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Pharmacology > Urinary > Flashcards

Urinary Flashcards

1
Q

I/O

A

intake and output.
method of evaluating the renal system
totaled at the end of each 24 hour period

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2
Q

average adult water intake

A

2500 cc/day

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3
Q

water is excreted from?

A

kidney
lung
skin
feces

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4
Q

urine output amount

A

up to 2000/day

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5
Q

hourly rate of urine output

A

> 30 mL/hr

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6
Q

function of the kidney

A
  1. maintain proper fluid volume
  2. secrete renin - regulates BP
  3. electrolyte composition
  4. acid/base balance
  5. produce calcitriolto help maintain bone homeostasis
  6. secrete erythropoietin - stim RBC production
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7
Q

Creatinine

A

waste product from muscle metabolism

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8
Q

creatinine reabsorption in tubule

A

for excretion

1.4 g

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9
Q

nephron processes

A
  1. glomerular filtration - filters blood
  2. tubular secretion
  3. tubular fluid reabsorption - includes 99% of water
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10
Q

urea

A

final stage breakdown of amino acids from proteins

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11
Q

urea reabsorption in tubule

A

25.0 g

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12
Q

creatinine absorption into peritubular capillary

A

0 g

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13
Q

urea absorption into peritubular capillary

A

28.0 g

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14
Q

water absorption into peritubular capillary

A

178.5 L

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15
Q

ADH release results in ?

A

holding water

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16
Q

process of renin angiotensin system

A

renin is secreted as a result of decreased renal perfusion pressure and/or decreased salt delivery to Kd tubules =>
renin release with angiotensinogen in Lv => angiotensin I =>
combines with converting enzyme from Lu => angiotensin II =>
1. increased BP (prostaglandin release; vasoconstriction; increase myocardial contraction)
2. renal autoregulation
3. increased circulatory volume (aldosterone and ADH release; Na back in; K out)

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17
Q

factors stimulating ADH release

A
  1. falling blood volume
  2. sympathetic stimulation
  3. rising Na levels
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18
Q

ADH

A

produced by hypothalamus
store in posterior pituitary
maintains fluid balance (water retention)

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19
Q

isotonic solutions

A

same as body fluids
no shift in fluid occurs between ECF and ICF
normal saline

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20
Q

isotonic solutions

A

same as body fluids
no shift in fluid occurs between ECF and ICF
normal saline - 1 L of NS expands Plasma by 0.25 L

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21
Q

hypertonic solutions

A

water moves INTO ECF

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22
Q

hypotonic solutions

A

water moves INTO ICF

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23
Q

which electrolytes are supplied by diet and supplements

A

K and Mg

24
Q

which electrolyte levels are regulated by Kd function

A

Na and K

25
Q

normal range of K

A

3.5-5 mEq/L

26
Q

normal range of Na

A

135-145 mEq/L

27
Q

normal range of K

A

3.5-5 mEq/L

28
Q

normal range of Na

A

135-145 mEq/L
reabsorbed at proximal convoluted tubule
passive diffusion

29
Q

normal range of Cl

A

95-105 mEq/L

30
Q

normal range of PO

A

2.8-4.5 mg/dL

31
Q

normal range of Mg

A

2.0-3.0 mg/dL

32
Q

normal range of K

A

3.5-5 mEq/L
65% reabsorbed at Bowman’s capsule and PCT
25-30% reabsorbed at ascending loop of Henle

33
Q

Na/Cl pump

A

Cl is reabsorbed in ascending loop of Henle and distal tubule
Na is reabsorbed with Cl
Pump is blocked by Thiazide and Loop diuretics

34
Q

Carbonic anhydrase

A

catalyst that influences Na reabsorption at proximal tubule.
allows CO2 + H20= > carbonic acid H2CO3 =>
HCO3 + H + Na

35
Q

HCO3

A

bicarbonate
stored in Kd
used to modify the body’s acid base balance

36
Q

H+ ion

A

makes urine acidic

37
Q

aldosterone

A
  1. a hormone produced in adrenal glands that influences sodium and fluid levels
  2. released in response to high K levels, sympathetic stim or angiotensin II
  3. blocked by K sparing diuretics
  4. stimulates Na/K pump in distal tubule
38
Q

countercurrent mechanism

A

regulates Na, concentrates or dilutes urine

39
Q

acidosis s/s

A 
CNS sx
lethargy
confusion
depression leading to coma
Kd retains HCO3
use NaHCO3 IV drop for acidosis
40
Q

alkalosis s/s

A 
Kd will excrete HCO3
nervousness
hyperactive reflex
convulsions
IV NaCl with KCl can reverse
severe - treat with ammonium chloride
41
Q

vit D

A

regulates Ca absorption in Gi tract

activated in Kd to promote Ca absorption

42
Q

Ca

A

maintains by PTH and calcitonin

fine tuning occurs in distal convoluted tubule

43
Q

erythropoietin

A

release from juxtaglomerular cells in Kd due to decrease in O2
regulates RBC production
renal failure => anemia

44
Q

acute Kd failure

A

reversible

may be identifiable cause ie: Kd stone

45
Q

chronic Kd failure

A

progressive, irreversible
etiology: hypertension, DM, pylonephritis
needs dialysis, transplant

46
Q

Kd failure indications

A

low urine output 20 mg/dl

poor creatinine clearance (0.6-1.2 mg/dl)

47
Q

indications for diuretic use

A
  1. edema assoc with CHF
  2. acute pulmonary edema
  3. Lv dz - cirrrhosis => ascites
  4. Kd dz
  5. hypertension
  6. conditions that cause hyperkalemia
48
Q

normal urine osmolarity

A

500-800 mOsm/kg

49
Q

specific gravity of urine

A

1.010-1.020 g/mL

50
Q

normal blood osmolarity

A

275-295 mOsm/kg

thickness of blood

51
Q

treatment of hyperkalemia

A

Sodium polystyrene sulfonate (kayexalte)
causes massive diarrhea to push K+ out
PO or enema

52
Q

UTI treatment

A

block spasm of UB
decrease pain
protect cells from irritation
treat enlargement of prostate

53
Q

Lv enzymes

A

ALT - 6-59 units/L
AST - 10-34 units/L
alkaline phosphatase - 44-147 units/L

54
Q

bilirubin

A

0.2-1.9 mg/dl
breakdown of HB
measures functional status of Lv
turns feces brown and urine yellow

55
Q

PT/PTT

A

measures clotting factors

30-40seconds/11-12.5 sec

56
Q

Lv enzymes

A

ALT - 6-59 units/L
AST - 10-34 units/L
alkaline phosphatase - 44-147 units/L
enzymes rise when Lv is stressed

Pharmacology (8 decks)

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