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111 Cards in this Set
- Front
- Back
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This is a homrmone synthesized and released by the adrenal cortex; causes the kidneys to reabsorb more sodium
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aldosterone
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This hormone is cedreted by the posterior pituitary gland; causes the kidneys to reabsorb more water; also called vasopressin.
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Antidiuretic hormone (ADH)
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Total urine output less then 50ml in 24hrs
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Anuria
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Bacteria in the urin; bacteria count highter than 100,000 colonies /ml
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bacteriuria
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endogenous waste product of muscle energy metabolism
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creatinine
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Increased formation and secretion of urine
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Diureses
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painful or difficulty urination
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diuresis
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voiding more frequently than every 3hrs
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frequency
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plasma filtered at the glomerulus into the kidney tubules
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glomerular filtration
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tuft of capillaries forming part of the nephron through which filtration occurs
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glomerulus
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red blood cells in the urine
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hematuria
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urination or voiding
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micturition
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structural and functional unit of the kidney responsible for urine formation.
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nephron
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awakening at night to urinate
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nocturia
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total urine output less than 500ml in 24hrs
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oliguria
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protein in the urine
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proteinuria
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white blood cells in the urine
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pyuria
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volume of plasma that the kidneys can clear of a specific solute (ex. creatinine); expressed in mL/minute
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renal clearance
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reflects the weight of particles dissolved in the urine; expression of the degree of concentration of the urine.
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specific gravity
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movement of a substance from the kidney tubule into the blood in the peritubular capillaries or vasa recta
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tubular reabsorption
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movement of a substance from the blood in the peritubular capillaries or vasa recta into the kidney tubule
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tubular secretion
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nitrogenous end product of protein metabolism
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urea nitrogen
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What is the primary purpose of the renal and urinary system?
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To maintain the body's state of homeostasis by carefully regulating fluid and electrolytes, and removing wastes.
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What is the function of the kidney?
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1. Urine formation
2. excretion of waste products 3. regulation of electrolytes 4. regulation of acid base balance 5. control of water balance 6. control of blood pressure 7. renal clearance 8. regulation of red blood cell production 9. synthesis of vitamin D to active form. 10. secretion of prostaglandins 11. regulates calcium and phosphorus balance. |
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Where are the kidneys located?
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on the posterior wall of the abdomen from the 12th thoracic vertebra to the third lumbar vertebra
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True or false?
The right kidney is slightly lower than the left due to the location of the liver |
true
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The renal parenchyma is divided into two parts what are they?
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Medulla, and cortex
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What does the medulla contain?
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loops of henle, vasa recta, and collecting ducts.
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The pyramids drain into the _____________ calices, which then drain into the ____________ calices that open into the renal pelvis.
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Minor, and Major
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What is the concave portion of the kidney through which the renal artery enters and the ureters and renal vein exit.
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Hilum
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True or false
The kidneys receive 20% to 25% of the total cardiac output. |
True
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How many times is the body's blood circulated in an hr?
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12 times.
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How many nephrons are in each kidney?
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1 million
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What are the two types of nephrons?
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Cortical nephron, and Juxtamedullary nephron
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What is the average urinary output for a adult?
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1500ml
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How much urine can the bladder hold?
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300-500ml
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Where are the kidneys located?
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Posterior around the 12th thoracic vertebra to the third lumbar vertebra in an adult
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What is the average urine output for children ages 2yrs to 6yrs?
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540ml to 600
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Urine is formed in the nephrons in a three step process what is it?
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Filtration, re-absorption, and excretion.
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True or false?
Water electroylytes, and other substances such as glucose and creatine are filtered by the glomerulus; varying amounts of these substances are reabsorbed in the renal tubule or excreted in the urine. |
true
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Strep throat can lead to this if left untreated.
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Chronic kidney disease
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If a patient is immobilized what uroligical disorder can it cause?
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Kidney stone formation
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Diabetes mellitus can lead to this urological disorder
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Chronic kidney disease neurogienic bladder
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Multiple sclerosis can lead to these urological problems.
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Incontinence and neurogienic bladder
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Systemic lupus erythematosus can lead to these urological problems.
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Nephritis chronic kidney disease
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Gout, hyperparathyroidism, crohn's disease and ileostomy can lead to this urological problem.
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kidney stone formation
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Sickle cell anemia, and multiple myeloma can lead to this urological problem.
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Chronic kidney disease
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Benign prostatic hyperplasia can lead to these urological problems.
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Obstruction to urine flow leading to frequency, oliguria, and anuria.
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Radiation therapy to the pelvis can lead to these urological problems.
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Cystitis fibrosis of the ureter, or fistula in urinary tract.
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Recent pelvic surgery can lead to these urological problems.
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Inadvertent trauma to ureters or bladder.
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Pregnancy can lead to this urological disorder.
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Proteinuria, frequent voiding.
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An abnormal constituent of urine is:
a. Creatinine b. Glucose c. Potassium d. urea |
b.
