test 3 Flashcards
1
Q
where is blood filtered
A
nephrons
2
Q
3 parts of the kidney
A
cortex, medulla, renal pelvis
3
Q
what do nephrons do
A
filtrate, reabsorb, secrete
4
Q
renal pyramids
A
bundles of collecting tubules
in medulla
5
Q
what does renal pelvis do
A
receives urine from renal pyramids, stores until ready to go to bladder
6
Q
outer layer of kidney
A
cortex. houses nephrons
7
Q
inner layer
A
medulla. where renal pyramids are
8
Q
filtrate is removed from blood
A
bowmans capsule
9
Q
where reabsorption in kidney occurs
A
convoluted tubules
10
Q
controls convuluted tubules
A
ADH- increase water absorption
aldosterone- increase sodium reabsorption
both cause less water= less urine
11
Q
what percentage of urine is filtrate
A
1% is filtrate, the rest is water
12
Q
transports urine from renal pelvis to urinary bladder
A
ureters
13
Q
muscular sac like organ that holds averagely 500 mL urine
A
urinary bladder
14
Q
where do most UTIs happen
A
urinary bladder
15
Q
transports urine to exterior
A
urethra
16
Q
why are females more prone to UTI
A
due to close proximity to anus, and the short urethra (1.5 inches approximately)
17
Q
is the internal urethral sphincter involuntary or voluntary
A
involuntary
18
Q
is the external urethral sphincter voluntary or involuntary
A
voluntary, if you are potty trained
19
Q
normal kidneys produce how much urine for avg adult
A
50-60 mL/hr
1500 ml/day
avg person urinates 5-6 times daily
20
Q
what can cause increased urination
A
diabetes, UTI, tumor, pregnancy
21
Q
what can cause decreased urination
A
kidneys aren’t functioning, blockage, dehydration
22
Q
urination in infants is based on
A
weight.
15-60mL per Kg
they dont have voluntary control
23
Q
what is needed for toilet training
A
a mature neuromuscular system
adequate communication skills
24
Q
when do most kids have full bladder control by
A
4-5 years of age
25
enuresis
unable to hold urine, usually from holding too long.
26
nocturnal enuresis
bed wetting
27
primary nocturnal enuresis
bed wetting in a child who hasnt yet learned to hold all night
28
secondary nocturnal enuresis
child had no issues with bed wetting but it randomly started occurring all of a sudden. usually related to something else such as some type of trauma, or diabetes.
29
what happens to kidneys as they age
nephrons decrease
kidney size decreases
30
common urinary issues in elderly
urgency and frequency occurs
kidney function decreases
loss of bladder elasticity
31
nocturia
getting up to pee in night
32
retention
bladder can't fully empty
33
nutrition factors influencing urination
high salt intake holds onto water which causes less urine
34
surgical factors influencing urination
anesthesia can cause urinary retention
35
how does pregnancy affect urination
pelvic floor muscles weaken
36
pyridium
medication that makes urine bright orange. Numbs urethra
37
amitriptyline
medication that causes a blue/green urine
38
levodopa
medication that causes brown or black urine
39
what kind of medications can be nephrotoxic
antibiotics, NSAIDs, chemo drugs
40
med that prevents reabsorption of water
diuretics
41
why does decreased blood flow affect urine
less blood, less filtration
42
hypertrophy of prostate
prostate to big, urine cant pass. urinary retention
43
neuro problems with urination
cant sense bladder is full
44
urethritis
uti in urethra
45
cystitis
uti in bladder
46
pyelonephritis
uti in kidney
47
most common cause of uti
e. coli
found in human intestinal tract
- wiping front to back helps prevent
48
uti risk factors
enlarged prostate
females
frequent sex
menopause
uncircumcised males
indwelling catheters
49
uti symptoms, treatment and diagnostic
back pain, nausea, frequency, urgency, dysuria, hematuria, pyuria, fever, cloudy urine
treatment- antibiotics. cipro is most common
drink water
analgesic for pain
diagnosed by UA and CNS
50
should you be able to palpate empty bladder
no
51
what can cause urinary retention
muscle dysfunction
enlarged prostate
anesthesia
disease
injury
infection
obstruction
sensory impairment
52
urinary retention symptoms and treatment
abdominal pain, bladder distention, low urine output, residual urine, frequency, urgency
treatment- straight (intermittent) catheter, indwelling catheter, suprapubic catheter
53
stress incontinence
urinating when laughing, sneezing, etc
common in pregnancy
54
urgency incontinence
overactive detrusor muscle
55
overflow incontinence
bladder overfills and leaks
56
functional incontinence
inability to get to bathroom
57
total incontinence
involuntary
58
management of incontinence
kegel exercises (women)
bladder training- increase bladder volume
lifestyle modification
prevention of skin breakdown
59
urinary diversion
surgical opening for urine elimination. can be permanent or temporary
