Week 2 180

In the retroperitoneum on either side of the spine

A small cluster of small-convoluted mass of capillaries. A network of vascular tufts encased in Bowman’s capsule where blood is filtered of excess water and waste products.

Maintaining a long-term acid-base balance to keep blood pH within the expected reference range of 7.35-7.45

Regulating plasma osmolarity

Concentration of a solution in terms of osmoses of solutes per liter of solution

A glycoprotein hormone (messenger hormone) that is secreted by the kidneys in adults (liver in a fetus) which acts on bone marrow stem cells stimulating red blood cell production

An enzyme that is secreted by the kidney that assists with regulating blood pressure

Convert to the active form (calcitriol)

Approximately one million

20

Enters via the renal artery, flows through multiple arteries until it reaches the interlobular arteries which further branches into afferent arterioles. Blood then enters the Bowman’s capsule and exits through efferent arterioles which divide into smaller peritubular cappilaries. Then leaves and returns to venous circulation.

Transport urine produced in the kidneys to the bladder

Sensory nerves send a message to the central nervous system about the urge to urinate. The detrusor muscle receives an impulse to contract as the internal and external urethral sphincters relax and urine leaves the body.

Contraction of both urethral sphincters

Prostatic, membranous, and penile

The amount of blood and plasma filtered over one minute

20-29 years old: high of 116 mL/min/1.73 m2
70 or older: 75mL/min/1.73 m2

BUN, serum creatinine, and GFR

10-20mg/dL

A waste product from normal use of muscles within the body

Females: less than 1.2 mg/dL
Males: less than 1.3 mg/dL

An infection in the bladder, kidneys, ureters, or urethra

UTI involving the urethra

UTI involving the bladder

UTI involving the kidney

Antibiotic compliance through entire prescription

Involuntary urine leakage with sneezing, coughing, or physical exertion caused by weakness of the urethral sphincter or pelvic floor muscles

Frequent sense of urge to urinate that either precedes or is accompanied by leakage or urine and is caused by detrusor muscle overactivity which causes bladder contraction

Urine leakage from an overdistended bladder caused by a bladder obstruction that blocks urine excretion or impaired contractility of the detrusor muscle

An abnormal increase in the reproduction of cells in an organ or tissue

Noncancerous enlargement of the prostate through which rhe urethra passes

Oxybutynin (Ditropin XL)

-Difficulty initiating urine stream, dysuria, nocturia, increased frequency and urgency, urine retention, and weak urine stream.

Being make and older than 50

Changes that can help relieve lower urinary tract manifestations:
-Reducing caffeine intake
-Losing weight
-Controlling hypertension
-Improving diabetic control
-Decreasing fluid intake in the evening
-Preventing constipation

Decreasing saturated fat intake (foods high in saturated fats: beef, lamb, pork, poultry with skin, beef fat, lard, cream, butter, cheese, ice cream, coconut, some baked and fried foods)

A common medical procedure that uses sterile salone fluids to flush clots from the bladder after surgery

A severe kidney infection that occurs suddenly and causes the kidneys to swell

Usually develops from a lower UTI where the bacteria has entered the urethra, spread to the bladder, then spreads to the kidneys by traveling up the ureter

-Any condition that leads to an interruption of the normal flow of urine
-Being female
-Renal stones or kidney and bladder disorders
-Enlarged prostate

A serious complication of acute pyelonephritis. A necrotizing infection that destroys the kidney tissues

Formation of renal abscesses, thrombosis in the renal vein, and acute renal failure

Most common: fever over 102, pain in the side, back, or groin, dysuria, cloudy or bloody urine, and fishy odor to the urine
-Other: chills, nausea, vomiting, fatigue, and mental confusion

Fluid overload (weight gain and edema)

-Focused GU
-Pain assessment
-Assess flank area for tenderness, edema, or redness
-Monitor kidney function tests

An inherited disorder that causes fluid-filled cysts to develop in the kidneys, damaging them and impairing renal function. PKD is progressive and leads to renal failure

