplements caffeine spice

What elimination question would you ask a GU pt?

blood in urine awaken at night color smell constipation or diarrhea controlling bowels

What activity question would you ask a GU pt?

ADLs worsening stopping awaken at night daytime sleepiness urge sex pleasure

Objective assessment of GU

Inspect Listen Palpate Percuassion in costal vertebral space if able

Blood Studies for UA

Creatinine BUN Ration GFR 24 Hour HIGH K

Normal BUN

7-21

Normal Creatinine

0.7-1.4

If BUN is elevated by Creatinine is not what does it mean

dehydrated

If BUN and Creatinine are both high what does that mean?

renal or kidney damage

FIRST morning void (concentrated) within 1 hour to lab

Culture and sensitivity is used for

bacteria identification and medicine needed

Creatinine Clearance

24 hour **closely approximates GFR** discard 1st urine and collect EVERY void for 24 Hours and at the end go one last time **ON ICE**

Creatinine is the

waste product of protein

Radiographic Exam for GU

KUB (stones and foreign X-RAY exams) IVP (contrast not for kidney failure) CT (good for not contrast) Cystography Ultrasound (masses)

IVP is contraindicated because

the dye is nephrotoxic - no kidney disease elevated BUN, Creatinine and GFR

If IVP is used then

assess for allergies notify of warm and flushed feelings increase fluid intake to flush out dye

Dx Studies of GU

Renal Bx (renal tissue for exam by needle) Cystoscopy Arteriogram(visual blood vessels)

Renal Bx Post Op

**lay on the biopsy site for maximum pressure (stop bleeding) affected side for 30-60 mins bed rest for 24 hours** avoid lifting 5-7 days and don't take anticoagulant until Physician orders

How often are VS done on a Renal Bx pt?

5-10 mins 1st hours then every 15 etc

What are you looking for during VS of renal Bx pt?

low BP, HR Fever, chills urine frequency dysuria hematuria massive pain **means infection or bleeding**

Renal Bx Contraindications

**bleeding disorders single kidney uncontrolled HTN** suspected renal infection hydronephrosis vascular lesions

Renal Bx Pre-Op

Type and Cross for transfusion consent coagulation Hx CBC and H&H **Blood thinner held not aspirin or warfarin**

Arteriogram Renal Before

enema, antibiotic assess for iodine sensitivity for contrast warm feeling

After arteriogram renal

Pressure dressing over femoral artery observe for bleeding and inflammation bed rest with affected leg straight Peripheral pulses 30-60 mins to detect occlusion

If they start to bleed from the femoral artery what do you do

put your fist there to stop the bleeding

What are the labs of a gerontologic pt?

low creatinine clearance HIGH BUN AND CREATININE slightly less muscle mass

GU Assessments Flashcards

(76 cards)