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101 Cards in this Set
- Front
- Back
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When does the micturition reflex kick in?
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at about 250 to 300 mL
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What part of the kidney contains the glomeruli?
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outer cortex
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What part of the kidney contains most of the tubules and collecting ducts?
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medulla
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What is the function of the proximal tubule?
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it reabsorbs water (without the stimulation of ADH)
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What is the function of the distal tubule?
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it reabsorbs water with stimulation from ADH
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What is the function of the loop of Henle?
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concentrates the urine
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What is the best indicator of kidney function?
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GFR - glomerular filtration rate
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What is the normal level of creatinine in the body?
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0.7 - 1.2 mg/dl
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What is the normal BUN in the body?
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10 - 20 mg/dl
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What is the normal pH of urine?
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5.0 - 6.5
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What is the normal specific gravity of urine?
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1.016 - 1.022
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What is the best indicator of kidney function BESIDES GFR?
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creatinine levels
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What happens to creatinine as GFR decreases?
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it increases
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What happens to BUN as GFR decreases?
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it increases
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What do you NOT want to see in a urinalysis?
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RBCs
protein glucose WBCs |
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What is the medical term for urination?
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micturition
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As far as endocrine function goes, the kidney regulates what 3 things?
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blood pressure (by secreting renin)
RBC production (by secreting erthyropoietin) calcium (by secreting 1,25-dihydrooxyvitamin D3) |
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What percentage of cardiac output goes to the kidneys?
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20-25%
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the movement of fluids/solutes from the tubules into the peritubular capillaries
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tubular reabsorption
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the movement of fluids/solutes from the peritubular capillaries into the tubules
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tubular secretion
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an interference with the flow of urine at any site along the urinary tract
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urinary tract obstruction
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What are some of the causes of urinary tract obstruction?
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tumors
edema trauma stones pregnancy benign prostatic hyperplasia carcinoma inflammation of GI tract |
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accumulation of urine in the ureter, causing an abnormal distention
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hydroureter
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enlargement of the renal pelvis and calyces
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hydronephrosis
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Complete obstruction of the urinary tract leads to ________?
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renal failure
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a mass of crystal, protein, or other substances that is a common cause of urinary tract obstruction in adults
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kidney stone (calculus)
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What is the most common type of kidney stone?
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calcium
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If your urine is basic, what kind of kidney stone are you at risk for?
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calcium
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If your urine is acidic, what kind of kidney stone are you at risk for?
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uric acid
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What is the hallmark symptom of kidney stones?
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PAIN!!
(in the flank and groin) |
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What are the principal components of treating a kidney stone?
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1. Pain management
2. Teach the patient to strain his urine to look for stone *Also, get him to drink plenty of water and increase dietary fiber. |
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procedure that is not as invasive as surgery
breaks up kidneys stone into a bunch of smaller pieces |
lithotripsy
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a functional UTO caused by an interruption of the nerve supply to the bladder caused by motor neuron lesions in the CNS or spinal cord
(paralysis of the bladder) |
neurogenic bladder
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What does neurogenic bladder often lead to?
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bladder infection
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What are the CM of neurogenic bladder?
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burning sensation
fever chills shivering |
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benign tumors that are uncommon
usually solid and small can become malignant so they are usually removed surgically |
renal adenomas
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the most common type of renal tumor
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renal cell carcinoma
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What is renal cell carcinoma often associated with?
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tobacco use
obesity analgesic use (overuse of pain meds) |
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What are the CM of renal cell carcinoma?
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often silent until it spreads
can cause symptoms of a UTI: flank pain hematuria fatigue weight loss anemia hypertension |
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Where does renal cell carcinoma metastasize to?
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liver
lungs lymph nodes |
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How is renal cell carcinoma treated?
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surgical removal of kidney (radical nephrectomy)
radiation chemotherapy |
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a test in which dye is injected and an x-ray is taken
can look for renal cell carcinoma |
intravenous pyelogram (IVP)
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Who is at the highest risk of developing bladder cancer?
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men who smoke or work in the chemical, rubber, or textile industries
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What are the CM of bladder cancer?
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hematuria
pelvic pain frequent urination |
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What test is used to diagnose bladder cancer?
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cystoscopy (camera looks at bladder)
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How is bladder cancer treated?
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surgery (removal of bladder)
laser chemotherapy |
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infection of the bladder, ususally by E. coli, staph, or pseudomonas
most common site of UTI |
cystitis
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What are the CM of cystitis?
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frequency
urgency dysuria suprapubic and low back pain hematuria cloudy urine flank pain |
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How is cystitis diagnosed?
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There must be 10,000 bacteria/ml of freshly voided urine.
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How is cystitis treated?
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antibiotics
follow-up UA |
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has the same S/S as cystitis but no bacteria shows up on a urine culture
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nonbacterial cystitis
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What are the 2 types of nonbacterial cystitis?
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urethral syndrome (acute)
interstitial cystitis (chronic) |
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infection of the renal pelvis and interstitium, usually by E. coli
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acute pyelonephritis
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What can cause acute pyelonephritis?
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reflux of urine from bladder or obstruction of flow
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What are the CM of acute pyelonephritis?
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fever
pain frequency dysuria N/V |
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How is acute pyelonephritis treated?
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antibiotics
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persistent infection of the renal pelvis and interstitium with scarring
usually related to an obstruction can progress to renal failure |
chronic pyelonephritis
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How is chronic pyelonephritis treated?
