Renal and Urological Systems Flashcards
1
Q
What structures does waste product pass through to eliminate through urination
A
- Kidneys
- Renal pelvis
- Ureter
- Bladder
- Urethra
2
Q
Functions of the kidneys
A
- Regulates composition and pH of body fluids
- Eliminates metabolic waste
- Assists BP regulation through rennin-angiotension-aldosterone mechanisms and salt/water elimination
- Controls production of RBC in bone marrow
3
Q
What is the glomerular filtration rate (GFR)
A
- The amount of filtrate that is formed each minute as blood moves through the glomeruli and serves as an important gauge of renal function
- Measured clinically by obtaining creatinine levels in blood and urine
- Normal creatinine clearance is 115-125 mL/min
4
Q
What is BUN
A
- Blood urea nitrogen is urea produced in the liver as a by-product of protein metabolism that is eliminated by the kidneys
- BUN levels are elevated with increased protein intake, GI bleeding, and dehydration
5
Q
Normal UA findings
A
- Color: yellow-amber
- Clarity: clear
- Specific gravity: 1.010-1.025 with normal fluid intake
- pH: 4.6-8.0; average is 6 (acid)
- Protein: 0-8 mg/dL
- Sugar: 0
6
Q
Signs and symptoms of dehydration
A
- Poor skin turgor (rigidity)
- Dry mucous membranes
- HA
- Irritability
- Postural hypotension
- Incoordination
- Lethargy
- Disorientation
7
Q
Define edema
A
- An excess of body fluids with expansion of interstitial fluid volume
8
Q
What should you look for/observe with edema
A
- Swelling of ankles and feet
- Weight gain
- HA
- Blurred vision
- Muscle cramps and twitches
9
Q
Signs and symptoms of hypokalemia
A
- Potassium <3.5
- Muscle weakness
- Aches
- Fatigue
- Abdominal distention
- Nausea and vomiting
- Life threatening arrhythmias
- Flattened or inverted T-wave
- ST depression
10
Q
Signs and symptoms of hyperkalemia
A
- Potassium >5.5
- Often symptomless until very high levels
- Observe for muscle weakness
11
Q
Signs and symptoms of hyponatremia
A
- Sodium <135
- Confusion
- Decreased mental alertness can progress to convulsions
- Signs of increased intracerebral pressure
- Poor motor coordination
- Sleepiness
- Anorexia
12
Q
Signs and symptoms of hypernatremia
A
- Sodium >146
- Circulatory congestion (pitting edema, excessive weight gain)
- Pulmonary edema with dyspnea
- HTN
- Tachycardia
- Agitation
- Restlessness
- Convulsions
13
Q
Signs and symptoms of hypocalcemia
A
- Calcium <8.4
- Muscle cramps
- Tetany
- Spasms
- Paresthesias
- Anxiety
- Irritability
- Twitching convulsion
- Arrhythmias
- Hypotension
14
Q
Signs and symptoms of hypercalcemia
A
- Calcium >10.4
- Fatigue
- Depression
- Mental confusion
- Nausea and vomiting
- Increased urination
- Occasional cardiac arrhythmias
15
Q
Signs and symptoms of hypomagnesemia
A
- Magnesium <1.8
- Hyperirritability
- Confusion
- Leg and foot cramps
16
Q
Signs and symptoms of hypermagnesemia
A
- Magnesium >2.4
- Hyporeflexia
- Muscle weakness
- Drowsiness
- Lethargy
- Confusion
- Bradycardia
- Hypotension
17
Q
What are the normal value ranges for pH, CO2, and HCO for acid-vase relationships
A
- pH: 7.35-7.45
- CO2: 35-45 (inverse relationship with pH; CO2 high pH low)
- HCO: 23-27 (direct relationship with pH; HCO high pH high)
18
Q
Signs and symptoms of metabolic acidosis
A
- Hyperventilation
- Deep respirations
- Weakness
- Muscular twitching
- Malaise
- Nausea and vomiting
- Diarrhea
- HA
- Dry skin and mucous membranes
- Poor skin turgor
19
Q
Signs and symptoms of metabolic alkalosis
A
- Hypoventilation
- Depressed respirations
- Dysrhythmias
- Prolonged vomiting
- Diarrhea
- Weakness
- Muscle twitching
- Irritability