60
urostomy
ureter to surface
61
continent urinary reservoir
holding bag for urine
62
neobladder
alternate bladder
63
dialysis
when we need to take filtrate out because kidneys aren't working properly
can:
- restore fluid and electrolytes
- control acid-base balance
- remove waste and toxic materials
from movement of high to low concent
64
peritoneal dialysis
in abdomen. dialysis fluid in body that pushes waste out
done at home, filtered thru peritoneum
65
hemodialysis
cleaning the blood. shunt in arm pulls blood out, runs thru dialysis machine and cleans blood and puts it back in thru other shunt
done at a clinic
66
CNS
urine culture and sensitivity
cultures what is growing and what antibiotics work for it
67
lab test and bedside tests of urine
UA
CNS
electrolytes
blood urea/creatinine- for dehydration
input and output
daily weights - if holding fluids, more weight
68
mastication
chewing
69
what is persistalsis
muscular movement that pushes food in stomach
70
where is cardiac sphincter
upper part of stomach
71
how long does food say in stomach on average
4 hours
72
what does pepsin and protease do
digests proteins
73
what does food leave stomach as
chyme
74
where are most things absorbed
small intestine
75
why does fecal become more solid as it moves toward rectum
more absorption
76
what does villi and microvilli allow for
maximum absorption
77
main function of large intestine
water absorption
78
internal anal sphincter
involuntary
79
external anal sphincter
voluntary
80
breaks down carbs
salivatory amylases
81
how long in between peristalsis contractions
3-12 mins
82
mass peristalsis movement that occurs 1-4 times a day averagely
bowel movement
83
what helps prevent loose stools
fiber, it doesn't digest so it helps harden and clean out the intestine
84
what helps prevent constipation
fluids
85
why do infants have watery stool
intestines aren't mature yet
86
biggest risk factor for IBS
stress
87
foods that can cause constipation
lean meat, cheese, eggs , pasta
88
laxative foods
dark chocolate, fruit, veggies, bran cereal, alcohol, coffee
89
gas producing foods
onions, cabbage, broccoli, cauliflower, beans, sweet potatoe
90
prolonged use of laxatives
decreases peristalsis
91
what 2 most common medications cause diarrhea
iron and narcotics
92
what does iron do to stool
make it black
93
anesthesia relationship with stomach
it slows the movement and can result in paralytic ileus
94
how to avoid paralytic ileus
stay on NPO and NG tube
95
pregnancy relationship with bowels
fetus crowds and can cause constipation
elevated progesterone slows intestinal activity
iron supplement for anemia constipates
96
what does antibiotics do to stool
can make it green or gray
97
what could aspirin and anticoagulants do GI tract
possibly cause GI bleeding
98
flatulence
passing gas
99
hemmorrhoids
varicose vein in rectum
100
diverticulosis
pouches in intestine. can turn into diverticulitis
101
What is diarrhea
when the stool moves to quickly making it loose and watery.
this has to happen multiple times to be considered diarrhea
102
fecal impactatin
dry hard stool that becomes lodged and cant be passed
may result in enema or digital removal
103
diverticulosis risk factor
eating lots of red meat, low fiber, or obesity
104
bowel diversion
surgically created opening that brings bowel to surface
105
what causes diverticulitis
something getting stuck in diverticula
avoid small seeds and eat a high fiber diet
106
how many gurgles should you hear a minute when auscultating stomach
3-15
107
if there is no sound in bowel when auscultating for 3-5 mins, what should you do
notify provider
monitor blockage
108
how much formed stool is needed for a sample
1 inch, or 2 tablespoons
109
how much liquid stool is needed for sample
20-30 oz, or an ounce
110
how does a occult blood test work
fecal is smeared and test looks for peroxidase which is a enzyme in blood
111
where does a EDG look at
upper part of GI
112
where does colonscopy look
begining of large intestine
113
where does sigmoidoscopy look
end of colon near rectum
114
what is barium
radioactive dye
115
interventions for patients with diarrhea
dilute gatorade/pedialyte with water
BRAT diet
encourage clear liquids
anti diarrhea meds not recommended for acute cases
116
why does depression effect bowels
it slows all body processes
117
how long should enema be held
15 mins
118
digital impaction
digital removal of stool
119
stool softener
prevents straining
better than laxative
120
what does NG tube do
drains stomach and keeps it empty. allows GI tract to rest
121
what should stoma look like
beefy red or dark pink
shiny
122
what to teach patient with stoma
when and how to change it
what it should/shouldn't look like
body positivity
123
the higher in tract the stoma...
