chapter 36 for cathey exam 1

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What is the main function of the urinary system?

Production of erythropoietin
Regulation of electrolyte balance
Regulation of blood pressure
Removal of toxic waste. Regulation of blood volume, pressure, and composition Regulation of the acid-base balance of the blood Regulation of Electrolyte Balance Production of erythropoietin Activation of vitamin D 2 (correct)

What is the function of the ureters

Eliminates waste products from the body
Reservoir for urine
Carry Urine from Kidneys to Bladder – Narrow point where each ureter joins the renal pelvis is the uretropelvic junction (UPJ) – Point where each ureter inserts in the side of the bladder base is the ureterovesical junction (UVJ) (correct)
Point where each ureter inserts in the side of the bladder base

What controls voiding in the urethra? and its functions

Afferent arteriole
Carry urine from bladder to outside of body • Controls voiding via internal and external sphincters Length • Female: 1-2 inches • Male: 8-10 inches (correct)
Renal vein
Internal sphincter

what is the elctrolyte balance

blood k level rises--aldosterone released from adrenal cortex---aldosterone targets kidneys--k release falls---blood na/K levels normalize (C) Signup and view all the answers

Which part of the urinary system serves as a reservoir for urine?

Urinary bladder-----Eliminates waste products from the body (B) Signup and view all the answers

Where is the urethral meatus positioned in hypospadias?

Congenital malformation of male urethra • Hypospadias- urethral meatus is abnormally positioned somewhere on the ventral (underside) surface of penis • Epispadias- urethral meatus is positioned on dorsal surface/top of penis (B) Signup and view all the answers

In epispadias, where is the urethral meatus located?

On the dorsal surface of the penis (B) Signup and view all the answers

What is the normal range for glomerular filtration rate (GFR)?

125mL/minute and egfr is 60ml/min1.73 m2 (A) Signup and view all the answers

Which of the following substances normally filters into urine during glomerular filtration?

potassium, hydrogen ions (H+), ammonia (C) Signup and view all the answers

What is the specific gravity range considered normal in urinalysis?

1.005 to 1.030 (D) Signup and view all the answers

What does not cross into tubules in normal GFR

blood cells, platelets, protein (A) Signup and view all the answers

In a clean catch specimen for urinalysis, what is the correct procedure after initially voiding in the toilet?

Void into a sterile cup immediately after initial voiding..........Urinalysis – Common Test – Voided or Sterile Catheter Specimen – Clean Catch Specimen – clean urethral area, void small amount in toilet, then void in sterile cup (D) Signup and view all the answers

What is reabsorbed into the blood during normal GFR

• Water • Sodium • Chloride • Calcium • Bicarb (HCO3) (D) Signup and view all the answers

Lab tests of urinalysis

color-• Pale yellow • Dark Amber • Brown/green • Orange • Red/pink • Smoky Clarity • Clear • Cloudy Specific Gravity • 1.005 to 1.03..... pH 4.5 to 8.0 ..........Protein0-8 mg/dL • 24 hour: 30-150 mg/dL......... Glucose None ........Ketones None .........Bilirubin None ........Nitrites None ........Leukocytes None......... Red Blood Cells less than 5.....White Blood Cells less than 5.......... Casts None to rare (B) Signup and view all the answers

What is considered a normal specific gravity range in urinalysis?

1.005 to 1.03 (A) Signup and view all the answers

What is the culture and sensitivity test

Identifies – number of bacteria or yeast in urine – Causative organism of urinary tract infection – Most effective medication use • Normal Value – Negative: None. – Positive: 100,000 or more/mL of urine................must collect before antibiotics (D) Signup and view all the answers

What are renal function test

Renal Function Tests – Serum Creatinine- 0.6-1.2 – Blood Urea Nitrogen (BUN)- 10-20 – Creatinine Clearance Test- 85-135 (24-hour urine) – Estimated Glomerular Filtration Rate (eGFR)- >60 (A) Signup and view all the answers

What is a potential cause of contrast-induced nephropathy?

