Med Surg- Renal and Urinary System

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Urinary System
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1

Function to maintain the body's state of homeostasis by regulating fluid and electrolytes, removing wastes, and providing hormones involved in RBC production, bone metabolism, and control of bp

Renal and Urinary System

2

What are the 4 main structures of the Renal and Urinary System?

1) Kidneys 2)Ureters 3)Bladder 4)Urethra

3

What are the 3 steps in formation of urine?

1) Filtration 2) Reabsorption 3) Secrete

4

What is the normal urine characteristics for the following?
1) Amount:
2) Color:
3) Clarity:
4) Specific Gravity:
5) pH:

1) Amount: 1000-2000 mL/day
2) Color: straw or amber (amber - concentrated)
3) Clarity: Clear
4) Spec Gravity: 1.010-1.025 (^ it is - ^ concen)
5) pH: 4.6 - 8.0

5

How many mL should a person excrete per hour?

30 - 50 mL: if it is under 30, it should be reported to the Dr.

6

What constitutes urine?

95% water and waste products such as urea, creatinine, and uric acid

7

T/F
Blood, protein, glucose, and WBC are considered a normal constitute of urine

False - these are all abnormal

8

What is the normal ADULT bladder capacity?

300 - 500 mL

9

What is the best indicator for a physical assessment?

Daily weight

10

How many mL is considered urinary retention?

100 mL or more

11

The absence of urine formation is termed ________.

Anuria (less than 300 mL)

12

Urine cultures ID bacteria and are collected __________ taking an antibiotic.

Before

13

The most important indicator for renal function is the value of ________ _________.

Serum Creatinine

14

Creatinine Clearance Test is a ____ hr screening.

24 hr.

15

Specific Gravity test is used to evaluate which organ?

kidneys

16

Urine osmolarity evaluates ________ function.

kidney

17

Blood urea nitrogen can be used to tell what organ's functions?

liver

18

KUB radiologic study stands for:

Kidneys Ureter Bladder

19

What radiologic study shows tumors, swollen kidneys, and kidney stones?

KUB Radiologic Study

20

Before doing an intravenous pyleogram study, you must:

1)check allergies 2)creatinine lvl for renal function 3) BUN lvl (liver and kidney function)

21

What does a renal ultrasound show:

kidney enlargement, kidney stones, chronic infection, and tumors

22

T/F
After diagnostic type procedures such as cystoscopy for the urinary patient you CAN encourage sitz baths.

True - You want to discourage bubble baths. A sitz bath may contain medication and is defined as a warm water bath used for healing or cleansing purposes.

23

A 24 hr urine collection is scheduled to start at 3 p.m. When should the nurse start the procedure?

After discarding the first specimen.

24

T/F
Urea is an abnormal constituent of urine.

False - urea is normal in small amt. It is considered abnormal in high concentrations.

25

A condition that typically occurs when one kidney becomes swollen due to the failure of normal drainage of urine from the kidney to the bladder (due to obstruction in the urinary tract).

Hydronephrosis

26

Low output of urine - typically 400 mL is called ______.

Oliguria

27

Oliguria, anorexia, and lethargy are all indicators of ______ ______.

Renal Failure

28

Frequency, urgency, dysuria and hematuria, flank and back pain, and renal failure are all common signs and symptoms of __________.

hydronephrosis

29

Therapeutic interventions for hydronephrosis include urinary catheters, stents, a nephrostomy tube, and _________.

Treating the cause - relieving the obstruction, neph tube inserted direction into the kidney pelvis to drain the urine.

30

Multiple cysts in the kidneys is called ______ _____ disease.

Polycystic Kidney Disease

31

The most common complication with polycystic kidney disease is ____

UTI

32

T/F
A person who has polycystic kidney disease and hypertension has NA restrictions.

True

33

What urinary disease is classified as progressive, hereditary, and no treatment available?

Polycystic Kidney Disease

34

How do you assess polycystic kidney disease?

palpate and feed for an enlarged cystic kidney

35

What diagnostic test can be performed to identify polycystic kidney disease?

ultrasound

36

T/F
Kidney cancer is very common and has many known causes.

False - the exact cause is unknown and kidney cancer is rare

37

Risk factors for kidney cancer are ___________.

smoking, obesity, hypertension, and exposure to lead/cadmium/and phosphates

38

T/F
Kidney cancer is more prevalent in women of the ages 50-70.

False- kidney cancer is more prevalent in men of he ages 50 - 70.

39

A palpable abdominal mass found during a routine exam (early), hematuria, and dull pain in flank area are all signs of __________.

Kidney cancer

40

IVP cystoscopy and pyleogram, renal ultrasound, ct scan, mri of abdomen, and biopsy are all diagnostic tests for what type of cancer?

Kidney

41

A sudden loss of kidney function

Acute renal failure

42

Waste products accumulate (nitrous waste), GFR decreases, and BUN increases is known as ________.

Azotemia

43

T/F
A pt dx with acute renal failure cannot recover.

False - A pt can recover from acute renal failure

44

What are the three stages of acute renal failure?

1) Prerenal failure 2) intrarenal failure 3) postrenal failure

45

Decreased blood supply to the kidneys describes which stage of acute renal failure?

stage 1 - pre renal failure

46

Damage to the nephrons describes which stage of acute renal failure?

stage 2 - intra renal failure

47

Obstruction describes which stage of acute renal failure?

stage 3 - post renal failure

48

Describe and put in order the 4 phases a person undergoes when diagnosed with acute renal failure (oliguria, recovery, initiation, diuresis)

Initiation - begins with the initial insult and ends when oliguria develops

Oliguria – less than 400 ml urine in 24 hours

Diuresis – kidneys are able to excrete waste products

Recovery –GFR rises and waste production decreases

49

Muscle twitching and seizures, dry skin and mucous membranes, and an increase in BUN and creatinine are signs of what renal disorder?

Acute Renal Failure

50

This renal disorder is characterized by a gradual decrease in kidney function, is irreversible, and refereed to as End Stage Renal Disease (ESRD).

Chronic Renal Failure

51

T/F
Diabetic Nephropathy is the leading cause of acute renal failure.

False- chronic renal failure

52

A person who is in chronic renal failure is prone to fractures and may need what type of supplement?

calcium

53

The most common UTI - (inflammation of the bladder wall) is called ________________.

cystitis

54

This bacteria causes 80% of UTIs

E-Coli

55

This type of infection can result from a lower uti and can lead to sepsis.

pyleonephritis

56

What type of incontinence is described as involuntary urine loss from increasing abdominal pressure?

stress

57

What type of incontinence is described as involuntary urine loss with abrupt/strong desire to void?

urge

58

What type of incontinence is described as distension of the bladder?

overflow

59

What type of incontinence is described as impairment of physical/mental function?

functional

60

What type of incontinence is described as continuous and unpredictable loss of urine?

total

61

T/F

Shock, urinary tract obstruction, and neurogenic bladders are all justifiable reasons for an indwelling catheter.

True - urinary incontinence is not.

62

T/F

An intermittent catheter is the best form of caterization and can be self-catherized.

True

63

This type of indwelling catheter is inserted through an incision in the lower abdomen into the bladder

suprapubic catheter

64

Renal calculi are also known as ____________.

Kidney Stones

65

The leading cause of bladder cancer is ________.

Smoking


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