the more liquidy it is and smelly
124
TPN
total peripheral
all feeding is from vein
125
PPN
parietal peripheral
only portion of feeding thru vein
126
why thickeners in drinks for people with swallowing issues
to prevent aspiration
127
3 main functions of skin
thermoregulation, protect, sensation
128
superficial wound depth
epidermis
129
partial thickness wound depth
dermis, epidermis
130
full thickness wound depth
down to subcutaneous tissue. muscle,
131
penetrating wound depth
organs
132
older adult skin
less elastic, drier, reduced collagen, hyperpigmentation, more prone to injury
133
why may tenting on elderly be normal
less elasticity
134
exudate
drainage
135
friction
rubbing together
136
shearing
gravity with friction
137
ischemia
decreased oxygenation
138
how does protein help the skin
building block. helps maintain, repair and reserve intravascular volume
139
what vitamins are associated with collagen formation
vitamin c, zinc, copper, vitamin A
140
What are some meds that can effect skin
blood thinners, vitamin k, steroids (reduces inflammation, inflammation is skin response to injury to help heal)
141
what's maceration and what causes it
pruny skin, moisture
142
how do fever affect skin healing
increased metabolic rate, making more work to reduce that rather then healing skin, and they create moisture
143
examples of closed wound
hematoma (bleeding under skin), ecchymosis (bruising), redness
144
induration
hard area, gives evidence that there may be problem under skin
145
not breaking sterile technique in surgery
clean
146
higher risk body surgery (GI, GU, resp) locations whose at risk for infection
clean contaminated
147
pathogen growing, localized
contaminated
148
systemic problem throughout whole body from contamination
infection
149
serous exudate drainage
straw colored (clear to yellow), plasma, thin, watery
150
sanguineous drainage
bloody drainage
151
serosanguineous drainage
mix of bloody and straw colored fluid
152
purulent drainage
yellow, pus, usually with foul odor
153
regeneration
superficial, no scar
154
primary intention
wound closed by surgery, edges are together
155
secondary intention
letting wound heal from inside out, not completely closed in surgery
156
tertiary intention "delayed primary"
wound is left open to start with, but will eventually be fully closed in surgery
usually cause of infection/contamination
157
how to look for hemorrhage
Look for internal bleeding, low bp, high HR, hematoma in gravitational areas, mental status changes, low hematic hemoglobin levels
158
whens a fever considered concerning
101F and above
159
signs of infection
fever, elevated WBC, inflammation
160
fistula formation
connection between 2 points that typically don't have on. usually in GI or GU
161
dehiscence
tissue pulls apart or splits
162
evisceration
protrusion of organ thru incision
163
what is braden scale based on
sensory perception, moisture, activity and mobility, nutrition, friction and shear
164
braden scale scoring
best score=23
score that is at risk= 18 and under
165
why does location change wound healing
places that are more vascular heal faster
166
debriding
removing dead, dying, or useless tissue
167
BEAMS acronym for debriding
B- biologic ex- maggots
E- enzymatic drug on dressing to liquefy junk on wound
A- autolysis letting the body do its own thing. Only thing we do is put dressing
M- mechanical wet to dry
S- sharp/surgical scalpel and cutting out
168
why should some wounds be immobilized
to prevent reopening skin
169
necrotic tissue that is yellow. only seen in stage 3&4 ulcers not 1&2.
slough
170
dead tissue that's black or brown. typically hard
eschar
171
suspected deep tissue injury
Looks like stage one ulcer, but more purplish bruise looking, stage one is more pink tone
172
how to find stage 1 ulcer on darker skin
Palpate for temp and induration
173
unstageable ulcer
cant see 50% of wound bed
174
what causes pressure injuries
decreased blood flow
175
TIME acronym- assessing wounds
Tissue- what does it look like
Infection or inflammation
Moisture
Edge of wound- what does it look like
176
wound bed curls under. signs of inadequate nutrition, not enough hydration to wound
epiable
177
what to do if wound bed pink
protect, monitor blood flow.
178
what to do if wound bed yellow
monitor for infection, clean and debride
179
what to do if wound bed black
eschar, dead tissue, debride and monitor for circulation
180
red wound bed
usually healthy, protect
181
tells us about protein stores here and now
prealbumin
182
tells us about protein stores over time (3 weeks or so)
albumin
183
Phlebitis
Redness following path of vein
Purulent drainage, pain, edema
184
Infiltration
Bubbling at the site
Skin blanched, bruised, swollen, pitting edema, numbness, cool to touch, pain
