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37 Cards in this Set
- Front
- Back
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BLOOD UREA NITROGEN (BUN)
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When Nephrons FAIL to REMOVE WASTE PRODUCTS efficiently from the body, blood chemistry is altered. deterioration in renal function is manifested by RISES in the BLOOD UREA NITROGEN (BUN) and creatininevalues, both of which are PROTEIN BREAKDOWN PRODUCTS.
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Normal Serum Values AND RENAL DISEASE BLOOD UREA NITROGEN(BUN)
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7-18mg/dL
Increased in renal disease and urinary obstruction. |
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COSTOVERTEBRAL ANGLE
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(CVA) aSSESSING THE KIDNEYS FOR TENDERNESS OR PAIN IS DONE BY LIGHTLY STRIKING THE FIST @ THE COSTOVERTEBRAL angle, which is where the lower ribs meet the vertebrae. normally the client experiences a DULL THUD. Pain & tenderness may indicate a renal d/o.
Also, assess for signs of ELECTROLYTE & h20 IMBALANCE |
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WHAT ARE THE SIGNS OF A UTI ?
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~PERIORBITAL EDEMA, EDEMA OF THE EXTREMITIES, CARDIAC FAILURE, and MENTAL CHANGES. ALL THESE SIGNS MAY INDICATE URINARY TRACT DISORDERS.
aLSO OBTAIN VITAL SIGNS & WEIGHT. |
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CREATININE IS WHAT ?
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Creatinine is a substance that results from the breakdown of PHOSPHOCREATININE(an amino acid waste product), present in MUSCLE TISSUE. It is FILTERED BY GLOMERULI AND EXCRETED @ A FAIRLY CONSTANT RATE BY THE KIDNEYS.
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1)WHAT IS THE TOTAL AMOUNT OF EXCRETED CREATININE CALLED? 2)WHAT IS A CREATININE CLEARANCE TEST ?
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1)CREATININE CLEARANCE
2)A CREATININE CLEARANCE TEST IS USED TO DETERMINE KIDNEY FUNCTION AND CREATININE EXCRETION. |
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CYSTOGRAM IS WHAT ?
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A CYSTOGRAM evaluates abnormalities in bladder STRUCTURE and FILLING through INSTILLATION OF CONTRAST DYE AND RADIOGRAPHY.
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A VOIDING CYSTOURETHROGRAM (VCUG)?
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Is SIMILAR to a cystogram EXCEPT THE CLIENT IS INSTRUCTED TO VOID (THE URINE CONTAINS THE RADIOPAQUE DYE), AND A RAPID SERIES OF X-RAYS ARE TAKEN. UTI is a CONTRAINDICATION to a VCUG.
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cytometrogram is ......?
(CMG) |
A Cytometrogram (CMG) evaluates bladder tone and capacity. A retention catheter is inserted into the bladder AFTER THE CLIENT VOIDS. The bladder is SLOWLY FILLED WITH STERILE SALINE. MOST FEEL THE URGE @ 120ML AND A STRON URGE @ 250ML. hOWEVER THE CLIENT WITH A NEUROGENIC BLADDER NEVER FEELS THE URGE OR ONLY AFTER 500ML OR MORE
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CYTOSCOPE & CYTOSCOPIC EXAMINATION (figure 57.5)
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IS A VISUAL EXAMINATION OF THE INSIDE OF THE BLADDER USING AN INSTRUMENT CALLED A CYTOSCOPE. tHE CYTOSCOPE CONSISTS OF A LIGHTED TUBE W/ A TELESCOPE LENS. IT IDENTIFIES THE CAUSE OF PAINLESS HEMATAURIA, URINARY INCONTINENCE, OR URINARY RETENTION.
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Intravenous Pyelogram (IVP)
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Is a RADIOLOGIC STUDY TO EVALUATE STRUCTURE AND FUNCTION OF THE KIDNEYS, URETERS, AND BLADDER. IT LOCATES URINARY TRACT OBSTRUCTIONS AND INVESTIGATES THE CAUSES OF FLANK PAIN, HEMATAURIA, OR RENAL COLIC. IT IS BASED ON THE ABILITY OF THE KIDNEYS TO EXCRETE A RADIOPAQUE DYE IN URINE.
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WHAT IS A NONIONIC CONTRAST MEDIUM ?
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ONE THAT DOES NOT CONTAIN IODINE
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POSTVOID RESIDUE
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THE AMOUNT OF URINE LEFT IN THE BLADDER AFTER VOIDING AND PROVIDES INFO @ BLADDER FUNCTION. NORMAL POSTVOID RESIDUAL IS 0-30 ML, BUT RETENTION OF UP TO 100ML MAY BE ACCEPTABLE IN THE OLDER ADULT.