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antibiotics
remove the obstruction! |
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the urine in glomeruluar diseases associated with ___________ contain massive amounts of protein and lipids and either very little blood or no blood
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nephrotic sediment
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the urine in glomerular diseases associated with ______________ contain blood with red cell casts, white cell casts, and varying degrees of protein
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nephritic sediment
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What is the most common cause of end stage renal failure?
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glomerulonephritis
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What are the CM of glomerulonephritis?
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brown urine
proteinuria RBC casts fluid retention hypertension |
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associated with group A post-streptococcal infections (about 7-10 days later)
S/S = hematuria, proteinuria, decrased GFR, edema around the eyes |
acute glomerulonephritis
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What is a type of acute glomerulonephritis?
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Goodpasture syndrome
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antibody formation against the lungs and kidneys
occurs in young people causes chronic kidney disease highly associated with smoking |
Goodpasture syndrome
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What two major changes in the urine are distinctive of chronic glomerulonephritis?
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1. hematuria with red cell casts
2. proteinuria exceeding 3-5 g/day (mainly albumin) |
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What age group is acute glomerulonephritis most prevalent in?
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children
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excretion of 3.5 or more grams of protein in the urine per day along with hypoalbuminemia, edema, hyperlipidemia, and lipiduria
also associated with certain drugs, infections, malignancies, and disorders such as diabetes and lupus |
nephrotic syndrome
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What are the CM of nephrotic syndrome?
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proteinuria
edema may be the first symptom |
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How is nephrotic syndrome treated?
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Replace albumin
Low-fat/normal protein diet Salt restriction Diuertics |
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What is the most common cause of end stage renal failure?
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glomerulonephritis
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What are the CM of glomerulonephritis?
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brown urine
proteinuria RBC casts fluid retention hypertension |
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associated with group A post-streptococcal infections (about 7-10 days later)
S/S = hematuria, proteinuria, decrased GFR, edema around the eyes |
acute glomerulonephritis
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What is a type of acute glomerulonephritis?
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Goodpasture syndrome
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antibody formation against the lungs and kidneys
occurs in young people causes chronic kidney disease highly associated with smoking |
Goodpasture syndrome
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What two major changes in the urine are distinctive of chronic glomerulonephritis?
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1. hematuria with red cell casts
2. proteinuria exceeding 3-5 g/day (mainly albumin) |
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What age group is acute glomerulonephritis most prevalent in?
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children
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excretion of 3.5 or more grams of protein in the urine per day along with hypoalbuminemia, edema, hyperlipidemia, and lipiduria
also associated with certain drugs, infections, malignancies, and disorders such as diabetes and lupus |
nephrotic syndrome
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What are the CM of nephrotic syndrome?
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proteinuria
edema may be the first symptom |
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How is nephrotic syndrome treated?
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Replace albumin
Low-fat/normal protein diet Salt restriction Diuertics |
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a decline in renal function to about 25% of normal or a GFR of 25 to 30 ml/min
levels of serum creatinine and urea are mildly elevated |
renal insufficiency
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a significant loss of renal function
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renal failure
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term used when less than 10% of renal function remains
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end-stage renal failure (ESRF)
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a syndrome of renal failure
includes elevated BUN and creatinine levels, N/V, pruritis, and neurologic changes |
uremia
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increased urea levels and often increased creatinine levels as well
caused by renal insufficiency or renal failure |
azotemia
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term to describe when you are still putting out urine, but it's not concentrated enough
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nonoliguric failure
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an abrupt reduction in renal function with elevation of BUN and creatinine levels
often reversible if diagnosed and treated early |
acute renal failure
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What are the 3 stages of acute renal failure?
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1. Oliguria (1-3 weeks)
- increased BUN - edema - high potassium 2. Diuresis - urine volume picks up - slight improvement in BUN and creatinine levels - Watch out for electrolyte imbalance 3. Recovery (up to 1 yr) - Urine output normal - BUN and creatinine normal |
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What is the diagnostic criteria for oliguria?
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urine output is less than 30 cc/hr or 400 cc/day
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What are the 3 causes of renal failure?
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1. prerenal
- problem before blood gets to the kidneys - hypotension, hypovolemia 2. intrarenal - something wrong in the kidney - glomerulonephritis 3. postrenal - something wrong past the kidney - trauma to ureters or bladder, obstruction |
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What is involved in treating acute renal failure?
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The main goal is to prevent death. This is done by:
managing fluid and electrolytes treating infections maintaining nutrition dialysis |
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a progressive and irreversible loss of renal function
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chronic renal failure
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What are the CM of chronic renal failure?
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Described using the term uremia:
hypertension anorexia N/V diarrhea weight loss pruritis edema anemia neurologic changes |
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How is chronic renal failure treated?
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diet management
sodium and fluid regulation potassium restrictions adequate caloric intake erythropoietin (to treat anemia) |
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a congenital condition in which the urethral meatus can be located anywhere on the ventral surface of the glans, the penile shaft, the midline of the scrotum, or the perineum.
It may be caused by defects in testosterone synthesis or environmental factors. It may be accompanied by penile torsion (rotation of the shaft). Treatment involves corrective surgery. |
hypospadias
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congenital condition in which the urethral opening is located on the dorsal surface of the penis
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epispadias
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the failure of a kidney to grow or develop
may be unilateral or bilateral and may occur as an isolated entity or in association with other disorders |
renal agenesis
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a rare embryonoal tumor of the kidney
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Wilms tumor (nephroblastoma)
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What are the CM of Wilms tumor?
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lacking the iris in the eye
horseshoe-shaped kidney hypospadias polycystic kidney disease (fluid filled sacs all over kidney) |
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the child has never been continent
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primary enuresis
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the child became continent but lost control 6 months to 1 year later
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secondary enuresis
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