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48 Cards in this Set

  • Front
  • Back
The urinary system consists of two 1_____, two 2_____, the 3_____ 3_____, and the 4_____.
1 kidneys
2 ureters
3 urinary bladder
4 urethra
In addition to removing waste products from the blood, the kidneys also regulate:
1 blood volume
2 electrolyte balance
3 acid-base balance
4 tissue fluid
What are the two major parts of a nephron?
The renal corpuscle

The renal tubule
the process by which blood pressure forces plasma & dissolved materials out of capillaries
The formation of urine involves three major processes:
1 glomerular filtration
2 tubular reabsorption
3 tubular secretion
glomerular filtration rate (GFR)
amount of renal filtrate formed by the kidneys in one minute

averages 100 to 125 mL
tubular reabsorption
recovery of useful materials from renal filtrate & their return to the blood in the peritubular capillaries
What percentage of renal filtrate is retained in the body due to tubular reabsorption?
a. 75%
b. 89%
c. 90%
d. 99%
d. 99%

Approximately 99 percent of the renal filtrate formed is reabsorbed . . .
p 575
renal filtrate
end product of blood pressure forcing plasma, dissolved substances, & small proteins out of glomeruli & into Bowman's capsules

similar to blood plasma except far less protein & no blood cells present
Normal urinary output for a 24 hour period is:
a. 500 to 750 mL
b. 750 to 1500 mL
c. 1000 to 2000 mL
d. 2000 to 2500 mL
c. 1000 to 2000 mL

. . . and normal urinary output is 1000 to 2000 mL per 24 hours.
p 575
tubular secretion
substances actively secreted from blood in peritubular capillaries into filtrate in renal tubules
hormone secreted by kidneys during states of hypoxia

stimulates red bone marrow to increase rate of RBC production which then increase oxygen-carrying capacity of blood
Each ureter extends from the 1_____ of a kidney to the lower, posterior side of the 2_____ 2_____.
1 hilus
2 urinary bladder
What are the two functions of the urinary bladder?
1 storage of urine
2 elimination of urine
What is the function of the urethra?
The urethra carries urine from the bladder to the exterior.
The usual range of specific gravity of urine is 1_____ to 2_____; this is a measure of the 3_____ 3_____in urine. The 4_____ the specific gravity, the more that is present.
1 1.010
2 1.025
3 dissolved materials
4 higher
The pH range of urine is ___ to ___, with an average of ___.
a. 4.6 to 8.0; average of 6.0
b. 4.6 to 8.0; average of 6.5
c. 5.6 to 8.5; average of 6.0
d. 5.6 to 8.0; average of 6.0
a. 4.6 to 8.0; average of 6.0
Urine is approximately 1_____% water, which is the solvent for 2_____ 2_____ and 3____.
1 95%
2 waste products
3 salts
waste products building up in blood
uremic frost
crystals on the skin indicating waste products building up in blood

waste products are not filtered by kidneys so are coming out through skin
An 1_____ in blood pressure is commonly seen with renal disease. A 2_____ in blood pressure accompanied by a 3_____ in pulse rate as the patient rises to sitting or standing positions is called 4_____ or 5_____ hypotension and may indicate fluid deficit.
1 increase
2 drop
3 rise
4 orthostatic
5 postural
How do you locate your kidneys?
-> put your hands on your hips w/thumbs pointing back & upward

-> thumbs are now pointing to bottom of kidneys

-> known as the flank area & is location of flank pain
blood in urine
What are some S/S of illness detected in urine?

(four listed)
1 hematuria
2 cloudiness
3 foul odor
4 dark-amber color
gives information regarding kidney function & various body functions

commonly performed diagnostic test for renal system
What is the minimum amount of urine necessary to perform a urinalysis?
minimum of 10 mL
urine culture
determines number of bacteria present in urine & identifies organism causing infection in urine

urine should be collected before antibiotic treatment is begun

midstream clean-catch system used to obtain specimen
Generally, a bacterial count of _____ or more per milliliter of urine indicates a urinary tract infection.
a. 750,000
b. 500,000
c. 300,000
d. 100,000
d. 100,000 per milliliter
What is a method for quickly approximating kidney function?
-> equate the creatinine clearance result to % of renal function

-> ex: creatinine clearance of 100 mL/min = 100% renal function

-> ex: 30 mL/min = 30% renal function

-> ex: 5 mL/min = 5% renal function
serum creatinine test
measures waste product (present in blood) from muscle metabolism

normal: 0.6 to 1.5 mg/dL

higher creatinine level = greater kidney impairment
blood urea nitrogen (BUN) test
measures waste product of protein metabolism

normal: 8 to 25 mg/dL

numerous factors can affect results (kidneys, dehydration, high-protein diet, steroid use, and gastrointestinal bleeding)
uric acid test
measures end product of purine metabolism & breakdown of body proteins

normal: 2 to 7 mg/dL

can be affected by several factors (kidenys, gout, malnutrition, leukemia, thiazide diuretics)
creatinine clearance test
measures amount of creatinine cleared from blood in a specified period by comparing amount of creatinine in blood w/amount of creatinine in urine

test performed utilizing urine collected for 24 hours

results expressed in volume of blood cleared of creatinine in 1 min.

normal: 85 to 125 mL (min of 10 mL needed to survive w/o dialysis)
kidney-ureter-bladder (KUB)
x-ray exam of named structures
intravenous pyelogram (IVP)
radiopaque dye is injected into large vein and outlines renal structures for visualization

pt preps w/laxatives day prior to test & NPO after midnight
renal angiography
test to visualize renal arteries

femoral artery is pierced w/needle & catheter threaded through body to renal artery

contrast agent is injected to make renal areterial supply visible on x-ray

assists w/visualizing blood flow to kidneys

pt is NPO for 4-8 hours before & on bedrest for 12 hrs following w/head of bed not raised more than 45 degrees
cystoscopy and pyelogram (C& P)
minor surgical procedure involving fiberoptic instrument (cystoscope) inserted into bladder via urethra

pyelogram involves injecting dye into pelvis of kidney & radiographs are taken
What are four therapeutic interventions that can be done during a C&P?
1 removal of small bladder tumors
2 removal of stones from bladder
3 removal of stones from ureters
4 dilation of ureters
difficult/painful urination
done with a needle through the skin
renal biopsy
most are percutaneous

pt is NPO 6 to 8 hrs before

mild sedative given & local anesthetic used

pressure dressing applied to prevent bleeding

pt on bedrest for 24 hrs after
urinary incontinence
involuntary passing of urine
stress incontinence
involuntary loss of urine associated w/increasing abdominal pressure during coughing, sneezing, laughing, or other physical activities
urge incontinence
involuntary loss of urine associated w/abrupt & strong desire to void

pt often "unable" to make it to bathroom
functional incontinence
caused by chronic impairment of physical function or ability to think, leaving pt unable to get to toilet in time to maintain continence
total incontinence
continuous & unpredictable loss of urine

often pt is neurologically impaired

nurse's priority is keeping pt clean & dry
Normally the bladder contains less than 1_____ mL after urination. A residual volume of 2_____ to 2_____ mL of urine indicates the need for treatment for urinary retention.
1 50
2 150 to 200
What are two ways bacteria can enter the bladder of a pt w/an indwelling catheter?
1 through outlet at end of drainage bag

2 around catheter up the urethra & into bladder