Renal/Urologic System Flashcards Preview

Medical Conditions II > Renal/Urologic System > Flashcards

Flashcards in Renal/Urologic System Deck (79):
1

Nephron Function

-filter blood
-reabsorb fluid
-forms filtrate of protein-free plasma
-maintain body fluid volume
-maintain electrolyte composition
-maintain body pH

2

Kidney receives _____& of cardiac output

-20%

3

Pathway

-blood vessel
-bowman's capsule
-glomerulus
-prox convoluted tubule
-Loop of Henle
-Distal convoluted tubule
-collecting duct
-urethra

4

____ of plasma is filtered into the renal tubules

20%

5

urinary output=____L/day

1.5L/day

(most fluid reabsorbed back from tubules)

6

GFR

-glomerular filtration rate
-rate of plasma filtration by glomerulus

7

Clearance

-volume from which all test substance is removed

8

______ is often used to measure GFR

-creatinine clearance

9

Creatine

-Mm metabolism byproduct
-has fairly constant plasma level

10

_________level alone is often used to monitor GFR

-plasma creatinine

11

Substantial GFR changes may be reflected in _______

-relatively small plasma creatinine changes

12

Normal Creatinine Levels

Male=0.7-1.3
Female=0.6-1.1

13

Tests of Renal System

-GFR
-Plasma Creatinine Concentration
-BUN
-Urinalysis

14

Urinalysis

-best test for infectious agents or foreign materials (toxins, drugs)
-color, turbidity, protein, pH, specific gravity, sediment)

15

Diuretics

-inhibit Na+ uptake
-->more water remains in tubule and urine

16

Diuretic Effects on Body

-decrease BP, edema, body fluid, CHF symptoms

17

Pathologies of Renal System

-Infection
-Cancer
-Renal Cystic Disease
-Renal Calculi
-Chronic Renal Failure
-Glomerulonephritis
-Neurogenic disorders
-urinary incontinence

18

UTI

-Urethritis
-Cystitis (bladder infection)

19

Urethritis Sx

-Inflamm/pain at urethral opening
-painful urination

20

Cystitis Sx

-bladder infection
-Painful urinatino
-frequent urination
-urgent need to urinate
-urine cloudy/red
-fever sometimes
-suprapubic/low back pain
-flank pain

21

Pyelonephritis Symptoms

-(Kidney infection)
-symptoms suggesting bladder infection
-abrupt onset
-high fever/chills
-back pain around kidney
-nausea/vomiting

22

Kidney/UTI Evaluation

-Urinalysis
-tender to percussion at costovertebral angle (pyelonephritis)

23

Prevention of Kidney/UTI

-post-void residual assessment to assess urinary retention
-sufficient fluid intake
-urogenital hygiene

24

Kidney/UTI Treatment

-antibiotics
-increase fluids
-consider lactobacillius acidophilus to prevent yeast growth when on antibiotics
-contact doc if not better in 48-72 hours

25

Renal Cell Carcinoma

-malignant tumor
-80-90% of all renal neoplasms

26

Renal Cell Carcinoma Incidence

-male (over 60) 2x > female

27

S/Sx Renal Cell Carcinoma

-bloody urine
-abdominal/flank pain
-palpable mass
-HTN
-hyperparathyroidism

28

Metastases of Renal Cell Carcinoma

-lungs
-bone (lumbar vert)

29

Eval/Treatment of Renal Cell Carcinoma

-radiographic imaging
-surgical removal of tumor

30

Risk Factors of Renal Cell Carcinoma

-tobacco use
-obesity
-HTN
-decreased fruits/veggies
-increased red meat
-occupational toxins

31

Bladder Cancer Incidence

-4th leading cause of cancer in men
-7th leading cause of cancer death in US

32

S/Sx Bladder Cancer

-hematuria
-frequency
-urgency
-dysuria (painful)

33

Metastases of Bladder Cancer

-bone
-pariaortic lymphnodes may cause low back pain

34

Prevention of Bladder Cancer

-tobacco cessation

35

_________& ______ may reduce recurrence of bladder cancer by 40%

-vitamin/zinc supplement & immunotherapy

36

Treatment of Bladder Cancer

-resection of pelvic lymph nodes/prostate/seminal vesicles/uterus
-radiation/chemo
-salvage cystectomy &/or transplantation

37

Bladder Cancer Screening

-screening of men at risk over 50 significantly lowers incidence & mortality

38

Nephrolithiasis

-kidney stones

39

Renal Calculi

-masses of crystals and proteins

40

Nephrolithiasis Cause

-unknown

41

S/Sx Nephrolithiasis

-pain along flank
-N/V
-hematuria

42

Eval/Treatment of Nephrolithiasis

-increase urine flow
-modify dietary intake of possible irritant substances

43

Renal Failure

-acute renal failure (ARF) (reversible)
-Chronic renal failure (irreversible)

