| A | B |
|---|
| kidney produces 3 | renin for BP, erythropietin for RBC, Vit D |
| 3 steps in urine formation | glomerular filteration, tubular reabsorb, tubular secretion |
| glomerular filtration what is it | filtration of plasma |
| tubular reabsorption | placed back n 2 the systemic circulation |
| tubular secretion | what you get rid of |
| reabsorbed items | amino acids, glucose, protein |
| transient proteinuria in a small amout | not considered a problem less 150mg/dl |
| desire to void when | nerve reflex is triggered - 150 ml |
| cystoscopy | visual exam of bladder |
| cystoscopy used to identify (3) | painless hematuria, incontinence, retention |
| intravenous pyelogram | xray study - dye used - assess structure & funct kidney, ureters, bladder |
| biopsy of urinary tract when obtained | during cystoscopy |
| big risk for renal biopsy | bleeding - 25% cardiac output |
| severe pain in __ __ __ can indicate bleeding | back shoulder abdomen |
| bladder holds how many ml | 500 |
| BUN normals | 7-20 mg |
| creatinine normals | .06-1.5 |
| elevations in both BUN and creatinine mean | kidney dysfunction |
| glomerulonephritis is | inflammation but noninfectious w/widespread kidney damage |
| one major s/s of glomerulonephritis is | big eyes - periorbital edema |
| BUN and Creatine both have to go up to | be renal issue |
| disease that accounts for 40% of all dialysis | glomerulonephritis |
| ARF - three categories | prerenal, intrarenal, postrenal disorders |
| hormone produced by kidney | erythropoietin |
| erythropoietin is needed for | red blood cell production |
| pacer maker of the bladder | sacral nerve |
| autoimmune is | systematic - thruout entire body |
| bladder stones report immediately | gross hematuria |
| cystoscopy is | visualize inside of bladder using scope |
| specific gravity in urine | 1.003 - 1.029 |
| pH | 4.5 -7.5 |
| potassium | 3.5 -5 |
| what is in urine | water sodium chloride, bicarbonate potassium urea creatinine uric acid |
| urine specific gravity | measures kidneys ability to concentrate and excrete urine |
| urine specific gravity how measured | density of urine compared to density of distilled water |
| urine protein - to identify what | renal disease - protein is minimal in urine |
| creatinine is | substance result from break down of amino acid waste |
| why blood chemistry | when nephrons fail to remove wast products, ALL blood chemistry will be altered |
| most common urologic disorders | infectious and inflammatory |
| pyelonephritis | bacterial infect of kidney and lining |
| pyelonephritis acute v chronic | acute - kidneys large - chronic kidneys small |
| polyuria and nocturia develop when | tubules of nephrons fail to reabsorb water efficiently |
| what causes acute glomerulonephritis | upper R infect, STREP, impetigo mumps, HebB |
| chronic glomerulonephritis is ____ damage | irreversible to nephrons |
| treatment for chronic glomeru | bedrest, sodium restrict, antibotics, vit & iron - dylasis |
| generalized edema is called | anascara |
| why do you have low RBC | excretion of erythrocytes - |
| urolithiasis | condition of stones |
| causes of stones | increase calicum in urine, dehydrate, UTI, obstructive etc |
| drainage of urine from kidney is done when | post surigical - from obstruction - uses nephrostome tube |
| diet recommendation to prevent stones | reduce - protein, sodium - do not limit calcium |
| 2 types of renal failure | ARF - CRF |
| 4 phases of ARF | initiation, oliguric, diuretic, recovery |
| most common type of renal failure | acute |
| initation phase | starts w/onset with decreased blood flow |
| oliguric phase | less than adequate urinary volume |
| fluid volume excess leads to | edema |
| diuretic phase | begins as nehrons recover |
| recovery phase | glomerular filtration function retored 1 or more years |
| CRF is usually associated with | intrarenal conditions - lupus, diabetes |
| 3 stages of CRF | reduced renal reserve, renal insufficiency, end stage |
| end stage the skin becomes | uremicfrost - sub the kidneys secrete come out skin |
| ARF - 3 types | prerenal, intrrenal, postrenal |
| most common causes of ARF - prerenal | fluid volume loss - surgery, trauma, burns HF sepsis |
| intrarenal is what | conditions w/n kidney itself that destroys nephrons |
| postrenal is | obstructive problems below kidneys - stones, tumor prostate, foley |
| S/S for both ARF and CRF | high BP, wt gain, low urine output |
| S/S for CRF | face puffy, pale, ulcerations/bleeding GI, pruritus, dry scaly skin, oral mucus bleed |
| azotemia | both BUN and creatinine are elevated |
| CRF electrolyte imbalance | hypoatremia, hyperkalemia, hypermagnesima, hypocalcima |
| CRF - fluid volume and BP | renin released then angiotensin is converted by renin, BP and thirst |
| aldosterone is a | volume regulator - released in response to renin |
| osteodystophy | bones become demineralized because of vit K |
| dopamine | low doses increase renal profusion |
| renagel | GIVE WITH FOOD - binds to phosphorus in GI tract |
| epogen | stimulates RBC |
| dialysis - what is it | procedure for cleaning and filtering blood |
| dialysate - what is it | solution used during dialysis |
| hemodialysis | transporting blood from pt thru dialyzer |
| 2 ways for hemodialysis | arteriovenous fistula or graft |
| arteriovenous fistula | vessels joined - better patent w/few complications |
| arteriovenous graft | uses tube of synthetic material - connect vein & artery in upper arm or leg |
| nursing management dialysis | s/s over fistula infection, color nail beds, wash skin, avoid puncture to same site |
| most important nursing management dialysis | palpate for THRILL, BRUIT - NO INJECTIONS 2 hrs after |
| teaching hemodialysis | no carry heavy objects, loose sleeve clothes, sleep, no BP or punctures on side |
| what should dialysis pt do daily | wash site, listen for thrill and bruit |
| peritoneal dialysis | uses peritoneum, osmotic effect - drained by cath |
| peritoneal dialysis RISKS | peritonitis - s/s acute pain, rigid board like abd, fever |
| all renal pt need strict ___ and ___ | I&O and daily weight |