- Agitation
- Convulsions and coma (death)
20
Q
Signs and symptoms of respiratory acidosis
A
- Dyspnea
- Hyperventilation cyanosis
- Restlessness
- HA
21
Q
Signs and symptoms of respiratory alkalosis
A
- Tachypnea
- Dizziness
- Anxiety
- Difficulty concentrating
- Numbness and tingling
- Blurred vision
- Diaphoresis
- Muscle cramps
- Twitching or tetany
- Weakness
- Arrhythmias
- Convulsions
22
Q
Symptoms of urinary frequency, urgency, burning sensation during urination, urine may be cloudy and foul smelling, pain noted in suprapubic, lower abdominal, or groin areas
A
- Lower UTI
- Cystitis: inflammation and infection of the bladder
- Urethritis: inflammation and infection of the urethra
23
Q
Symptoms of systemic involvement such as fever, chills, malaise, HA, tenderness and pain over kidneys, tenderness over costovertebral angle (Murphy’s sign), frequent and burning urination, nausea and vomiting may occur
A
- Upper UTI
- Pyelonephritis: inflammation and infection of one of both kidneys
24
Q
Fluid filled cavities that form along the nephron and can lead to renal degeneration or obstruction; symptoms include pain, hematuria, and HTN
A
- Renal cysts
25
Crystalline structures formed from normal components of urine
- Renal calculi (kidney stones)
26
Sudden loss of kidney function with resulting elevation in serum urea and creatinine
- Acute renal failure
27
Progressive loss of kidney function leading to end-stage failure
- Chronic renal failure
28
End-stage toxic condition resulting from renal insufficiency and retention of nitrogenous wastes in blood; symptoms include anorexia, nausea, and mental confusion
- Uremia
29
Describe the purpose of dialysis
- Process of diffusing blood across a semipermeable membrane for the purposes of removal of toxic substances; maintains fluid, electrolyte and acid-base balance in presence of renal failure
30
Symptoms of dialysis disequilibrium
- Nausea and vomiting
- Drowsiness
- HA
- Seizures
- Result of rapid changes after beginning dialysis
31
Symptoms of dialysis dementia
- Signs of cerebral dysfunction: speech difficulties, mental confusion, myoclonus, seizures, eventually death
- Result of long standing years of dialysis treatment
32
Risk factors for renal cancer
- Smoking
- High BP
- Males
- African Americans
- Family history of renal CA
- Advanced kidney disease
33
Risk factors for bladder cancer
- Smoking
- Work place exposures (textiles, rubber, leather, paint)
- Not drinking enough fluid
- Age >55
- Males
- Previous radiation/chemotherapy
- Family history
34
Define stress incontinence
- Sudden release of urine due to increases in intra-abdominal pressure (coughing, laughing, etc.), weakness and laxity of pelvic floor musculature, sphincter weakness
35
Define urge incontinence
- Bladder begins contracting and urine is leaked after sensation of bladder fullness is perceived; inability to delay voiding to reach toilet due to detrusor muscle instability or hyperreflexia or sensory instability/hypersensitive bladder
36
Define overflow incontinence
- Bladder continuously leaks secondary to urinary retention (an over distended bladder or incomplete emptying of bladder)
37
Define functional incontinence
- Leakage associated with inability or unwillingness to toilet due to impaired cognition, impaired physical functioning, and/or environmental barriers
38
Parameters for Kegel exercises
- Type 1: works on holding contractions, progressing to 10sec holds, rest 10sec between contractions
- Type 2: works on quick contractions, 10-80 reps a day, avoid squeezing buttocks or contracting abdominals (bearing down)