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The normal quantity of water ingested and excreted in the urine is approximately:
a. 0.5 L/day b. 1.5 L/day c. 2.5 L/day d. 4.0 L/day |
b
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The normal amount of sodium ingested and excreted in the urine is approximately? a. 2 to 3 g/day b. 4 to 5 g/day c. 6 to 8 g/day d. 9 to 10 g/day |
c
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Increased blood osmolality will result in?
a. Antidiuretic hormone (ADH) stimulation b. An increased in urine volume c. serum potassium level. d. uric acid level |
a
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A major sensitive indicator of kidney disease is the?
a. blood urea nitrogen level. b. creatinine clearance leve. c. serum potassium level d. uric acid level |
b
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A major manifestation of uremia is?
a. Decreased serum phosphorus level. b. hyperparathyroidism c. hypocalcemia with bone changes d. increased secretion of parathormone. |
c
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Significant nursing assessment data relevant to renal function should include information about?
a. any voiding disorders b. the patients occupation c. the presence of hypertension d. all of the above. |
d
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Oliguria is said to be present when urinary output is?
a. less then 30mL/hr b. about 100 ml/hr c. between 300 and 500mL/hr d. between 500 and 1000mL/hr |
a
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A 24hr urine collection is scheduled to begin at 8am. The nurse should begin the procedure?
a. after discarding the 8:00am specimen. b. at 8am, with or without a specimen c. 6hr after the urine is discarded d. with the first specimen voided after 8am. |
a
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Nursing responsibilities after renal angiography include?
a. assessment of peripheral pulses. b. color and temperature comparisons between the involved and uninvolved extremities c. examination of puncture site for swelling and hematoma formation. d. all of the above. |
b
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The nurse should inform a patient that preparation for intravenous urography includes?
a. A liquid restriction for 8 to 10hr before. b. Liquids before the test c. enemas until clear d. remaining NPO from midnight before the test. |
b
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A cystoscope allows visualization of the?
a. bladder b. ureteral orifices c. uretha d. all the above. |
b
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Nursing management after a renal brush biopsy includes?
a. assessing for the clinical manifestation of hemorrhage b. encouraging a fluid intake of 3L every 24hrs c. obtaining a sample of each voided urine to compare it with a prebiopsy specimen. d. all of the above. |
b
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The functional unit of each kidney is the _______ located in the _______ of the kidney
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Nephron; cortex
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Normal abult bladder capacity is _____ mL of urine
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300
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The urine osmolality that indicates and early sign of kidney disease is ________
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300mOsm/kg
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When a person is dehydrated the urine osmolality is ___________
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increased
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Water is reabsorbed rather than excreted under the control of the __________
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ADH
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The major waste product of protein metabolism is __________. Approximately how many grams are produced and excreted daily? ________
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urea; 20 to 30g
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The test that most accurately reflects glomerular filtration and renal excretory function is the __________
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creatine clearance.
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Describe the blood circulation through the kidneys and the filtration role of the glomerulus?
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The kidneys receive 20 to 25% of the bodys blood circulation. Which means all of the body's blood circulates through the kidneys approximately 12 times per hr. The renal artery devides into smaller and smaller vessels eventurally forming afferent arteriols. Each afferent ateriole branches to form a Glomerulus which is the caplillary bed responsible for glomerular filtration. Blood leaves the glomerulus through the efferent arteriole and flows back into the inferior vena cava through a network of capillaries and veins.
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Compare the filtration functions of the cortical and juxtamedullary nephrons.
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Cortical nephrons make up 80 to 85% of the total number of nephrons, where as Juxtamedullary nephrons make up the remaining 15 to 20%. Juxtamedullary nephrons are located deeper in the cortex and are distinguished by long loops of Henle and surrounded by long capillary loops called vasta recta. The length of the tubular components of the nephron is directly related to its ability to concentrate urine.
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Explain the three step process of urine formation that involves glomerular filtration tubular re-absorption and tubular secretion.
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Urine is formed in a three step process Filtration, re-absorption, and excretion.
1. Water electrolytes, and other substances such as glucose and creatinine are filtered by the glomerulus. 2. Varying amounts of these substaces are reabsorbed in the peritubular capillaries. 3. Reabsorption into tubule for excertion in urine. |
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True or false?
Amino acids and glucose are usually filtered at the level of the glomerulus and reabsorbed so that neither is excreted in the urine. |
True
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Renal ___________ occurs in diabetes and most common condition that causes blood glucose level to exceed the kidney's re-absorption capacity.
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glycosuria
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True or false?
Renal glycosuria is common in pregnancy. |
True
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The normal blood flow through the kidneys is about _________ mL/min
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1200
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Filtrate normally consists of what?
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Water, electrolytes, and other small molecules.
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____________ is a hormone directly involved in the control of arterial blood pressure.
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Renin
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True or false?
The left ureter is slightly shorter than the right |
True
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True or false?
Of the 180L of filtrate that the kidneys produce each day 99% is reabsorbed into the blood stream resulting in the formation of 1L to 2L of urine each day. |
True
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What specialized vessels in the kidney constantly monitory blood pressure as blood begins its passage into the kidney.
