Urinary Elimination

Question 1

What is included in the upper urinary tract?

Answer 1

Kidney, Ureter

Question 2

What is part of the lower urinary tract?

Answer 2

Urethra, bladder

Question 3

What is the prim role of the urinary sys?

Answer 3

• filter waste products from the blood
• maintain fluid and electrolyte + acid-base balance in the body
• excrete metabolic waste products

Question 4

What is secondary fct?

Answer 4

• regulate BP
• regulate bone density
• regulare erythropoiesis (RBC production)

Question 5

What is prim fct of kidneys?

Answer 5

• Where urine is formed
• 1200 mL/min of blood flow (25% is CO2)

Question 6

What is glomerular fct?

Answer 6

Filtration

Glomerulus:
- Cleanse plasma of unnecessary substances
- extremely permeable (liquids and gasses easily pass through)

*pic

Question 7

What is glomerus filtrates?

Answer 7

• Water
• Bicorbonate
• electrolytes (Na+, Cl-, K+, Ca+)
• glucose
• hydrogen ions
• amino acids
• urea
• creatinine

Question 8

What shouldn’t be in the filtrate?

Answer 8

• Blood cells
• platelets
• large plasma proteins

=> kidney injury due to increased permeability

Question 9

What is tubular fct?

Answer 9

Reintroduces necessary subs that have been filtered out through the glomerulus
- proximal tubule
- loop of Henle
- distal tubule
- collecting ducts
*pic

Question 10

What is EPO?

Answer 10

Erythropoietin production
1. Anemia (low RBC concentration)
2. Decreased tissue oxygenation
3. Kidneys increase EPO
4. Stimulates RBC production
5.

Question 11

What vit is activated by kidneys and liver?

Answer 11

Vit D

Question 12

What is RAAS?

Answer 12

Renin-angiotensin-aldesterone system

Activated by:
- LOW: BP, ECF, Serum Na+
- High urine Na+

Question 13

How does RAAS work?

Answer 13

1. kidneys make renin
2. convert angiotensinogen from liver into angiotensin I
3. ACE enzyme from lungs converts angiotensin I to angiotensin II
   3.2. Angiotensin causes vasoconstriction
4. Angiotensin II stimulate adrenal gland and produced Aldesterone
5. aldesterone causes retention of water and NaCl in kidneys

Question 14

What is ureterovesical junction?

Answer 14

Most narrow part of ureters
- blackflow of urine can cause kidney damange
- asceding infection-kidney infection

Question 15

What is bladder fct?

Answer 15

• Detrusor muscle capable of considerable distension (filing) and contraction (emptying)
• 200-250 mL => moderate distension and urge to void
• 400-600 mL => uncomfortable
• total capacity varies: 600-1000 mL

Question 16

What is micturation urethrovesical unit fct?

Answer 16

Autonomic reflex that can be facilitated or inhibited by higher centers

Question 17

What are the two steps of micturition reflex?

Answer 17

1. Progressive filling of the bladder until a threshold is reached
2. At the threshold, a nervous reflex is initiated “micturition reflex” to empty the bladder

Question 18

What are subjective data assessments?

Question 19

What to assess for?

Answer 19

• Health hx
• physical assessment of abd
• inspection of urine characteristics
• relevant diagnostic exams

Question 20

What are subjective data to acquire?

Answer 20

• Past health hx
• meds
• surgery
• nutritional assessment
• elimination assessment
• activity assessment
• pain assessment
• relationship an sexuality assessment

“How often do you urinate?”
“Does it burn?”
“How much water do you drink”

Question 21

What to inspect for?

Answer 21

• Skin: yellow, greyish color (CKD), poor skin turgor
• mouth: smell ammonia (urine in body for long time, reconverted to ammonia => toxic)
• face and extremities
• abd: feel full bladder
• weight: weight gain bc of excess fluid

Question 22

What to palpate for?

Answer 22

• Use costovertebral angle
• left kidney difficult
• bladder need to be distended