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Questions and Answers
What is the primary function of the kidneys?
What is the primary function of the kidneys?
Which of the following best describes the location of the kidneys?
Which of the following best describes the location of the kidneys?
Which structure is responsible for draining urine directly from the renal pyramids?
Which structure is responsible for draining urine directly from the renal pyramids?
What is the functional unit of the kidney?
What is the functional unit of the kidney?
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Which of the following is NOT a listed function of the nephron?
Which of the following is NOT a listed function of the nephron?
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Which structure directly encapsulates the glomerulus?
Which structure directly encapsulates the glomerulus?
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Following a renal angiography, which post-procedure nursing intervention is MOST critical for preventing complications at the catheter insertion site?
Following a renal angiography, which post-procedure nursing intervention is MOST critical for preventing complications at the catheter insertion site?
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A patient is scheduled for a cystoscopy. Which of these pre-procedure actions should the nurse prioritize?
A patient is scheduled for a cystoscopy. Which of these pre-procedure actions should the nurse prioritize?
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Which of the following diagnostic procedures for the urinary system is considered non-invasive and does not typically require any patient preparation?
Which of the following diagnostic procedures for the urinary system is considered non-invasive and does not typically require any patient preparation?
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Which of the following is NOT a common factor contributing to urinary incontinence?
Which of the following is NOT a common factor contributing to urinary incontinence?
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What is the primary purpose of a 24-hour urine test?
What is the primary purpose of a 24-hour urine test?
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What does the presence of albumin in urine most likely indicate?
What does the presence of albumin in urine most likely indicate?
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A patient has ketoaciduria. Which of the following conditions or situations would MOST likely explain this finding?
A patient has ketoaciduria. Which of the following conditions or situations would MOST likely explain this finding?
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What does a high urine specific gravity typically suggest about a patient's condition?
What does a high urine specific gravity typically suggest about a patient's condition?
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Which of the following is NOT a component evaluated in a routine urinalysis?
Which of the following is NOT a component evaluated in a routine urinalysis?
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What physiological change in aging males increases their risk of UTIs?
What physiological change in aging males increases their risk of UTIs?
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What is the primary reason for discarding the first void of a 24-hour urine collection?
What is the primary reason for discarding the first void of a 24-hour urine collection?
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What distinguishes a urine culture and sensitivity test from a routine urinalysis?
What distinguishes a urine culture and sensitivity test from a routine urinalysis?
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What does an increased blood urea nitrogen level (BUN) indicate about a patient's condition?
What does an increased blood urea nitrogen level (BUN) indicate about a patient's condition?
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Which of the following is the primary function of the juxtaglomerular apparatus?
Which of the following is the primary function of the juxtaglomerular apparatus?
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What is the primary function of the peritubular capillary network regarding urine formation?
What is the primary function of the peritubular capillary network regarding urine formation?
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What is the role of the hormone ADH in kidney function?
What is the role of the hormone ADH in kidney function?
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Which of these processes primarily occurs in the distal convoluted tubule?
Which of these processes primarily occurs in the distal convoluted tubule?
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What effect does decreased systemic blood pressure have on juxtaglomerular cells?
What effect does decreased systemic blood pressure have on juxtaglomerular cells?
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If a patient experiences significant fluid loss through extensive sweating, which of the following hormonal responses would be most likely?
If a patient experiences significant fluid loss through extensive sweating, which of the following hormonal responses would be most likely?
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What is the cause of the yellow color of normal urine?
What is the cause of the yellow color of normal urine?
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What change occurs with aging that impacts kidney function?
What change occurs with aging that impacts kidney function?
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Which of the following conditions can result from a reduced bladder tone in older women?
Which of the following conditions can result from a reduced bladder tone in older women?
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Which of the following laboratory findings indicates a potential renal disease?
Which of the following laboratory findings indicates a potential renal disease?
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A patient is scheduled for an Intravenous Pyelography (IVP). What is the most important pre-procedure consideration?
A patient is scheduled for an Intravenous Pyelography (IVP). What is the most important pre-procedure consideration?
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A male patient’s Prostatic-Specific Antigen (PSA) level is 5 ng/mL. According to the provided content, which statement may be true?
A male patient’s Prostatic-Specific Antigen (PSA) level is 5 ng/mL. According to the provided content, which statement may be true?
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Which of the following best describes the purpose of assessing urine osmolality?
Which of the following best describes the purpose of assessing urine osmolality?
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If a patient's urine sample shows a higher specific gravity than normal, what might be suspected based on the information provided?
If a patient's urine sample shows a higher specific gravity than normal, what might be suspected based on the information provided?
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During a creatinine clearance test, what is an important factor patients should avoid to ensure the accuracy of the result?
During a creatinine clearance test, what is an important factor patients should avoid to ensure the accuracy of the result?
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Which of the following statements best describes the relationship between serum creatinine and muscle mass?
Which of the following statements best describes the relationship between serum creatinine and muscle mass?
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Study Notes
Urinary System Anatomy and Function
- The urinary system maintains homeostasis by removing waste, excess water, and electrolytes from the blood, concentrating them into urine. It also produces erythropoietin, stimulating red blood cell production.
- The system comprises two kidneys, two ureters, the bladder, and the urethra.
- Kidneys are situated behind the peritoneum, roughly 4-5 inches long, 2-3 inches wide, and 1 inch thick. The right kidney is slightly lower than the left, due to the liver's position.
- Each kidney is encased in adipose tissue. The hilus is a notch where the ureter, blood vessels, and nerves enter and exit.
