Nursing 4Th- Renal System

Front 1

What is the best indicator of I & O?

Back 1

Daily Weight

Front 2

What are some of the main functions of the kidneys?

Back 2

regulate volume and composition of extracellular fluid
excretory function- waste
BP control
erythropoietin production
Vitamin D activation (synthesis of Vitamin D for calcium absorption and regulation of parathyroid hormones)
Acid-base balance regulation

Front 3

We take in about __ liters of fluid a day and our urine output is about ____ liters. We get rid of about ____ liters in insensible water loss.

Back 3

We take in about 2 liters of fluid a day and our urine output is about 1.5 liters. We get rid of about 0.5 liters in insensible water loss.

Front 4

Review basic urinary system Ch 45, diagnostic tests for urinary system p. 1114-1119 and in notes

Back 4

..
and check out this website
http://www.surgeryencyclopedia.com/St-Wr/Urinalysis.html#b

Front 5

Urine should contain....

Urine should NOT contain...

Back 5

Urine should contain....
water
urea
electrolytes: sodium, potassium, chloride, bicarbonate

Urine should NOT contain...
glucose
protein

(lecture)

Front 6

Normal urinalyisis

Back 6

Normal urine is a clear straw-colored liquid, but may also be slightly hazy. It has a slight odor, and some laboratories will note strong or atypical odors on the urinalysis report. A normal urine specimen may contain some normal crystals as well as squamous or transitional epithelial cells from the bladder, lower urinary tract, or vagina. Urine may contain transparent (hyaline) casts, especially if it was collected after vigorous exercise . The presence of hyaline casts may be a sign of kidney disease, however, when the cause cannot be attributed to exercise, running, or medications. Normal urine contains a small amount of urobilinogen, and may contain a few RBCs and WBCs. Normal urine does not contain detectable amounts of glucose or other sugars, protein, ketones, bilirubin, bacteria, yeast cells, or trichomonads. Normal values used in many laboratories are given below:

Glucose: negative (quantitative less than 130 mg/day or 30 mg/dL).
Bilirubin: negative (quantitative less than 0.02 mg/dL).
Ketones: negative (quantitative 0.5–3.0 mg/dL).
pH: 5.0–8.0.
Protein: negative (quantitative 15–150 mg/day, less than 10 mg/dL).
Blood: negative.
Nitrite: negative.
Specific gravity: 1.015–1.025.
Urobilinogen: 0–2 Ehrlich units (quantitative 0.3–1.0 Ehrlich units).
Leukocyte esterase: negative.
Red blood cells: 0–2 per high power field.
White blood cells: 0–5 per high power field (0–10 per high power field for some standardized systems).

Front 7

What is the most potent vasodilator in the body?

Back 7

angiotensin 2
(renin...angiotensin I --> angiotensin II)
...which is why we use ace inhibitors, lots of BP meds have to do with kidneys

Front 8

Describe normal bladder capacity in terms of urge to go, max capacity etc.

Back 8

200-250 ml feel urge to urinate,
moderate distention
400-600 ml uncomfortable, gotta go soon..
600-1000ml normal bladder capacity, really time to go!

Front 9

Any injury below what vertebrae(s) may effect bladder control?

Back 9

T11 -12
(double check this)

(Impulses to thoracolumbar T11- L2 and sacral S2-4 areas of spinal cord that control voiding)

Front 10

Review UTI

Back 10

p. 1122-27

Front 11

systemic infection arising from a urologic source

Back 11

urosepsis

Front 12

Acute pyelonephritis is an inflammation of the renal parenchyma and collecting system (including the renal pelvis) The most common culprit is bacterial infection, but can be due to other microorganisms. How does pyelonephritis usually begin? Who is at risk?

Back 12

Acute pyelonephritis is an inflammation of the renal parenchyma and collecting system (including the renal pelvis) The most common culprit is bacterial infection, but can be due to other microorganisms. Pyelonephritis usually begins with colonization and infection of the lower urinary tract via the ascending urethral route.

A preexisting factor in its development is often present, such as vesicoureteral reflux (retrograde or backward movement of urine from lower to upper urinary tract) or dysfunction of the lower urinary tract function such as obstruction from BPH, stricture, or a urinary stone. Overuse of urinary tract catheterization is a common cause of pyelonephritis and urosepsis.

One of the most important risk factors is pregnancy-induced physiologic changes in the urinary system.

Front 13

S/S of acute pyelonephritis

Back 13

vary from mild fatigue to suddden onset of chills, fever, vomiting, malaise, flank pain, and the LUTS characteristic of cystitis including dysuria, urgency, and frequency.
Costovertebral tenderness is typically present on the affected side. The clinical manifestations usually subside within a few days, even without specific therapy, but bacteruria and pyuria usually persist.

Front 14

• The amount of blood filtered by the glomeruli in a given time is termed the glomerular filtration rate (GFR). What is the normal rate?

Back 14

The normal GFR is about 125 ml/min.

Front 15

Antidiuretic hormone (ADH) is required for water ________. ________ acts on the distal tubule to cause reabsorption of Na+ and water. In exchange for Na+, potassium ions (K+) are excreted.

Back 15

Antidiuretic hormone (ADH) is required for water reabsorption. Aldosterone acts on the distal tubule to cause reabsorption of Na+ and water. In exchange for Na+, potassium ions (K+) are excreted.

Front 16

True or False: Acid-base regulation involves reabsorbing and conserving most of the bicarbonate (HCO3) and secreting excess H+.

Back 16

true