Urinary System And Male Reproductive Disorders

Front 1

Functions of the urinary system are:

Back 1

Maintain homeostasis

Urine formation and excretion of waste products

Regulation of water, electrolytes, and acid-base balalnce and blood pressure

Front 2

Functions of the urinary system

-Regulation of RBC formation in response to ___________ and __________urine flow.

Back 2

Hypoxia

decreased

Front 3

Function of Urinary System


-Synthesis of ______to active form-this is essential for absorption of calcium from GI

Back 3

Vitamin D

Front 4

What is the functional unit of the kidneys?

Back 4

Nephron.

more than 1 million in each kidney

It is responsible for filtering the blood and processing the urine.

Front 5

Three major functions of the nephron-

Back 5

1. Controls body fluid levels by selectively removing or retaining water

2.assists with regulation of the pH of the blood

3.removes toxic waste from the blood.

Front 6

Approximately____times a day, the body's___________________
through the kidneys.

Back 6

60

entire volume of blood is filtered

Front 7

The two main structures of the nephron

Back 7

Renal corpuscle--glomeruli and Bowman's capsule

Renal tubule

Front 8

renal capsule

Back 8

outer covering of kidney composed of strong connective tissue

Front 9

renal cortex

Back 9

contains 1.25 million renal tubules/nephrons

Front 10

medulla

Back 10

contains pyramids

Front 11

calyces

Back 11

cup like structures that empty urine into the ureters

Front 12

Renal pelvis

Back 12

expansion of upper end of the ureter

Front 13

The three phases of urine formation are

Back 13

Filtration

Reabsorption

Secretion

Front 14

filtration

Back 14

water and blood products-occurs in Bowman's capsule

Front 15

reabsorption

Back 15

water, glucose and ions taken back into the blood-takes place primarily in the proximal convoluted tubules;

this process reclaimes important substances needed by the body

Front 16

secretion

Back 16

certain ions, nitrogenous waste and drugs;

occurs primarily in the distal convoluted tubule

substance moves from blood into the filtrate

Front 17

Glomerulus

its process in urine formation

Back 17

Filters

water and solutes through the glomeruli into bowmans capsule

Front 18

Proximal convoluted tubule

its process in urine formation

Back 18

Reabsorbs

water and solutes

Front 19

Loop of henle

its process in urine formation

Back 19

Reabsorbs

Sodium and chloride ions

Front 20

Distal convoluted and collecting tubules

process in urine formation

Back 20

reabsorbs water, sodium and other chloride ions


secretes ammonia, potassium ions, urea, uric acid, creatinint, hydrogen ions, and some drugs

Front 21

Specific Gravity

Back 21

measures patients hydration status and gives information about the kindeys ability to concentrate urine.

Front 22

What is specific gravity decreased by?

Back 22

high fluid intake

reduced renal concentrating abilities

diabetes insipidus

diuretic use

Front 23

What is specific gravity increased by?

Back 23

dehydration due to fever

diaphoresis

vomiting

diarrhea

diabetes mellitus

inappropriate secretion of ADH

Front 24

Blood Urea Nitrogen
(BUN)

Back 24

used to determine the kidneys ability to rid the blood of non-protein nitrogen and urea

patient NPO for 8 hours for most accurate test results

normal 10-20 mg/dl

Front 25

Blood Serum creatinine

Back 25

creatinine level in blood; creatinine is a catobolic by product of skeletal muscle contractions---it is directly related to renal excretory function

only renal disorders-will cause an abnormal elevation
glomerulonephritis
pyelonephritis
acute tubular necrosis
urinary obstruction

normal female range-0.5-1.1

normal male range-0.6-1.2

Front 26

Creatine Clearance (urine)

Back 26

urine is usually measured for a 24 hour period

directly related to muscle mass

avoid excessive physical activity while collecting urine

discard initial fasting urine and begin 24 hr time frame

normal 85-135 ml/min

Front 27

Creatine Clearance

Elevated serum(blood) and decline in urine creatinine indicates____________.

Back 27

Renal disease

Front 28

Prostate Specific Antigen (PSA)

elevated levels indicitave of

Back 28

prostate cancer, benign prostatic hypertrophy and prostatitis

Noral 4ng/ml

Front 29

Kidney-ureter-bladder
(KUB)

Back 29

radigraph assesses the general status of the abdomen and evaluates the size, structure, and position of the urinary tract structures.

No special preparation necessary

Abnormal findings related to urinary system may indicate tumors, calculi, glomerulonephritis, cysts

Front 30

Intravenous Pyleogram

IVP

Back 30

uses radiopaque dye

ck pt allergy to iodine and seafood-may need antihistamine, or steroid or other alternatives

dont use dye if taking (this woman is one of the devils minions)---cause it can lead to kidney failure.

Front 31

osmolality

Back 31

measures weight of solute compared with its own weight-may be preferred over specific gravity.

Results provide information of the concentration ability of the kidney.

Front 32

Endoscopic Procedures

Back 32

visualize hollow organs--invasive procedure informed consent is needed-often performed in surgical suite by urologist.

Pt in lithotomy postion--contiuous fluid irrigation of bladder necessary to help visualization.

Monitor first voiding after procedure--note time, amount, color, dysureia--first voiding is usually blood tinged from trauma.