The disease is not curable or preventable as it is a genetic disorder

Flank pain, polyuria, nocturia, palpable kidney masses, hematuria, hypertension, and proteinuria

Primarily support, advocacy, and education. Also recognizing signs of psychosocial impairment, anxiety, or depression, and notifying their provider

-Dietary changes (may be recommended to follow a low protein, low sodium diet)
-Smoking cessation
-Do not take ibuprofen, naproxen, or other NSAIDs unless cleared by the provider
-Support groups

-Thorough history
-Thorough pain assessment (location, radiation, onset, frequency, duration, and aggravating or alleviating factors)
-Blood pressure baseline and history
-Measure clients abdominal girth

As the disease progresses, activation of the renin-angiotensin system may cause hypertension

-Renal failure s/s
-Taking and recording BP
-Need to strictly control BP
-Antibiotic prescription compliance
-Importance of maintaining adequate hydration
-Manifestations of bladder/kidney infection

An abnormally decreased volume of circulating blood in the body

A condition where there is too much nitrogen and other waste products in the blood, usually caused by kidney dysfunction

A group of renal diseases in which immune-mediated damage occurs to portions of the glomerulus and results in proteinuria, azotemia, and hematuria

Abrupt onset is usually caused by streptococcus, but can also have unknown causes

An autoimmune disorder where antibodies attack the kidneys and lungs

-Periorbital edema
-Dark and frothy urine
-Elevated blood pressure
-Weakness
-Fever
-Malaise
-Abdominal discomfort

Acute- Salt restriction
Chronic - Sodium, potassium, and protein restriction
Both - Smoking cessation and control of diabetes, hypertension, and hyperlipidemia

Low urine output

-Periorbital edema
-Peripheral edema
-Elevated blood pressure
-Fine inspiratory crackles
-Pleural effusion

-Administration of medicstions to decrease blood pressure
-Remove excess fluid

-Kidney stones
-Nephrolithiasis
-Urilithiasis

Accumulations of minerals and salts and can lodge in the kidney or any portion of the urinary tract and causing pain and blood in the urine

80-90%

-Age: 43 and older
-sex: males are twice as likely to develop calculi
-Extreme heat and sun exposure
-High protein, low carbohydrate diet or a diet high in calcium or salt

-Severe flank pain with acute onset
-Nausea and vomiting are common

-Pain management
-Fluid volume deficit

There is a decrease in the blood flow to the kidneys caused by hypotension, hypovolemia, heart or liver failure

There has been damage to the functional part of the kidney, the parenchyma (renal cortex and renal medulla)

Usually occurs with acute tubular necrosis due to nephrotoxic agents or medications, contrast dyes, extended pre-renal failire, or aminoglycosides

Eight antibiotics used to treat particular bacterial infections: amikacin, neomycin, streptomycin, gentamicin, netilmicin, kanamycin, tobramycin, and paromycin

The disintegration of striated muscle fibers with excretion of myoglobin in the urine

The cells of the renal tubules become damaged and proceeds to cell death and GFR begins to decrease

Involves the urinary system below the kidney preventing the urine from draining

Initiate fluid challenge therapy

A condition in which there is a gradual loss of kidney function over time

-eGFR greater than 90
-Kidneys are functioning within normal range. Little kidney damage is present

-eGFR 60-90
-Kidneys are still functioning within normal range. Mild kidney damage is present

-eGFR: 45-59
-Kidneys are not functioning within normal range
-Mild to moderate damage to kidneys

-eGFR: 30-44
-Kidneys are not functioning within normal range
-Moderate to severe damage to kidneys

-eGFR: 15-29
-Kidneys are not functioning within normal range and are close to not functioning at all
-Severe kidney damage

-eGFR less than 15
-Kidneys are either very close to not functioning or have stopped functioning
-Most severe kidney damage present

Diabetes mellitus, type two is responsible for 30-50% of cases

-Diabetes mellitus
-Systemic hypertension
-Proteinuria (limiting protein intake iss important)
-Obesity and smoking may also be related

Race and ethnicity
-Asian, hispanic, and black clients are at higher risk
-Males older than 65 are also at higher risk

