Kidney & Urinary Tract Function
Q: What is the functional unit of the kidney?
A: The nephron.
Q: What forces are responsible for filtration in the kidneys?
A: Hydrostatic pressure (pushes fluid out) and osmotic pressure (pulls fluid in).
Q: What waste product do the kidneys excrete from protein metabolism?
A: Urea.
Q: What are the main functions of the renal system?
A: Fluid volume regulation, acid-base balance, blood pressure regulation (RAAS), and red blood cell production.
Q: What happens to kidney function in older adults?
A: Decreased GFR, slower drug clearance, altered acid-base balance, decreased thirst.
Q: Why are older adults at higher risk for UTIs?
A: Incomplete bladder emptying → urinary stasis.
Q: What should be included in a renal health history?
A: Voiding patterns, pain, fluid intake, hygiene, history of diabetes or hypertension.
Q: Which kidney sits lower in the body?
A: The right kidney.
Q: How can a distended bladder be assessed?
A: Light palpation above the pubic symphysis and bladder scan.
Diagnostic Tests
Q: What does a urinalysis evaluate?
A: Specific gravity, color, protein, blood, sugar, WBCs.
Q: What is the normal specific gravity range?
A: 1.005–1.025.
Q: What do protein, blood, or WBCs in urine indicate?
A: Infection or kidney damage.
Q: What do BUN and creatinine measure?
A: Kidney function.
Q: What does a 24-hour urine collection measure?
A: Creatinine clearance and kidney disease progression.
Q: What do ultrasounds and X-rays assess?
A: Kidney size, structure, and stones.
Q: What is IVP?
A: Imaging using contrast dye to view urinary tract structure and flow.
Q: What must be assessed before contrast dye procedures?
A: Allergy to iodine or contrast.
Q: What is a cystoscopy?
A: Camera inserted through urethra to view bladder and obtain biopsies.
Q: What do urodynamic tests evaluate?
A: Bladder and sphincter function.
Q: What should patients be taught before urodynamic testing?
A: Catheters and electrodes will be used.
Q: What symptoms may occur after urodynamic testing?
A: Frequency, urgency, dysuria.
Q: What should patients avoid after urodynamic testing?
A: Caffeine and alcohol.
Inflammatory Disorders
Q: What is a UTI?
A: Infection of the lower urinary tract (cystitis).
Q: What are common UTI symptoms?
A: Frequency, urgency, suprapubic pain, dysuria.
Q: What is often the first sign of UTI in older adults?
A: Confusion.
Q: Why are females at higher risk for UTIs?
A: Shorter urethra.
Q: What increases UTI risk?
A: Diabetes, gout, obstruction, urinary stasis, pregnancy.
Q: What is pyelonephritis?
A: Infection of the kidney (upper UTI).
Q: What causes pyelonephritis?
A: Untreated lower UTI spreading upward.
Q: Symptoms of acute pyelonephritis?
A: Fever, chills, nausea, vomiting, flank pain.
Q: What can untreated pyelonephritis lead to?
A: Sepsis.
Q: What is chronic pyelonephritis?
A: Recurrent infections causing kidney scarring.
Q: How are UTIs treated?
A: Antibiotics, analgesics, antispasmodics, IV fluids.
Q: Key UTI prevention teaching?
A: Hydration, wipe front-to-back, void after intercourse, avoid tight clothes, avoid irritants.
Immunologic Disorders
Q: What is glomerulonephritis?
A: Inflammation of the glomeruli.
Q: When does glomerulonephritis often occur?
A: 2–3 weeks after infection (strep/viral).
Q: Symptoms of glomerulonephritis?
A: Headache, hypertension, edema, oliguria.
Q: What is nephritic syndrome?
A: Glomerular inflammation with hematuria.
Q: What color is urine in nephritic syndrome?
A: Cola or tea-colored.
Q: Common cause of nephritic syndrome?
A: IgA nephropathy (Berger’s disease).
Q: What is nephrotic syndrome?
A: Severe protein loss in urine.
Q: Key features of nephrotic syndrome?
A: Proteinuria, hypoalbuminemia, hyperlipidemia, edema.
Q: What does nephrotic urine look like?
A: Frothy/foamy.
Q: Why are nephrotic patients at clot risk?
A: Thickened blood from fluid shifts.
Q: Complications of nephrotic syndrome?
A: PE and DVT.
Q: Treatment for nephrotic syndrome?
A: Steroids, diuretics, albumin, ACE inhibitors.
Obstructive Disorders
Q: What are urinary calculi?
A: Kidney stones.
Q: What are most kidney stones made of?
A: Calcium.
Q: Symptoms of kidney stones?
A: Severe colicky pain, hematuria, oliguria.
Q: Where does kidney stone pain radiate?
A: Genital area.
Q: Treatment for kidney stones?
A: Analgesics, anti-inflammatories, IV fluids.
Q: Nursing role for kidney stones?
A: Strain urine to collect stones.
Q: Dietary teaching for kidney stones?
A: Reduce sodium and protein.
Urinary Incontinence
Q: Is urinary incontinence a normal part of aging?
A: No.
Q: What is stress incontinence?
A: Leakage with coughing/laughing/lifting.
Q: Treatment for stress incontinence?
A: Kegel exercises.
Q: What is urge incontinence?
A: Sudden urge, can’t reach bathroom in time.
Q: What is functional incontinence?
A: Due to physical or cognitive impairment.
Q: Nursing interventions for incontinence?
A: Bladder retraining and timed voiding.
Urinary Retention
Q: What is urinary retention?
A: Inability to empty bladder.
Q: Causes of urinary retention?
A: Surgery, anesthesia, diabetes, enlarged prostate, trauma, medications.
Male Reproductive-Urinary Issues
Q: What is BPH?
A: Enlarged prostate compressing urethra.
Q: Symptoms of BPH?
A: Nocturia and dribbling.
Q: Treatment for BPH?
A: Alpha-blockers or TURP.
Q: What is TURP?
A: Surgical removal of prostate tissue.
Q: What catheter is used post-TURP?
A: Three-way Foley catheter.
Q: Why is continuous bladder irrigation needed after TURP?
A: Prevent clots.
Q: Nursing priority after TURP?
A: Monitor intake/output and adjust irrigation.
Q: What indicates a clot after TURP?
A: Slowed drainage.
Prostatitis
Q: What is prostatitis?
A: Inflammation of the prostate.
Q: Common cause of prostatitis?
A: E. coli.
Q: Symptoms of prostatitis?
A: Flu-like symptoms, pelvic pain, cloudy urine.
Q: Treatment for prostatitis?
A: Antibiotics.
Urinary Diversions
Q: What is a continent urinary diversion?
A: Internal pouch with no external bag.
Q: Example of continent diversion?
A: Indiana pouch.
Q: How is urine removed in continent diversion?
A: Self-catheterization.
Q: What is a cutaneous diversion?
A: External stoma with drainage bag.
Q: Example of cutaneous diversion?
A: Ileal conduit.
Q: Nursing care for cutaneous diversion?
A: Ostomy care and skin monitoring.
Q: What should a healthy stoma look like?
A: Red (not pale).