Front 33

Renal angiography/venogram

Back 33

aids in evaluation of blood supply to the kidneys-evaluates masses and detects possible complications after kidney transplantation

with hold oral intake night before

small radiopaque cath placed into artery so pt will need to lie flat in bed for several hours to minimize risk of bleeding or hematoma

circulatory status of involved limb should be assessed every 15 min for 1st hour and every 2 hours for 24 hours after

Front 34

computed tomography

Back 34

locates masses of kidney

radiopaque dye may be used-assess pt for allergies-

dye not used if poor renal function-serum urea and creatinine level are obtained before test

CT is "taking pictures" and pt will need to lie very still

Front 35

Magnetic Resonance Imaging

Back 35

pts with metal prostheses-heart valves, screws, pacemakers--cant get MRI

Front 36

Renal Scan

Back 36

nuclear study

slight radiation-no pregnant nurses

pt can ususlly urinate in toilet--check protocol

Front 37

Transrectal untrasound

Back 37

show clear picture of prostate tumor

guided biopsy can be used

Front 38

ultrasonography

Back 38

uses sound waves to produce pictures

no special preperations necessary

shows any irregularities in structure/kidney

Front 39

Renal Biopsy

Back 39

also called percutaneous biopsy

tell pt there will be pain

instructions-like holding breath-must be followed

24 hour bed rest-watch for bleeding

usually can resume activities after 48-72 hours

Front 40

urodynamic studies

Back 40

measures storage of urine and flow of urine

cholinergic and anticholinergic meds may be used to determine the effects on the bladder

Front 41

Nursing Implications

If patient needs IVP-intravenous pyleogram and barium test which sould come first?

Back 41

The IVP needs to come first--the barium stays in the system.

Front 42

Nursing Implications

If dye used what should nurse do about pts fluids

Back 42

force fluid to remove dye unless contraindicated-

if dehydration occurs it can cause kidney failure--pt should not go out in hot weather

Front 43

Nursing Implications

What do you do after a biopsy?

Back 43

no aspirin

no heparin

no coumadin

use pressure dressing

lie prone for 60 minuets

monitor vital signs closely

bedrest for 24 hours

Front 44

Thiazide diuretics

What are they used for?

Back 44

chlorothiazide---Diuril

generalized edema and mild to moderate hypertension

Front 45

Thiazide Diuretics


Where in the body does it act?

Back 45

acts on the distal convoluted tubule to impair sodium and chloride reabsorption leading to excretion of electrolytes and water

Front 46

Thiazide Diuretics


What side effects do they have and what condition is it contraindicated in?

Back 46

hypokalemia

hyponatremia

hypercalcemia-it enhances the reabsorption of calcium in proximal tubules


Contraindicated in anuria

Front 47

Loop Diuretics

What are they used for?

Back 47

renal impairment

also called high-ceiling

most potent and may lead to significant electrolyte depletion

Lasix is used for nephrotic syndrome, heart failure and pulmonary edema.

Front 48

Loop Diuretics

What are some side effects?

Back 48

side effects are associated with fluid loss

vertigo

hypotension

hypokalemia

Front 49

Potassium sparing diuretics

How do they work?

Back 49

inhibit sodium reabsorption and potassium excretion

these diuretics are weak and are usually used in conjunction with other types of diuretics

Front 50

Potassium sparing diuretics

Which patients are these meds contraindicated in?

Back 50

Hyperkalemic pts--further retention of potassium could result in a fatal cardiac dysrhythmia

Front 51

Potassium sparing Diuretics

Name the two types

Back 51

triamterene (Dyrenium) has little diuretic effect and is mostly used in conjunction with other diuretics to lessen the excretion of potassium.

spironolactone (Aldactone)

Front 52

Osmotic Diuretics

How do they work?

Back 52

increase plasma osmotic pressure which redistributes fluid towards the circulatory vessels

Front 53

Osmotic Diuretics

What are they used for?

Back 53

manage edema

cerebral edema

decrease intraocular pressure and improve renal function in acute renal failure

Front 54

Osmotic Diuretics


Why should cardiac function be monitored carefully?

Name example of drug--

Back 54

it can induce heart failure

Mannitol`

Front 55

Carbonic anhydrase inhibitor

What is it used for?

Back 55

Diamox

used to lower intraocular pressure--has little effect as diuretic

Front 56

Nursing interventions for Diuretics


Monitor pt for s/s of....

Back 56

fluid overload because of condition changes in pulse rate, respirations, cardiac sounds and lung fields

also monitor for hypotension

ck weight daily and take accurate I and O and vital signs

Pt should keep sodium intake from getting too high

Potassium intake may need to be increased-unless pt is on potassium sparing

Oranges, potatoes and bananas are good sources of potassium

Front 57

Nursing Interventions for Diuretics

If patient is taking Digoxin why should serum levels be monitored closely?

Back 57

Id diuretic is effective it may cause an increase in serum level and could become toxic.

Front 58

UTI medications

quinolone

Back 58

neg gram

gram neg bacteria

antiinfective

contraindicated in renal impairment

Front 59

UTI medications

nitrofurantoin

Back 59

Macrodantin

antibacterial

Front 60

UTI medications

methenamine

Back 60

needs acid urine; bacteriocidal

Front 61

UTI medications

fluoroquinolone

Back 61

antibiotic

gonorrhea

give with full glass of water 1 hour before or 2 hours after meal

take with antacids

Front 62

Nursing interventions for UTI patients

Keep patient well______urine out put-2000 ml

Observe patient taking________for visual disturbances

Back 62

hydrated

NegGram

Front 63

UTI Nursion interventions

If pt has problems with acid what type of diet should they try?

Back 63

Ash diet to keep urine pH of 5.5

meat, whole grain, eggs, cheese, cranberries, prunes and plums