Podcast
Questions and Answers
What does a protein level greater than 0.15g/day in urine indicate?
What does a protein level greater than 0.15g/day in urine indicate?
Which of the following conditions is indicated by the presence of glucose in urine?
Which of the following conditions is indicated by the presence of glucose in urine?
What is the normal range for Creatinine levels in blood?
What is the normal range for Creatinine levels in blood?
What role do stretch receptors in the bladder play during the micturition reflex?
What role do stretch receptors in the bladder play during the micturition reflex?
Signup and view all the answers
Which electrolyte is often the first to become abnormal in kidney function tests?
Which electrolyte is often the first to become abnormal in kidney function tests?
Signup and view all the answers
What is the normal range for the Glomerular Filtration Rate (GFR)?
What is the normal range for the Glomerular Filtration Rate (GFR)?
Signup and view all the answers
What happens to the internal sphincter during the micturition reflex?
What happens to the internal sphincter during the micturition reflex?
Signup and view all the answers
What is the significance of finding leukocytes in urine analysis?
What is the significance of finding leukocytes in urine analysis?
Signup and view all the answers
What is a primary consequence of acute kidney injury (AKI)?
What is a primary consequence of acute kidney injury (AKI)?
Signup and view all the answers
What is oliguria defined as in acute kidney failure?
What is oliguria defined as in acute kidney failure?
Signup and view all the answers
Which of the following is NOT a common cause of acute kidney injury?
Which of the following is NOT a common cause of acute kidney injury?
Signup and view all the answers
What dietary intervention is recommended for patients with acute kidney injury?
What dietary intervention is recommended for patients with acute kidney injury?
Signup and view all the answers
What condition can result from prolonged urinary blockage?
What condition can result from prolonged urinary blockage?
Signup and view all the answers
What is the most common component of kidney stones?
What is the most common component of kidney stones?
Signup and view all the answers
Which clinical sign is commonly associated with the presence of kidney stones?
Which clinical sign is commonly associated with the presence of kidney stones?
Signup and view all the answers
Which of the following is a non-surgical treatment for kidney stones?
Which of the following is a non-surgical treatment for kidney stones?
Signup and view all the answers
What should be monitored closely after lithotripsy procedures?
What should be monitored closely after lithotripsy procedures?
Signup and view all the answers
What dietary factor increases the risk of developing kidney stones?
What dietary factor increases the risk of developing kidney stones?
Signup and view all the answers
What triggers the release of urine?
What triggers the release of urine?
Signup and view all the answers
Which type of glomerulonephritis develops gradually over time?
Which type of glomerulonephritis develops gradually over time?
Signup and view all the answers
How does urinary stasis in the bladder affect health?
How does urinary stasis in the bladder affect health?
Signup and view all the answers
What is a significant result of decreased renal perfusion?
What is a significant result of decreased renal perfusion?
Signup and view all the answers
Which condition is associated with injuries to neurons in the spinal cord?
Which condition is associated with injuries to neurons in the spinal cord?
Signup and view all the answers
What impact does increased fluid intake have on urine production?
What impact does increased fluid intake have on urine production?
Signup and view all the answers
What measurement serves as an indicator of decreased renal function?
What measurement serves as an indicator of decreased renal function?
Signup and view all the answers
Which factor does NOT impact urinary motility?
Which factor does NOT impact urinary motility?
Signup and view all the answers
What is the primary function of the renal system?
What is the primary function of the renal system?
Signup and view all the answers
Which substances are typically filtered in the glomerulus?
Which substances are typically filtered in the glomerulus?
Signup and view all the answers
In which part of the nephron does most reabsorption of sodium occur?
In which part of the nephron does most reabsorption of sodium occur?
Signup and view all the answers
How does active transport in the nephron differ from passive transport?
How does active transport in the nephron differ from passive transport?
Signup and view all the answers
What role does aldosterone play in the urinary system?
What role does aldosterone play in the urinary system?
Signup and view all the answers
Which process allows water to pass through cell membranes based on concentration gradients?
Which process allows water to pass through cell membranes based on concentration gradients?
Signup and view all the answers
What is the end product of the filtration and reabsorption processes in the nephron?
What is the end product of the filtration and reabsorption processes in the nephron?
Signup and view all the answers
What influences water reabsorption in the collecting duct?
What influences water reabsorption in the collecting duct?
Signup and view all the answers
What is the primary component of macroscopic urine analysis?
What is the primary component of macroscopic urine analysis?
Signup and view all the answers
Which of these mechanisms describes the movement of particles from an area of high concentration to an area of low concentration?
Which of these mechanisms describes the movement of particles from an area of high concentration to an area of low concentration?
Signup and view all the answers
Study Notes
Altered Elimination Module 1
- Elimination processes are vital for maintaining homeostasis by removing waste products from the body.
