Renal Urinary System

Flashcards covering anatomy, physiology, aging, assessment, labs, imaging, and procedures related to the Renal/Urinary System based on the lecture notes.

What are the main concepts assessed in the renal/urinary system notes?

Elimination of waste from the body; fluid and electrolyte balance; acid-base balance.

How many kidneys, ureters, bladder, and urethra are described in the anatomy review?

Two kidneys, two ureters, one urinary bladder, and one urethra.

Where are the kidneys located?

Behind the peritoneum, outside the abdominal cavity.

What are the typical dimensions of the kidneys?

4-5 inches long, 2-3 inches wide, 1 inch thick.

Which kidney is slightly longer and narrower?

The left kidney.

What are the kidneys' functions?

Formation of urine; excretion or conservation of water; electrolyte balance; acid-base balance; activation of Vitamin D; production of erythropoietin; production of renin.

What forms the outer region of the kidney?

Renal cortex.

What forms the inner region of the kidney?

Renal medulla.

What divides the renal interior into cone-shaped sections?

Renal columns.

What are the cone-shaped sections called?

Renal pyramids.

What is the tip of a renal pyramid called?

Renal papilla.

Into what cup does the renal papilla extend?

Minor calyx.

What collects urine leaving the papilla?

Minor calyx.

How many minor calyces join to form a major calyx?

Two or three.

What forms the renal pelvis?

Major calyces converge to form the renal pelvis.

What continues as the ureter?

The renal pelvis.

What is the nephron?

The functional unit of the kidney.

What vessel supplies blood to a nephron?

Afferent arteriole.

What encloses the glomerulus?

Bowman’s capsule.

Which vessel leaves the glomerulus?

Efferent arteriole.

What surrounds the renal tubules and reabsorbs water and solutes?

Peritubular capillaries.

What are the main segments of a nephron?

Proximal convoluted tubule, loop of Henle (descending and ascending limbs), distal convoluted tubule, collecting duct.

What percent of renal plasma flow is filtered through the glomeruli?

About 20%.

What is filtered through the glomeruli?

Water and small solutes such as electrolytes, glucose, amino acids, vitamins, and nitrogenous wastes.

What cannot pass through the glomeruli due to size?

Blood cells and most plasma proteins.

What is the daily glomerular filtration rate (GFR) approximately?

About 180 liters per day.

What percent of filtrate is reabsorbed?

About 99%.

What remains as urine after reabsorption?

About 1–2 liters per day.

What is the normal GFR range in mL/min?

100–125 mL/min.

What factors affect GFR?

Permeability of capillary walls; vascular pressure; filtration pressure.

What are the three major processes of urine formation?

Glomerular filtration, tubular reabsorption, tubular secretion.

What is the function of the ureters?

Carry urine from kidneys to the bladder.

What is the function of the urinary bladder?

Temporary storage of urine.

What is the function of the urethra?

Carries urine from the bladder to the exterior.

What is the normal daily urine volume?

1000–2000 mL.

What is typical urine color?

Pale yellow to amber.

What is the normal urine specific gravity range?

1.005 to 1.030.

What is the normal urine pH range?

4.5 to 8.0.

What are typical urine constituents?

About 95% water; waste products such as urea, creatinine, uric acid.

Which urinary pH indicates a high-protein diet or ketoacidosis?

Acidic urine (low pH).

Which urinary pH indicates a urinary tract infection (UTI)?

Alkaline urine (higher pH).

Presence of ketones in urine indicates what?

Metabolic states such as ketoacidosis or starvation.

What hormone increases water reabsorption and urine concentration?

Antidiuretic hormone (ADH).

Where is ADH produced?

Pituitary gland.

What is the effect of low ADH on urine volume and concentration?

Increases urine volume and decreases urine concentration.

What is the effect of high ADH on urine volume and concentration?

Decreases urine volume and increases urine concentration.

Where is aldosterone produced?

Adrenal glands.

What effect does aldosterone have on Na+ retention and K+ secretion?

Increases Na+ and water retention; increases K+ excretion (when levels are high).

What happens when aldosterone is low vs. high?

High aldosterone: increased Na+ and water retention; increased K+ excretion. Low aldosterone: increased Na+ and water excretion; potassium retention.

What aging-related change occurs to the bladder?

Decreased bladder size and detrusor muscle tone.

What aging-related changes occur in the kidneys/nephrons?

Decreased ability to concentrate urine and fewer nephrons; GFR decreases.

What aging change occurs in the prostate of males?

Prostate enlargement.

What increases the risk from nephrotoxic agents with aging?

Increased susceptibility due to medications and dyes.

What happens to pelvic floor muscles with aging?

They weaken.

What are common age-related urinary issues?

Urinary infections, incontinence, and retention.

What demographic information is collected in a renal nursing assessment?

Age, gender, race, and ethnicity.

What physical assessment items are important in renal assessment?

Vital signs (hypertension risk), lung sounds (crackles), edema, daily weights, intake and output, skin color.

What are the normal serum creatinine ranges for adults?

Men: 0.6–1.2 mg/dL; Women: 0.5–1.1 mg/dL.

What is the normal BUN range?

7–20 mg/dL.

How much urine is needed for a urinalysis?

10 mL.

When should a urinalysis specimen be examined?

Within 1 hour.

What is a KUB radiograph used for?

X-ray of kidneys, ureters, and bladder to detect tumors, swelling, stones.

What does VCUG stand for and assess?

Voiding cystourethrography; evaluates bladder and urethral function during voiding.

What is a renal biopsy and how is it performed?

Percutaneous or small open incision biopsy; typically performed with the patient NPO and mild sedative.

What post-care is required after a renal biopsy?

Monitor vital signs; keep supine with back support; monitor biopsy site for bleeding; obtain first urine void; apply pressure dressing.

Which post-kidney biopsy finding requires immediate action?

Reports of flank pain.