Kidney Gross Anatomy
- Renal Capsule: The strong outer covering of connective tissue.
- Renal Cortex: Inner layer beneath the capsule containing renal tubules (1.25 million per kidney).
- Renal Medulla: Located beneath the cortex, darker in appearance and comprised of pyramids.
- Papillae: The pointed tips of the pyramids, draining urine into calyces.
- Calyces: Collecting chambers draining into the renal pelvis.
- Renal Pelvis: The upper part of the ureters, receiving urine from the calyces.
- Ureters: Transport urine to the bladder.
- Bladder: Stores urine.
- Urethra: Transports urine from the bladder to the exterior.
Microscopic Kidney Structure (Nephron)
- The nephron is the functional unit, with over 1 million per kidney.
- It filters blood and processes urine, performing vital functions like:
- Regulating fluid levels
- Controlling blood pH
- Removing waste.
- Two main parts:
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Renal Corpuscle: A glomerulus (a network of capillaries) and Bowman's capsule (cup-like structure enclosing the glomerulus).
- Blood enters the glomerulus via the afferent arteriole and leaves via the efferent arteriole. The diameter difference controls filtration rate.
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Renal Tubule: Composed of the proximal convoluted tubule, loop of Henle, distal convoluted tubule, and collecting duct.
- Filtrate travels through the tubule: Water and electrolytes are reabsorbed or secreted to regulate homeostasis. This is controlled by ADH and aldosterone.
- Juxtaglomerular apparatus (adjacent to the glomerulus) regulates nephron function and systemic blood pressure. When blood pressure is low, renin is released to activate the renin-angiotensin mechanism, leading to hypertension.
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Renal Corpuscle: A glomerulus (a network of capillaries) and Bowman's capsule (cup-like structure enclosing the glomerulus).
Urine Formation
- Three phases:
- Filtration: Water and blood products filtered in the glomerulus and Bowman's capsule.
- Reabsorption: Water, glucose, and necessary ions return to the blood in the proximal convoluted tubules, loop of Henle, and distal convoluted tubules.
- Secretion: Ions, waste, and drugs move from the blood to the filtrate in the distal convoluted tubule.
Hormonal Influences
- ADH (antidiuretic hormone): Increases water reabsorption in the distal convoluted tubules in response to fluid loss (e.g., hemorrhage).
Urine Composition and Characteristics
- Urine is mostly water (95%) with nitrogenous waste and salts.
- Yellow color due to urochrome (pigment from hemoglobin breakdown).
- Normal pH: 4.6-8.0; specific gravity: 1.003-1.030.
- Urine is normally sterile, but decomposes rapidly at room temperature.
- Urine abnormalities are evaluated in diagnostic testing.
Urinary System Disorders in Aging Adults
- Aging kidneys: Decreased blood supply and nephron loss cause reduced filtering capacity, especially by age 70.
- Incontinence: Women face issues with bladder tone and perineal muscle relaxation. Men experience prostate enlargement, constricting the urethra and potentially leading to incomplete bladder emptying.
- Risk Factors for UTI: Incomplete bladder emptying in both men and women increases UTI risk.
Urinary System Diagnostic Tests
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Routine Urinalysis:
- Evaluates physical characteristics (color, clarity, odor), pH, specific gravity, and presence of proteins, glucose, ketones, blood cells, crystals.
- 24-Hour Urine Collection: Measures excreted substances to assess kidney function.
- Urine Culture and Sensitivity: Identifies causative organisms for infections and determines appropriate antibiotics.
- Urine Specific Gravity: Determines fluid balance. Affected by factors like dehydration, excessive fluid intake, and some disorders.
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Blood Tests:
- BUN (Blood Urea Nitrogen): Measures urea, a non-protein waste. Reflects renal function and protein intake, but not as reliable as serum creatinine.
- Serum Creatinine: Measures creatinine, which is excreted entirely by the kidneys Reflects renal function, less affected by factors like hydration and malnutrition compared to BUN.
- Creatinine Clearance Test: Measures creatinine levels in blood and urine to assess kidney function.
- PSA (Prostate Specific Antigen): Normal PSA is less than 4 ng/mL; elevated levels indicate potential prostate disorders.
- Urine Osmolality: Measures the number of particles per volume of urine, providing information about the kidneys' ability to concentrate urine.
Imaging and Endoscopic Procedures
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KUB (Kidney-Ureter-Bladder) radiography
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IVP/IVU (Intravenous pyelography/urography): Examines the urinary tract, using contrast dye. Preparation includes a light supper, laxative, and NPO status.
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Retrograde Pyelography: Injects contrast into ureters to view upper urinary tract structures.
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Voiding Cystourethrography: Evaluates bladder and urethra, often using an indwelling catheter.
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Cystoscopy: Visual examination of the urinary bladder. Procedures often include biopsy, urine samples, and other treatments.
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Nephroscopy (Renal Endoscopy): Direct visualization of upper urinary structures.
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Renal Angiography: Evaluates blood supply to kidneys, often using contrast dye.
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Renal Venography: Evaluates venous drainage of the kidneys.
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CT (Computed Tomography), MRI (Magnetic Resonance Imaging): Non-invasive imaging procedures, using contrast for certain cases.
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Renal Biopsy: Obtaining tissue samples from kidneys.
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Other procedures like Transrectal Ultrasound (for prostate), Urodynamic Studies (bladder function assessment) are also detailed.
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Description
Explore the anatomy and function of the urinary system in this quiz. Learn about the components including the kidneys, ureters, bladder, and their roles in maintaining homeostasis. Test your knowledge on kidney structure and function.