44

causes of ARF

-many causes
-impaired renal blood flow (reversible)

45

Chronic Renal Failure Results in:

-loss of normal kidney function

46

Indicators of Chronic Renal Failure

-GFR falls
-Uremia

47

Uremia

-accumulation of toxins in blood

48

S/Sx of Chronic Renal Failure

-anorexia
-N/V
-fatigue
-HTN
-pruritis
-decreased urin output
-edema
-neurological changes

49

Eval/Treatment of Chronic Renal Failure

-regulate food/fluid intake
-Na+ & K+ restriction
-Dialysis
-Transplantation

50

Stages of Chronic Renal Failure

-Diminished Renal Reserve
-Renal Insufficiency
-Renal Failure
-End-Stage Renal Disease (ESRD)

51

Diminished Renal Reserve

-GFR: 50% normal rate
-no overt Sx due to kidney adaptation

52

Renal Insufficiency

-GFR: 20-35% normal rate
-possible azotemia, anemia, HTN

53

Renal Failure
(stage)

-GFR <20-25% normal rate
-edema, metabolic acidosis, hypocalcemia

54

ESRD

-GFR: <5% normal rate
-90% kidney function lost
-all body systems involved

55

Systemic Manifestations of Kidney Failure

-decreased urine w/ abnormal constituents
-CAD, HTN, CHF, pulm edema, pericarditis
-GI bleeding, nausea, - HA, irritability irritability impaired judgment & concentration, seizures, coma
-PNS tremors, cramps weakness
-pruritis, hyperpigmentation, pallor, bruising
-anemia, platelet dysfunction
-joint pain, osteodystrophy
-fertility impairment, hyperparathyroidism

56

Leading cause of kidney failure in US

-diabetic neuropathy

57

Prevention of Kidney Failure

-edu of risk factors

58

Risk Factors of Kidney Failure

-DM (#1 cause)
-HTN (#2 cause)
-CAD
-Decreased activity
-tobacco
-NSAIDs/analgesic combos

59

Dialysis

-hemodialysis or peritoneal dialysis

60

Hemodialysis

-3x/week for 3-4 hours

61

Peritoneal dialysis

-3x daily

62

Risk of Dialysis

-infection of immunocompromised pts

63

Dialysis Considerations

-HTN before dialysis but hypotensive after
-loss lean Mm mass masked by fluid retention & weight gain

64

dialysis will improve _____ & ______ peripheral neuropathy

-sensory & motor

65

PT Considerations in CRF

-co-morbidities (in CV system)
-immunosuppression
-fatigue
-impaired O2 transport
-ex's help ctrl BP
-VO2 max is 1/3 to 1/2 normal
-S/Sx of anemia, fatigue, Mm wasting, reduced work capacity, reduced cardiac performance

66

Neurogenic Bladder

-spastic bladder dysfunction
-hypotonic bladder dysfunction

67

Spastic Bladder Dysfunction

-functional urinary tract obstruction 2* to neurologic injury

68

Hypotonic Bladder Dysfunctino

-flaccid
-can be seen in spina bifida, cauda equina, similar disorders

69

Pathophysiology of Neurogenic Bladder

-interrupted innervation results in loss of control
-may result in partial/complete urinary retention, incontinence, urgency/frequency

70

S/Sx Neurogenic Bladder

-burning sensation (not pain)
-infection common in spastic bladder

71

Cause of Death in Kidney Failure

-heart failure

72

Eval/Treat of Neurogenic Bladder

-catheterization
-bladder training
-pharmacologic interventions

73

Urinary Incontinence

-Functional Incontinence
-Overflow Incontinence
-Stress Incontinence
-Urge Incontinence

74

Functional Incontinence

-normal control but difficulty getting to toilet
-insufficient mobility

75

Overflow Incontinence

-dribbling with constantly full bladder
-when urinary outlet obstructed

76

Stress Incontinence

-uncontrollable voiding when intravesicle pressure > extravesile pressure
-"giggle incontinence"
-insufficient/weak pelvic floor Mm

77

Urge Incontinence

-sudden/uncontrollable need to void
-suggests neurologic condition (spastic bladder)
-hyper tonicity of bladder/pelvic floor Mm

78

Suggested Ex's for ESRF

-4-6x/week at low capacity
-30 min
-resistance, aerobic

79

pts experiencing urge incontinence >/= 1 episode/week are ________

34% more likely to sustain a fracture due to falls at night