National Kidney Foundation recommends that people older than 60 receive annual screening assessing for proteinuria

30mg or less

-Edema
-Crackles in the lungs
-S3 gallop
-Jugular vein distention

Serum level of urea, which is a byproduct of the metabolism of proteins

Specific gravity test

Disease prevention or slowing the progression as well as identification and treatment of complications related to kidney disease

1. Sodium control (less than 2300 mg/day)
2. Protein (right amountight types) important to eat small portions
3. Heart and kidney (healthy food choices) limiting saturated and trans fats
4. Bones and blood vessels: limit phosphorus
5. Limit potassium

Draws calcium from them which weakens them

Because kidney disease affects many body systems, perform a head-to-toe assessment

-AV graft that surgically combines a piece of tubing inserted in the arm to join the artery and vein
-AV fistula: Surgically combines an artery and a vein
-Central Venous Dialysis Catheter: inserted into a large vein, usually in the neck

Fistula because it typically lasts the longest

Vibration/pulsation felt on palpation of a fistula. Demonstrates adequate blood flow

A swooshing sound that can be heard when auscultating over a hemodialysis access site

Notify provider

Vertigo, nausea, lightheadedness

Dialysis performed through a specialized catheter surgically placed in the abdominal cavity

A surgical opening through the abdominal wall to the colon (colostomy), small intestines (ileostomy), or ileal conduit (urostomy) to allow for drainage of urine

Every three days or when the ostomy is leaking or accidentally removed

Should have a pink-red, moist appearance and skin surrounding should be free from breakdown

Decreased perfusion

Every 8-12 hours or more frequently if soiled with blood or feces

Involves using a noninvasive ultrasound decice to determine the amount of urine in the bladder

Post-void residual volume

Breast development, growth of pubic and axillary hair, and a growth spurt

Follicular stimulating hormone and luteinizing hormone

The tube that connects the testicle to the vas deferens through which sperm are transported

The tube that connects the epididymis to the urethra and where sperm are stored

Hormone secreted by the anterier pituitary gland that increases during the first half of the menstrual cycle, triggering ovulation. Levels decrease after ovulation

Hormone produced by the anterior pituitary gland. levels surge during the first half of the menstrual cycle, triggering ovulation, and then levels decrease after ovulation

Painful menstruation
-Primary-not associated with other conditions
-Secondary-associated with another medical condition

The absence of menstruation during reproductive years, after puberty and before menopause.
-Primary-never menstruated
-Secondary-did previously menstruate

A wide range of physiological and psychological manifestations, including abdominal pain, bloating, headaches, and mood fluctuations that occur before and during menstruation

A more severe form of premenstrual disorder that may require treatment with selective serotonin reuptake inhibitors

Chronic condition that is caused by endometrial tissue that has moved outside the uterus, causing pain and inflammation

Endometrial cells move through the fallopian tubes into the peritoneum during menstruation

Pregnancy, miscarriage, ectopic pregnancy, or cancer

5000-10000/mm3

12-16 g/dL

37-47%

Abnormal cells that are not cancerous but may have the potential to become cancer cells. Usually categorized as mild, moderate, or severe.

Procedure that involves the provider inspecting the client’s vagina and cervix using a speculum and colposcope (magnifying glass)

The uterus and cervix are removed

The uterus is removed

The uterus, fallopian tubes, cervix, upper part of the vagina, and surrounding lymph nodes are removed

One or both ovaries are removed

One or both of the fallopian tubes are removed

Separation of the edges of a surgical wound

A surgical procedure that is used to remove uterine fibroids

An inflammatory process occurring within the prostate gland

Narrowing of the urethra that causes obstruction leading to difficulty voiding

A blood test that is used to screen for prostate cancer. PSA is a protein created by the prostate. An elevated level may be caused by prostate cancer, an enlarged prostate, other prostate problems, or medications

Prolonged erection of the penis that continues without sexual stimulation

An individual who is responsible for identifying, investigating, and resolving complaints or concerns made by or made on behalf of a client