Glossary of Renal System KSU-Nursing
Created by opalkakl
- How does aging affect the renal system?
- -kindeys shrink
-kidneys progressively lose function
- how do nutritional changes affect the renal system?
- -ingestion of protein causes progressive damange to the glomeruli
- what percentage of nephrons are housed in the cortex?
- what percentage of nephrons are housed in the medulla?
- What is the function of the cortex?
- extretory and regulates eletrolytes
- what is the function of the medulla?
- concentrates and dilutes.
- what does the afferent arteriole do?
- supplies the glomerulus with blood
- what does the efferent arteriole do?
- drains blood from the glomerulus
- what is the bowman's campsule?
- responsible for formation of the ultrafiltrate from blood
- where the filtering takes place
- what is absorbed in the proximal tubule?
- 65% of the H2O is absorbed here. reabsorbs Na, Cl, K, bicarb, glucose, urea, and amino acids
- when glucose is above 300 what occurs?
- the glucose will spill out into the urine
- what determines the rate of blood flow through the glomerulus?
- blood pressure
- what is a normal GFR?
- 125 ml/min
- define GFR
- the volume of plasma filtered from the glomerular capillaries into Bowmans capsule each minute.
- what affects GFR?
- -renal blood flow
-permeability of glomerular membrane
-# of working nephrons
-resin and angiotensin system
- what eletrolytes are regulated by the kidney?
- K, Ca, Mg, Na, Cl
- What are the functions of the kidney?
- -fluid and electrolyte regulation
-acid base balance
-excretion of wastes
-regulation of BP (by resin andgiotensin system)
-stimulation of RBC production
- what does a elevated serum creatinine mean?
- kidneys are not working correctly.
- why should patients not been given Mg or K if their kidneys are failing?
- Because they cannot filter and excrete them properly so they can build up in the body.
- what are some functions of the kidney?
- -regulation of calcium and phosphorus
-excretion of foreign chemicals
-vitamin D metabolism
- describe the renin angitensin system
- low bp via afferent vessels cause the kidneys to release renin which turns angioteninogen into angiotensin I and angiotensin I is converted to angiotensin II via angiotensinase which causes aldosterone to be released from adrenal cortex. This causes the increase of BP by vessel contriction and aldosterone stimulates the kidneys to absorb more Na and water which raises BP.
- Where do Sartins function in the renin-angiotensin system?
- sartins stop angiotensin II from releasing aldosterone.
- where do ACE inhibitors function in the renin-angiotensin system?
- ACE inhibitors inhibit the enzyme that turns angiotensin I to angiotensin II.
- How do you do a 24 hour creatinine test?
- collect urine for 24 hours. make sure you throw the first urine sample away and collect the rest of the urine for 24 hours and put on ice. draw serum creatinine to determine GFR
- what happens to the hgb and hct when the kidneys are not functioning correctly?
- the Hgb and Hct will be decreased because the kidneys are not producing eyrthopoieten which triggers the bone marrow to make RBCs
- What information do you get from an urinalysis?
-ketones (glucose >240)
- what is cystitis?
- inflammation of the lining of the urinary tract caused by bacteria, usually E.coli (80%)
also called a UTI
- what are some causes for cystitis?
-poor perineal hygiene
- what are the symptoms of cystitis?
- what is stress incontinence?
- the involuntary loss of urine during activities that increase abdominal and detrusor pressure
causes: sneeze, cough, laugh
- urge incontinence
- the involuntary loss of urine associated with a strong desire to urinate
causes: bladder or spinal cord lesion
- overflow urinary incontinence
- the involuntary loss of urine associated with over distension of the bladder when the bladder's capacity has reached it maximum.
causes: patients with neurogenic bladder or enlarged prostate
- functional incontinence
- when a person cannot physically get to the bathroom.
causes: broken hip or knee or leg.
- drug incontinence
- occurs when a patient is on a certain drug such as
alpha adrenergic blockers
- what is glomerulonephritis?
- inflammation and increased cells in the glomeruli in both kidneys caused by an immunologic response
can be acute or chronic
usually caused by the strep bacteria
- acute symptoms of glomerulonephritis
- -hx of strep infection
-fever, chills, nausea, vomiting, anorexia
- chronic symptoms of glomerulonephritis
-headache in the morning
-manifestations of CHF
-metallic taste in mouth
- Diagnosis of Glomerulonephritis
- -Urine analysis
-decreased Hgb and Hct
-increased BUN and CR
-increased specific gravity
-positive for strep
-decreased urine output
- what is pyelonephritis?
