Med Surg- Renal and Urinary System
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
What are the 4 main structures of the Renal and Urinary System?
1) Kidneys 2)Ureters 3)Bladder 4)Urethra
What are the 3 steps in formation of urine?
1) Filtration 2) Reabsorption 3) Secrete
What is the normal urine characteristics for the following?
4) Specific Gravity:
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
How many mL should a person excrete per hour?
30 - 50 mL: if it is under 30, it should be reported to the Dr.
What constitutes urine?
95% water and waste products such as urea, creatinine, and uric acid
Blood, protein, glucose, and WBC are considered a normal constitute of urine
False - these are all abnormal
What is the normal ADULT bladder capacity?
300 - 500 mL
What is the best indicator for a physical assessment?
How many mL is considered urinary retention?
100 mL or more
The absence of urine formation is termed ________.
Anuria (less than 300 mL)
Urine cultures ID bacteria and are collected __________ taking an antibiotic.
The most important indicator for renal function is the value of ________ _________.
Creatinine Clearance Test is a ____ hr screening.
Specific Gravity test is used to evaluate which organ?
Urine osmolarity evaluates ________ function.
Blood urea nitrogen can be used to tell what organ's functions?
KUB radiologic study stands for:
Kidneys Ureter Bladder
What radiologic study shows tumors, swollen kidneys, and kidney stones?
KUB Radiologic Study
Before doing an intravenous pyleogram study, you must:
1)check allergies 2)creatinine lvl for renal function 3) BUN lvl (liver and kidney function)
What does a renal ultrasound show:
kidney enlargement, kidney stones, chronic infection, and tumors
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.
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.
Urea is an abnormal constituent of urine.
False - urea is normal in small amt. It is considered abnormal in high concentrations.
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).
Low output of urine - typically 400 mL is called ______.
Oliguria, anorexia, and lethargy are all indicators of ______ ______.
Frequency, urgency, dysuria and hematuria, flank and back pain, and renal failure are all common signs and symptoms of __________.
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.
Multiple cysts in the kidneys is called ______ _____ disease.
Polycystic Kidney Disease
The most common complication with polycystic kidney disease is ____
A person who has polycystic kidney disease and hypertension has NA restrictions.
What urinary disease is classified as progressive, hereditary, and no treatment available?
Polycystic Kidney Disease
How do you assess polycystic kidney disease?
palpate and feed for an enlarged cystic kidney
What diagnostic test can be performed to identify polycystic kidney disease?
Kidney cancer is very common and has many known causes.
False - the exact cause is unknown and kidney cancer is rare
Risk factors for kidney cancer are ___________.
smoking, obesity, hypertension, and exposure to lead/cadmium/and phosphates
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.
A palpable abdominal mass found during a routine exam (early), hematuria, and dull pain in flank area are all signs of __________.
IVP cystoscopy and pyleogram, renal ultrasound, ct scan, mri of abdomen, and biopsy are all diagnostic tests for what type of cancer?
A sudden loss of kidney function
Acute renal failure
Waste products accumulate (nitrous waste), GFR decreases, and BUN increases is known as ________.
A pt dx with acute renal failure cannot recover.
False - A pt can recover from acute renal failure
What are the three stages of acute renal failure?
1) Prerenal failure 2) intrarenal failure 3) postrenal failure
Decreased blood supply to the kidneys describes which stage of acute renal failure?
stage 1 - pre renal failure
Damage to the nephrons describes which stage of acute renal failure?
stage 2 - intra renal failure
Obstruction describes which stage of acute renal failure?
stage 3 - post renal failure
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
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
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
Diabetic Nephropathy is the leading cause of acute renal failure.
False- chronic renal failure
A person who is in chronic renal failure is prone to fractures and may need what type of supplement?
The most common UTI - (inflammation of the bladder wall) is called ________________.
This bacteria causes 80% of UTIs
This type of infection can result from a lower uti and can lead to sepsis.
What type of incontinence is described as involuntary urine loss from increasing abdominal pressure?
What type of incontinence is described as involuntary urine loss with abrupt/strong desire to void?
What type of incontinence is described as distension of the bladder?
What type of incontinence is described as impairment of physical/mental function?
What type of incontinence is described as continuous and unpredictable loss of urine?
Shock, urinary tract obstruction, and neurogenic bladders are all justifiable reasons for an indwelling catheter.
True - urinary incontinence is not.
An intermittent catheter is the best form of caterization and can be self-catherized.
This type of indwelling catheter is inserted through an incision in the lower abdomen into the bladder
Renal calculi are also known as ____________.
The leading cause of bladder cancer is ________.