Caused by IV or oral contrast dye for CT or MRI Nephrotoxic Causes contrast-induced nephropathy Decline in renal function as shown by a rise in serum creatinine Risk Factors: • azotemia, • diabetes mellitus associated renal impairment (D) Signup and view all the answers

What is the purpose of an Intravenous Pyelogram (IVP) in radiologic studies?

Intravenous Contrast Media Injected – Contrast Media Outlines Renal Structures – Check Allergies – Monitor creatinine level – Hydration Before and After (D) Signup and view all the answers

What are pediatric considerations

Incontinence – Diapers • Potty training – Ineffective control • Hygiene – Improper wiping • Irritants- bubble bath, baby powder, etc. (D) Signup and view all the answers

What does a Kidneys-Ureter-Bladder (KUB) X-ray primarily show in pediatric radiologic studies?

Kidneys-Ureter-Bladder (KUB) XR • Will show: – Tumors – Swollen Kidneys – Kidney Stones (A) Signup and view all the answers

What are renal diagnostic test

Cystoscopy – Endoscopy through urethra to visualize bladder and/or collect specimens • Renal US • Renal biopsy – Pre/Post-op care same as any minor procedure (D) Signup and view all the answers

What type of urinary incontinence is characterized by involuntary urine loss with abrupt/strong desire to void?

Urge incontinence-----Involuntary Urine Loss with Abrupt/Strong Desire to Void – Most common in older adults – Can’t make it to the bathroom in time------------------------------------------------------Stress Incontinence – Involuntary Urine Loss from Increasing Abdominal Pressure – Occurs after sneezing, laughing, coughing – Most common in women after childbirth (A) Signup and view all the answers

Which type of urinary incontinence is linked to impairment of physical or mental function rather than a problem with the urinary system itself?

Functional incontinence------From Impairment of Physical/Mental Function (B) Signup and view all the answers

What type of urinary incontinence involves involuntary loss of urine associated with bladder overdistention?

Overflow incontinence------------Involuntary Loss of Urine Associated with Bladder Overdistention • Usually associated with urinary retention r/t SCI or enlarged prostate • “Dribbling (A) Signup and view all the answers

Which condition is characterized by continuous, unpredictable loss of urine?

Total incontinence---------Continuous, Unpredictable Loss of Urine (D) Signup and view all the answers

What is the common symptom associated with urinary retention regarding bladder distention?

Suprapubic tenderness (B) Signup and view all the answers

Urinary retention UOP

oliguria and anuria (A) Signup and view all the answers

Baldder distension in urinary retention

palpable over suprapubic firm (C) Signup and view all the answers

What is the primary use of bladder scan

normal residual volume is 50mL, residual volume of 150 to 200mL urine indicates need for further treatment (C) Signup and view all the answers

What is treatment for urinary retention

treatment is generally urinary catheterization that can be temporary or long term------------------------------------------------URINARY CATHETER S • Indwelling (Foley) – Needs justification for insertion and removal as soon as medically able – CAUTI protocol to prevent UTI – Sterile insertion – if not done correctly bacteria is introduced and will cause UTI in patient – Incontinence is NOT a reason for an indwelling catheter (C) Signup and view all the answers

What is a never event for catheter associated urinary tract infections (CAUTI)

Guidelines for Care of the patient with an indwelling urinary catheter – Maintain a closed system – Secure the catheter with tape or fastener – Encourage fluid consumption – Use aseptic technique when emptying collection bag – Wash perineum with soap and water daily and after BM – Keep tubing coiled on the bed and positioned for free flow of urine – Do not clamp catheters – Remove indwelling catheters as soon as possible (A) Signup and view all the answers

What is the recommended frequency for performing intermittent catheterization?

Every 3 hours (B) Signup and view all the answers

More info about urinary catheters

Intermittent catheterization – Best for pt who is unable to void r/t retention (BPH) or neurological condition (SCI) – Usually performed every 3 hours – Pts can be taught to self-catheterize at home (A) Signup and view all the answers

More urnary catheters

uprapubic catheter – Inserted ONLY by physician – If pulled out, short time frame for MD to reinsert 37 (A) Signup and view all the answers