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RENAL ARTERIOGRAM/RENAL ANGIOGRAM
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PROVIDES DETAILS OF ARTERIAL SUPPLY TO THE KIDNEYS, SPECIFICALLY THE LOCATION AND NUMBER OF RENAL ARTERIES (MULTIPLE VESSELS TO THE KIDNEYS ARE NOT UNUSUAL) AND PATENCY OF EACH RENAL ARTERY. A CATHETER IS PASSED UP THE FEMORAL ARTERY INTO THE AORTA TO THE LEVEL OF THE RENAL VESSELS. CONTRAST MEDIUM IS THEN INJECTED INTO THE CATHETER AND SERIAL X-RAYS ARE TAKEN. RADIOPAQUE DYE 1ST OUTLINES THE AORTA IN THE AREA OF THE RENAL ARTERY, THEN ENBTERS THE RENAL ARTERY AND THE KIDNEY. A SERIES OF X-RAYS ARE TAKEN. THIS PROCEDURE IS CONTRAINDICATED FOR THE CLIENT W/ ALLERGIES TO IODINE
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RETROGRADE PYELOGRAM
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MAY BE DONE FOR BETTER VISUALIZATION OF THE COMPLETE URETER & PELVIS.A FLEXIBLE RADIOPAQUE URETRAL CATHETER IS INSERTED IN EACH OF THE URETRAL ORIFICES (OPENING @ THE TERMINAL END OF THE URETER), WHICH LIE ON THE LOWER POSTERIOR WALL OF THE BLADDER. THIS IS DONE DURING A CYTOSCOPY.VISUALIZATION OF URETERS & RENAL PELVES IS POSSIBLE AFTER STERILE CONTRAST MEDIUM IS INSTILLED INTO THE RENAL COLLECTING SYSTEM. THIS PROCEDURE ALSO EVALUATES URETERAL STENT OR CATHETER PLACEMENT. RETROGRADE PYLEOGRAPHY CARRIES A RISK OF SEPSIS AND SEVERE UTINARY TRACT INFECTION !!!!!!!!!!
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WHAT IS GLOMERULAR FILTRATION ?
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Glomerular filtration involves the filtration of PLASMA BY THE GLOMERULUS. Filtered substances include: water, sodium chloride, bicarbonate, potassium, glucose, urea, creatinine, and uric acid. (8 total)
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tubular reabsorption
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the filtrate enters BOWMAN'S CAPSCULE and then moves through the tubular system of the nephron and is EITHER REABSORBED (placed back into the systemic circulation ) or excreted as urine.
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TUBULAR SECRETION
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FORMED URINE DRAINS FROM THE COLLECTING TUBULES, INTO THE RENAL PELVES, AND DOWN EACH URETER TO THE BLADDER.
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DOES THE FILTRATE THAT IS EXCRETED CONTAIN WATER ?
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YES, AS WELL AS; NACL, BICARBONATE, POTASSIUM, UREA, CREATININE, AND URIC ACID.
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ARE AMINO ACIDS & GLUCOSE ARE...TYPICALLY____________?
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Reabsorbed and NOT excreted in the urine.
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protein molecules (EXCEPT FOR PERIODIC SMALL AMOUNTS OF GLOBULINS & ALBUMIN, ARE ALSO REABSORBED
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are reabsorbed !!!!!!
otherwise you have proteinurea-NOT GOOD! |
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WHEN IS THE DESIRE TO URINATE FELT ?
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WHEN @ 150 ML OF URINE ARE ACCUMULATED.
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During urination, the bladder muscle CONTRACTS and SPHINCTER MUSCLES RELAX, forcing urine out of the bladder and the urethra through the urethral meatus. If there is any interference or ABNORMALITY OF THESES MUSCLES.......
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THE BLADDER MAY NOT EMPTY COMPLETELY OR EMPTY UNCONTROLLABLY ( INCONTINENCE)
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WHAT IS MEANT BY FREQUENCY ?
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~ Frequent voiding- MORE than every 3 hours
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urgency ?
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~ strong desire to void
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dysuria
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~ PAINFULL or difficult voiding
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enuresis ?
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involuntary voiding DURING SLEEP
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POLYURIA ?
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INCREASED VOLUME OF URINE VOIDED
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OLIGURIA ?
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URINE OUTPUT LESS THAN 400ML/DAY
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ANURIA
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` URINE OUTPUT LESS THAN 50ML/DAY
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PROTEINURIA
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ABNORMAL AMOUNTS OF PROTEIN IN THE URINE
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WHAT IS THE EFFECT OF ADH ON WATER RELEASE FROM THE KIDNEYS ?
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IF ADH IS HIGH-the kidneys REABSORB MORE WATER
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WHAT IS ANTIDIURETIC HORMONE (ADH)?
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THE MAJOR HORMONE THAT REGULATES WATER REABSORPTION IS ADH, WHICH OPERATES VIA NEGATIVE FEEDBACK!
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Would blood ADH level be higher or lower than normal in a person who has just completed a 5-km run without drinking any water?
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ADH WOULD INCREASE DUE TO LOSS OF H2O IN SWEAT !
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WHAT ARE DIURETICS?
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Diuretics are substances that SLOW REABSORPTION of water by the kidneys and therefore cause diuresis, an elevated urine flow rate.naturally occuring diuretics include; caffeine, tea, cola sodas, w/c INHIBITS NA+ REABSORPTION, ALCAHOL IN BEER, WINE, AND MIXED DRINKS, W/C INHIBITS SECRETION OF ADH.
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When ADH level DECLINES....?
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the water channels are removed from the membranes. The kidneys produce a LARGE VOLUME OF DILUTE URINE when ADH level is LOW !!!!!!
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where does ADH act in the urinary system?
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ADH acts on the tubule cells in the LAST part of the DISTAL CONVULUTED TUBULES AND THROUGHOUT THE COLLECTING DUCTS. IN THE ABSENCE OF ADH, THESE PARTS OF THER RENAL TUBULE HAVE A VERY LOW PERMEABILITY TO WATER. ADH INCREASES THE WATER PERMEABILITY OF THESE TUBULE CELLS BY CAUSING INSERTION OF proteins that funx
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