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Vasa recta
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When the vasa recta detect a decrease in blood pressure specialized juxtaglomerular cells called ___________ cells near the afferent arteriole, distal tubule and efferent arteriole secrete a hormone renin.
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Denta
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What is the function of renin?
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It converts angiotensinogen to angiotensin I, which is the convered to angiotensin II.
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What is the function of angiotensin II?
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It is the most powerful vaso-constrictor known and causes blood pressure to increase.
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Patient presents to the ER grabbing his back in the costovertebral angle area, and describes his pain as a constant dull ache and at times can be severe sharp and stabbing. Patient is nauseated, vomiting, diaphoreisis, pallor, and is showing signs of shock. What could possibly be going on with this patient.
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Acute obstruction, kidney stone, blood clot, acute pyelonephritis, trama
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Patient presents to the ER bent over holding her suprapubic area and is complaining of a dull continuous pain that is intense with voiding. She is having to go often to the bathroom and experiencing pain at the end of voiding, and states it is very painful when she strains. What could be going on with this patient?
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Over distended bladder, UTI, interstitual cystitis or tumor
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Patient present to the ER complaining of pain in the costovertebral angle, flank, testis and lower abdominal area. He discribes his pain as severe sharp, stabbing pain colicky in nature. He is nauseated and vomiting. What could be going on with this patient?
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Ureteral stone, Edema or stricture, blood clot.
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Patient presents to the doctors office complaining of pain in his perineum and rectal area. He describes his pain as a vague discomfort, feeling of fullness in perineum, and vague back pain. Upon examination, he has suprapubic tenderness, and states he has frequency, urgency, dysuria, and nocturia. What could be going on with this patient?
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Postratic cancer, accute or chronic prostatitis
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Patient states she is having to go to the bathroom every 2hrs or so what would you suspect could be the problem?
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Infection, obstruction of the lower urinary tract leading to residual urine and lover flow, anxiety, diuretics, benign prostatic hyperplasia, urethral stricture, diabetic neuropathy.
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___________ is the bulging of the anterior vaginal wall into the urethra
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Urethrocele
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__________ is the hernation of the bladder wall into the vaginal vault.
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Cyctocele
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____________ is the herniation of the bowel into the posterior vaginal wall.
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Enterocele
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________ is the herniation of the rectum into the vaginial wall
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Rectocele
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True or false?
The deep tendon reflexes of the knee are examined for quality and symmetry. This is an important part of testing for neurologic causes of bladder dysfunction because the sacral area, which innervates the lower extremities is the same peripheral nerve responsible for urinary continence. |
True
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If urine is colorless or pale yellow what is the possible cause?
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Dilute urine due to diuretics, alcohol consumption, diabetes insipidus, glycosuria, excesive fluid intake, renal disease.
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If urine is yellow to milky white what could be the possible cause?
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Pyuria, infection, vaginal cream
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If urine is bright yellow, pink to red what could be going on?
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Multiple vitamin preparations, hemoglobin breakdown, red blood cells, gross blood, menses, bladder or postate surgery, beets, and blackberries.
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What medications can cause the urine to be bright yellow, pink to red?
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Phenytoin, rifampin, pheothiazine, cascara, senna products. Vitamin B supplements
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If urine is blue, to blue green what could be going on?
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Dyes, methylene blue, pseudomonas species organisms, medications such as amitriptyline, and triamterine
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If urine is orange to amber what could be going on?
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Concentrated urine due to dehydration, fever, bile, exscess bilirubin or carotene, and medication such as pyridium.
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If urine is brown to black what could be going on?
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Old red blood cells, urobilinogen, bilirubin, melanin, porphyrin, extremely concentrated urine due to dehydration, medication such as Iron preparations, quinine, and senna products.
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What is creatinine?
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Measures the effectiveness of renal function and is the end product of muscle energy metabolism.
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What is the normal levels of of creatinine?
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0.6 to 1.2 mg/dL
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What is urea nitrogen (BUN)?
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Serves as index of renal function. Urea is nitrogenous end product of protein metabolism. Test values are affected by protein intake tissue breakdown and fluid volume changes.
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What is a normal BUN level?
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7 - 18mg/dL
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What is a normal BUN to creatinine ratio?
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10:1 This test evaluates hydration status. an elevated ratio is seen in hypovolemia. an normal ratio with an elevated BUN and creatinine is seen with intrinsic renal disease.
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In a ______________ catheters are advanced through the ureters into the renal pelvis by means of cystoscopy. A contrast agent is then injected.
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Retrograde pyelography
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Voiding ____________ uses fluoroscopy to visualize thelower urinary tract adn assess urine storage in the bladder. Is commonly used to identify vesicoreteral reflux.
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cystourethrography
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A _______ or _________________ provides an image of the renal arteries. This test is used to evaluate renal blood flow in suspected renal trauma, to differentiate renal cysts from tumors and to evaluate hypertension.
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renal angiogram or renal arteriogram
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