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Medical Conditions II > Renal/Urologic System > Flashcards

Renal/Urologic System Flashcards

(79 cards)

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1
Q

Nephron Function

A
  • filter blood
  • reabsorb fluid
  • forms filtrate of protein-free plasma
  • maintain body fluid volume
  • maintain electrolyte composition
  • maintain body pH
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2
Q

Kidney receives _____& of cardiac output

A

-20%

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3
Q

Pathway

A
  • blood vessel
  • bowman’s capsule
  • glomerulus
  • prox convoluted tubule
  • Loop of Henle
  • Distal convoluted tubule
  • collecting duct
  • urethra
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4
Q

____ of plasma is filtered into the renal tubules

A

20%

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5
Q

urinary output=____L/day

A

1.5L/day

most fluid reabsorbed back from tubules

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6
Q

GFR

A
  • glomerular filtration rate

- rate of plasma filtration by glomerulus

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7
Q

Clearance

A

-volume from which all test substance is removed

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8
Q

______ is often used to measure GFR

A

-creatinine clearance

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9
Q

Creatine

A
  • Mm metabolism byproduct

- has fairly constant plasma level

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10
Q

_________level alone is often used to monitor GFR

A

-plasma creatinine

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11
Q

Substantial GFR changes may be reflected in _______

A

-relatively small plasma creatinine changes

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12
Q

Normal Creatinine Levels

A

Male=0.7-1.3

Female=0.6-1.1

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13
Q

Tests of Renal System

A
  • GFR
  • Plasma Creatinine Concentration
  • BUN
  • Urinalysis
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14
Q

Urinalysis

A
  • best test for infectious agents or foreign materials (toxins, drugs)
  • color, turbidity, protein, pH, specific gravity, sediment)
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15
Q

Diuretics

A
  • inhibit Na+ uptake

- ->more water remains in tubule and urine

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16
Q

Diuretic Effects on Body

A

-decrease BP, edema, body fluid, CHF symptoms

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17
Q

Pathologies of Renal System

A
  • Infection
  • Cancer
  • Renal Cystic Disease
  • Renal Calculi
  • Chronic Renal Failure
  • Glomerulonephritis
  • Neurogenic disorders
  • urinary incontinence
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18
Q

UTI

A
  • Urethritis

- Cystitis (bladder infection)

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19
Q

Urethritis Sx

A
  • Inflamm/pain at urethral opening

- painful urination

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20
Q

Cystitis Sx

A
  • bladder infection
  • Painful urinatino
  • frequent urination
  • urgent need to urinate
  • urine cloudy/red
  • fever sometimes
  • suprapubic/low back pain
  • flank pain
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21
Q

Pyelonephritis Symptoms

A
  • (Kidney infection)
  • symptoms suggesting bladder infection
  • abrupt onset
  • high fever/chills
  • back pain around kidney
  • nausea/vomiting
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22
Q

Kidney/UTI Evaluation

A
  • Urinalysis

- tender to percussion at costovertebral angle (pyelonephritis)

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23
Q

Prevention of Kidney/UTI

A
  • post-void residual assessment to assess urinary retention
  • sufficient fluid intake
  • urogenital hygiene
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24
Q

Kidney/UTI Treatment

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

Medical Conditions II (34 decks)

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