- This module reviews the impact of altered urinary and gastrointestinal processes.
- A YouTube video link is provided for further information: https://www.youtube.com/watch?v=QV1Y
- The renal system is crucial for managing body fluid balance, blood pressure, and eliminating metabolic waste.
- The renal system produces erythropoietin for red blood cell production, renin for fluid and blood pressure balance, and vitamin D for calcium absorption.
- A YouTube video link is provided for further renal system information; https://www.youtube.com/watch?v=H2VkW9L5QSU (6.)
Renal System
- The nephron is the functional unit of the kidneys.
- It filters water-soluble substances, reabsorbs nutrients and water, and secretes wastes.
- A YouTube video link is provided: https://www.youtube.com/watch?v=SZ3BZ_
- Blood enters the kidneys through the renal artery, which branches into smaller arterioles.
- Blood then flows into the glomerular capillaries (glomerulus) where pressure forces a filtrate into the Bowman's capsule.
- The filtrate contains water, ions, glucose, and small proteins.
- The proximal tubule absorbs sodium and other ions back into the bloodstream.
- Filtrate passes through the loop of Henle, where further water and sodium are absorbed.
- The distal tubule further adjusts the electrolyte composition of the filtrate, secreting ions and wastes.
Urine Production
- Water, ions, glucose, and small proteins are filtered from the blood in the glomerulus.
- The proximal tubule absorbs valuable substances.
- The loop of Henle absorbs more water and sodium.
- The distal tubule, controlled by hormones like aldosterone and ADH, adjusts ion concentration and excretes waste.
- The filtrate is collected in the collecting ducts and finally becomes urine expelled from the body.
Filtration
- Filtrate composition includes water, ions (sodium, potassium, chloride), glucose, and small proteins.
- Substances are reabsorbed or secreted in different parts of the nephron, including the proximal tubule, loop of Henle and distal tubule.
- A diagram depicts the process of filtration.
Urine Production Overview
- The process involves the Bowman's capsule, glomerulus, proximal tubule, loop of Henle, distal tubule, and collecting duct.
- Water and solutes are reabsorbed or secreted depending on the specific location in the nephron.
- Various substances are reabsorbed or secreted along the process.
- ADH plays a significant role in controlling water reabsorption.
- Specialized blood vessels called the vasa recta facilitate efficient transport of water and substances.
Filtrate Absorption
- Diffusion, osmosis, facilitated transport, and active transport are the mechanisms used by the nephrons to reabsorb substances.
- Diffusion moves particles from an area of high concentration to one of low concentration.
- Osmosis moves water from high to low concentration.
- Facilitated transport utilizes specialized proteins to facilitate the movement of substances across cell membranes..
- Active transport requires energy to move particles across cell membranes.
Urine Production
- The majority of sodium is absorbed in the proximal convoluted loop.
- Glucose, potassium, amino acids, bicarbonate, phosphate, urea, and water are also reabsorbed (in the proximal convoluted loop)
- Water is reabsorbed, and sodium actively reabsorbed.
- In the distal tube, ions, acids, medications, and toxins (such as K+, urea, and ammonia) are secreted. Some ion and water absorption occurs.
Urine Production (Distal Convoluted Loop)
- Aldosterone regulates sodium reabsorption.
- Potassium, urea, hydrogen ions, and ammonia are secreted into the filtrate.
- Antidiuretic hormone (ADH) controls water reabsorption.
- The final product is urine.
Urine Production (Macroscopic Analysis)
- Urine is typically light yellow in color.
- The pH ranges from 4.6-8.0.
- Specific gravity is 1.005-1.030.
- Proteins are less than 0.15g/day.
- Red blood cells (RBCs) and white blood cells (WBCs) are typically 0-4 and 0-5/hpf respectively.
- Occasionally, casts (formed from proteins and cells) may be present.
Urine Analysis: Abnormal Findings
- Elevated protein levels (>0.15g/day) may indicate impaired filtration.
- Glucose presence suggests hyperglycemia or infection.
- Elevated ketones may indicate an acid-base imbalance or diabetes.
- Leukocytes presence may indicate an infection.
- Nitrites presence suggests an infection.
Lab and Kidney Function
- Blood urea nitrogen (BUN) is a measure of urea from protein metabolism. Normal range is 3.6 to 7.1 mmol/L.
- Creatinine is a waste product from muscle metabolism. Normal range is 53 to 103 μmol/L.
- Potassium is an electrolyte mostly excreted by the kidneys. Normal range is 3.5 to 5 mmol/L.
- Glomerular filtration rate (GFR) is the rate at which blood is filtered by the glomeruli; normal values are >90 mL/min/1.73 m².
Urine Removal
- Urine from the kidneys travels through the ureters to the bladder.