- bacterial infection of the renal pelvis, tubules, and interstitial tissues in the kidney.
usually caused by E.coli
can be acute or chronic
nephrons are replaced by scar tissue
- risk factors for pyelonephritis
- -ecoli infection (primary rx)
- acute symptoms of pyelonephritis
- -enlarged kidneys
-accumulation of polymorphonuclear lymphocytes
-cloudy, blood, foul smelling (dead fish) urine
-tenderness, colicky pain
- chronic symptoms of pyelonephritis
- -may have no symptoms
-may be discovered by HTN
- what is urolithiasis?
- urinary calculi- presence of a stone anywhere in the urinary tract. stones may be composed of
- risk factors of urolithiasis
- -men 30-50 years of age
-livinig in the stone belt
-high diet in purines
-hx of female genitalia mutilation
-medications (ie. Ca supplements)
- signs and symptoms of urolithiasis
- why should you use a thiazide diuretic for kidney stones?
- because it gets rid of excess calcium.
- what are some risk factors for bladder tumors?
- -tobacco use
-toxins in environment esp work related
-most sommon cancer in males
-usually >60 yrs age
- what are the signs and symptoms of bladder tumor?
- -painless hematuria
-frequency, urgency, dysuria
-changes in voiding patterns
- risk factors for renal tumors
- -develop in tissues that collect urine
-associated with bladder cancer
-90% develop in surface lining cells
-more likely in white males 60-70 yrs old
-over use of analgesics
-recurrent kidney stones
- signs and symptoms of renal tumors
- -bladder irritation
-palpable abd mass
- what is a cutaneous ureterostomy?
- ureters are brought out to skin in one or more stomas
- what is a ileal conduit?
- most common and permanent
ileum with a blood supply acts as a reservior as urine flows freely through a stoma to a pouch
- what is a continent urostomy?
- ureters drain into a reservoir that has a valves stoma and the stoma is cathed to remove urine
- what is benign protatic hyperplasia? (BPH)
- enlargement of the prostate gland.
- what is the Prostate specific antigen assay? (PSA)
- this is a test for prostate cancer. if the levels are >4 the chances of the male having prostate cancer is great.
- what causes BPH?
- testosterone causes the prostate tissues to enlarge
- what medicine is usually given to BPH patients to help them urinate?
- alpha adrenergic blockers are given to male patients to help relax smooth muscle of bladder
- what is the number one killing cancer in men and women?
- lung cancer
- what is the most common cancer in men?
- prostate cancer
- What is Acute renal failure?
- -sudden onset, but reversible
-oliguria, nonoliguria and azotemia
-goal is to keep patients alive until the lesions on the kidney heal.
- what is chronic renal failure?
- -slow progression
- what level of GFR is when you need dialysis?
- What are the symptoms during stage 1 and 2 renal failure?
- BUN and creatinine may be normal or slightly high
patient is asymptomatic
- what are the symptoms are stages 3 and 4 in chronic renal failure?
- >75% of renal tissue is dstroyed
GFR is decreased
may have anemia
decreased Hgb and Hct
azotemia is mild
nocturia and polyuria
- what symptoms occur in stage 5 renal failure?
- the nephrons of the kidney do not work
patient needs dialysis or transplant to live
- what is the renal diet?
- fluid restriction 1000-1500cc per day
low protein diet 60-80 grams if in early stage CRF
high protein if in ESRD
low potassium (60mEq)
low sodium (2gms)
- what are some high food sources of K?
- salt substitutes
dried beans and lentils
nuts, chocolate, coconut
- what are some high food sources of phosphorous?
chicken an beef liver
whoel grain breads and cereals
- what is the purpose of dialysis?
- removes excess fluid
replenishes bicabonate levels
removes end product of protein metabolism
maintain safe concentration of serum electrolytes
- complications of dialysis
- what is an AV fistula?
- -an internal anastomosis of an artery and vein
-located in the forearm, upper arm, upper thigh
-initial use 8-12 weeks after surgery
- what is a AV graft?
- synthetic vessel tubing tunneled beneath the skin connecting a artery to a vein.
located forearm, upper arm, or inner thigh
intial use can be as early as 1-2 weeks but generally 4-6 weeks
some patient may be able to use immediately after surgery
- what is a dual lumen hemodialysis catheter?
- only use temporarily
can use immediately after placement
should not be used for more than 14 days
locared in the subclavian, internal jugular, or femoral vein
if put in the femoral vein patient cannot be sitting
not very pliable
no cuff to prevent bacterial travel
- what is peritoneal dialysis?
- the dialyzing fluid is instilled intot he peritoneal cavity via a catheter placed in the abdomen using the peritoneum as the dialyzing membrane
- what is continuous ambulatory peritoneal dialysis? (CAPD)
- no machine needed
done 4 times a day
- what is continuous cycle peritoneal dialysis? (CCPD)
- a cycling machine is neede3 cycles are done at night
- what are complications to peritoneal dialysis?
- what are contraindications for peritoneal dialysis?
hx of ruptered diverticula
multiple abdominal surgeries with scar tissue
You must Login or Register to add cards