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ADN002 MED SURG > Week 3 GU System > Flashcards

Week 3 GU System Flashcards

1
Q

Kidneys function by

A

Filter blood
Urine formation
Regulates osmolarity and osmolarity
Regulates water excretion by ADH
Regulates electrolyte excretion mainly Na by action of aldosterone
Regulate Acid Base Balance at glomerlous and synthesis of new bicarb by renal tubular
Removal of Wastes - Urea, creatinine, phosphates, sulfates, and uric acid and drug metabolites
Release erthropetin- hormone that stimulates bone marrow to produce more RBCs
Release of Renin - Stimulates vasoconstriction to regulate BP RAAS- Vas Recta Identifies
Activates Vitamin D
Secretion of Prostaglandins
Regulates CA and Phosphate

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2
Q

Kidneys and Urinary Systems

A

Regulates fluid and electrolytes, removing wastes and providing hormones involved in RBC production, bone metabolism, and BP control.

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3
Q

Where are kidneys located?

A

Retroperitoneal and important to flank area during assessment

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4
Q

What does tenderness indicate?

A

UTI, pyelonephritis, and nephrolithiasis.

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5
Q

Where are nephrons located?

A

Renal cortex

Responsible urine formation.

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6
Q

Where are juxtamedullary nephrons located?

A

Renal Medulla. Responsible for concentration of urine .

Renal Medulla also contains loop of Henle and vas recta and collecting ducts of nephrons.

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7
Q

Main difference between juxta and cortical?

A

Loop henle much longer in Juxta which gives ability to concentrate Urine

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8
Q

Renal Arteries

A

Coming from AA and deliver 20- 25 percent of CO.
Then divide to smaller arteries. Then progress through glomelrus and then vessels to loop of henle

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9
Q

GFR

A

Glomerular Filtration Rate - Filtration rate of kidneys.

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10
Q

Where does most reabsorption occur?

A

PCT

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11
Q

Aldosterone and ADH affect what tubule?

A

Distal Tubule responsible for concentration of urine.

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12
Q

What apparatus is a major structural component of the RASS?

A

Juxtaglomerular

Also one of the most important regulator of renal salt and H20

Between afferent arteriole and DCT.

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13
Q

What cells secrete Renin?

A

Macula Densa

Sense change in serum osmolarity and secrete renin when needed

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14
Q

Loop of Henle works with?

A

Vas Recta.Work in opposite directions. Vas Recta is highly permeable to water. Solutes enter but water does not. They are intertwined

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15
Q

Osmolality

A

Amount of SOLUTES dissolved in water

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16
Q

Osmolarity

A

The RATE of solutes to water

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17
Q

ADH

A

Anti Direutic Hormone. Also known as vasopressor.
Synthesized by hypothalamus and store in PPG. PPg secrets ADH to response to increase solutes.

Causes DCT and collecting ducts to reabsorb more.

Too much water? Less ADH

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18
Q

Vasopressin shunts blood from?

A

Mesenteric system to core circulation

Assists in bleeding complications associated with GI tract used in TX of DI.

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19
Q

Dehydration?

A

ADH secreted to keep more nutrients

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20
Q

Overhydrated?

A

ADH not secreted and decrease absorption.

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21
Q

Osmotic Pressure

A

Min. pressure needed to be applied to a solution to prevent inward flow

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22
Q

What does ADH help control?

A

Body’s amount of water

Body can control amount of solutes through…. Aldosterone

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23
Q

Aldosterone

A

Mineralocorticoid steroid hormone secreted under Angiotensin II. Made from the adrenal cortex.

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24
Q

What does Aldosterone reabsorb?

A

Na

Excretes what? K

Helps expand intravascular fluid volume for proper BP and proper GFR.