- Peristalsis propels urine through the ureters.
- The trigone, located in the bladder, is sensitive to stretch, triggering the need to urinate.
- Messages are sent to the brain, signaling urination.
Micturition Reflex
- Stimulation of stretch receptors in the bladder sends impulses to the sacral spinal cord.
- Impulses travel to the pons and to the spinal detrusor muscles.
- Internal sphincter relaxation and external sphincter relaxation lead to urine release.
Incontinence and Retention
- Loss of voluntary bladder control = incontinence.
- Increased intra-abdominal pressure causes stress incontinence (laughing, coughing).
- Spinal cord injury or brain damage can disrupt the micturition reflex, causing retention or incontinence.
- Catheters can be used to drain urine.
Categorization of Urinary Track Problems
- Pre-renal, intra-renal, and post-renal problems are categorized.
- Kidney failure can be a result of these conditions.
Glomerulonephritis
- Glomerulonephritis is inflammation of the glomeruli.
- It can be acute or chronic, and it can be associated with other diseases (lupus, diabetes).
- Inflammation in the glomeruli can damage the kidneys.
Altered Urinary Neuromuscular Function
- Altered function can lead to urinary retention or incontinence.
- Spinal cord injuries may affect neural impulses that control urination.
- The level of the injury influences the impact and urinary function.
Alteration in Urinary Motility
- Fluid intake impacts urine output.
- Urine stasis can lead to infection.
- Stasis occurs with slow nephron movement or bladder retention of the filtrate.
Alteration in Urinary Perfusion
- The kidneys filter 1 liter of blood per minute.
- Decreased blood flow negatively impacts kidney function resulting in reduced filtration and toxicity.
- Elevated levels of blood urea nitrogen (BUN) and creatinine indicate reduced kidney function.
- High blood pressure is a significant cause of kidney damage.
Acute Kidney Failure
- Acute kidney failure is the inability of the kidneys to remove waste effectively.
- Characterized by rapid accumulation of waste products (azotemia) and reduced urine output (oliguria <500mL/24hrs.).
- Causes include hemorrhage, trauma, infection (such as pyelonephritis or glomerulonephritis)
Acute Kidney Failure Nursing Interventions
- Initially, fluid restriction to 1L/day is implemented.
- Intake and output are closely monitored, and daily weights are recorded.
- Low potassium diets are prescribed.
- Closely monitoring electrolytes, BUN, creatinine, and GFR are important. -Rehydration may be provided once GFR improves. -The role of youtube videos is mentioned.
Alteration of Urinary Patency
- Blockage or obstructions in the urinary tract disrupt urine flow, potentially damaging nephrons.
- Blockages may be caused by substances (stones) or external sources (tumors).
- Urine backing up into the kidneys creates a condition known as hydronephrosis.
- Urine stasis can lead to infection.
Urolithiasis (Kidney Stones)
- Urolithiasis is the presence of kidney stones.
- Calculi are solid masses, often composed of salts, or organic acids precipitating from the filtrate.
- Calcium, oxalate, and phosphate constitute most kidney stones.
- Kidney stones can form due to elevated calcium levels combining with oxalate or phosphate, creating stones, that are slowly increase in size.
- Sudden flank pain and microscopic blood in the urine indicate possible stones.
Urolithiasis (Kidney Stones) Risk Factors
- Genetic predisposition plays a significant role in kidney stone formation.
- Urinary tract infections increase susceptibility to kidney stones.
- Diabetes, obesity, and hyperparathyroidism are additional factors.
- High oxalate intake, high animal protein, and high sodium intake contribute to kidney stone development (while low fluid intake hinders stone dissolution).
Urolithiasis (Kidney Stones) Non Surgical Treatment
- Pain management techniques, fluids (non-caffeinated beverages), and antispasmodic medications are employed.
- Urine straining helps identify stones.
- Dietary modifications (reducing stone risk factors) and increased hydration are advocated.
- Decreasing caffeine and foods with oxalates aids in reducing the risks of stones.
Urolithiasis (Kidney Stones) Surgical Treatment
- Extracorporeal shockwave lithotripsy (ESWL) uses shock waves to break stones into smaller pieces.
- Ureteroscopes are used to retrieve or fragment stones in the ureters.
- Placement of a stent may be necessary after procedures.
- The importance of post-procedural nursing care is highlighted, including vital signs monitoring, IV fluids, intake and output management, pain management.
Learning Objectives
- Understanding kidney structure and functions, nephron structure and function (proximal tubule, loop of Henle, distal tubule)
- Defining filtrate and its components.
- Understanding bladder structure and function.
- Understanding the micturition reflex.
- Recognizing normal and abnormal urine content. Describing the processes of acute kidney failure, urolithiasis, and altered urinary motility, along with relevant nursing interventions.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