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25
When does RAAS get activated?
Renal arteriole pressure falls below normal.
26
When is Aldosterone released?
HyperK HypoNA Increased levels of ACTH
27
RAAS System
Decrased BP= Vas Recta Denta cells secrete Renin Renin released by kidneys with low pressure Converts Angio to AngioI ACE released by from pulmonary and Renal endothelium converts AngioI to AngioII Angio II stimulates vasoconstriction and reabsorbs sodium and water and excretes K. Adrenal glands secrete Aldosterone for more reabsorption and release ADH for more water reabsorption BP regular= Denta Cells stop renin release
28
After the Nephron...
Urine is formed No longer concentration gradient Within Renal Pyramid- Urine is transported from collecting duct through renal papilla to minor calyx
29
Renal Pelvis
Hilium- Concave portion
30
Ureter
Peristaltic contractions of smooth muscle Efflux or Antegrade- DOWNward movement of urine.
31
What prevents absorption?
Urothelium
32
Area that meets renal pelvis and the ureter?
Ureteropelvic Junction
33
Ureterovesical Junction
Area ureters meet the bladder. Central and hollow portion
34
What prevents reflux of urine?
Angle of Ureterovesical junction
35
Urethrovesical Junction
Area where bladder opens into urethra
36
When is the bladder completely empty?
Last second of micturition due to continual efflux
37
Urinalysis
Test for electrolytes, proteins, sugars, and hyaline casts.
38
Urine Culture
Determines type of microbe
39
Ultrasound
Noninvasive technique no med required
40
Renal Function Test
Blood sample and creatinine clearance.
41
Ct Scan
May or may not use dye
42
MRI
May or may not use dye used for soft tissue abnormalities, trauma, chronic, and renal infections
43
Nuclear Scan
Radioisotopes injected into blood stream. Use camera. Determine GFR used for acute and chronic renal failure.
44
Iv Urography
Contrast Dye injected and x-rays taken upper and lower part
45
Cytoscopy
Occur via urethra or percutaneously
46
Retrograde Pyelography
Use of catheter to advance through ureters and into renal pelvis via cytoscopy
47
Cystography
Catheter inserted through urethra to bladder and contrast dye instilled to determine leakage from potential injury
48
Voiding Cystourethrography
Use of fluoroscopy and contrast dye placed via catheter into the bladder
49
Renal Angiography
Catheter fed into the femoral artery up to aorta to renal arteries- dye injected to determine renal blood flow
50
Biopsies
Test for acute renal failure , proteinuria, hematuria, transplant rejection. Assess coags prior Contras in obesity, uncontrolled HTN, and bleeding tendencies
51
Renal Clearance
Ability to clear solutes from plasma
52
What is Creatinine?
Normal waste product of skeletal muscle. Good indicator for kidney function in ability to filter Amino acid in muscles and brain tissue
53
How is creatinine clearance measured?
Serum Creatinine halfway through 24 hour urine collection.
54
CKD
Stage 1 90 or higher - Stage 5 Less than 15 Disease worse, number DOWN
55
Nursing Considerations for Diagnostic Studies
Contrast Dye Educate not to take METFORMIN after 48 hrs after contrast administration Allergies NPO Consent Educate what to expect after May premedicate before Pay attention to GFR and Creatinine.
56
When does GFR decrease?
35-40 Yearly decline 1ml/ min thereafter
57
What does renal tubule dysfunction lead to?
Acid- Base Imbalance Renal Reserves are diminished
58
Gerontological Considerations
Decreased thirst Increased risk of HyperNa Structural and functional changes
59
Myogenic causes
Over distention of bladder wall
60
Neurogenic Causes
Stroke, Parkinson's, spinal cord injuries, ED, CNS tumor, surgeries of spine
61
BPH
Benign Prostate Enlargement
62
Estrogen level decreases leads to what?
Thinning of urogenital tissues causing increased vaginal irritation and urinary incontinence.
63
Deficient Knowledge Acute Pain Fear Anxiety Readiness for Enhanced Knowledge Impaired Urinary Elimination Situational Low Self Esteem
Nursing Dx
64
Adrenal Glands Cortex
Synthesizes Androgens- Sex hormones Glucocorticoids- Cortisol Mineralocorticoids- Aldosterone
65
What does Medulla synthesize?
Epi Norepi Both hormones and neurotransmitters Vasocontrictors
66
ACTH secreted by
Anterior Pituitary Gland
67
Adrenal Sex Hormones
Steroid hormones Produces sex hormones ACTH controls secretion of adrenal androgens too much= Women- masculinity Men- Feminization Children- Premature sexual development
68
Adrenal Cortex Feedback
Cortisol from Adrenal Glands decreases CRH and ACTH at hypothalamus and Pituitary Gland
69
Cortisol
Glucocorticoid Regulates metabolism and helps with memory. Also inflammation
70
Elevated Cortisol
Increased blood sugar Increased sodium and water retention Decreased CRH and ACTH
71
Corticosteroids
Decrease inflammation and suppress allergic reactions Used in organ transplant Sudden discontinuation- Addison's = Adrenal Insufficiency, why? body becoming dependent on exogenous corticoid steroid Dosages must be TAPERED
72
Addison's Disease
Addison's Disease ( Adrenal insufficiency) Lethargy Weakness Fever Anorexia Nausea and Vomiting Weight Loss HypoNa HyperK Hypogly
73
Cushings Syndrome
Adrenal Excess Buffalo Hump Heavy Trunk Thin Extremities Fragile Skin Impaired Wound Healing Bruising Women may have more masculine traits? why? Androgens excess

ADN002 MED SURG (18 decks)

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