patho > urinary function ch.7 > Flashcards

urinary function ch.7 Flashcards

(55 cards)

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1
Q

altered eliminations

A
  • incontience
  • neurogeniic bladder
  • UTI
  • nephrolithiasis
  • hydronephrosis
  • cancers: renal cell carcinoma & bladder
  • benign prostatic hyperplasia
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2
Q

impaired renal function

A
  • acute kidney injury

- chronic kidney disease

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3
Q

Incontinence

A

loss of urinary control

- affects 25-35% of population

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4
Q

types of incontinecne

A

children

  • enuresis
  • nocturnal enuresis

adults

  • stress
  • urge
  • reflex
  • overflow
  • functional
  • treatment
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5
Q

incontinence children enuresis

A

involuntary urination by a child after 4-5 years of age

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6
Q

incontinence children nocturnal enuresis

A
  • bed wetting

types

  • primary: child never developed normal bladder control @ night. might bc bladder too small
  • secondary: normal urinary control. physiological causes changes it

causes:

  • psychological
  • structural
  • underlying condition
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7
Q

incontinence adulthood stress

A
  • combined process of weakening of bladder sphincter and intra-abdominal pressure

contributing factors:

  • pregnancy
  • child birth
  • menopause
  • prostate removal and obesity
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8
Q

incontinence adulthood urge

A
  • sudden, intense urge to urinate and involuntary loss of urine
  • overacting bladder
  • few second warning

causes

  • parkinson
  • alzheimer disease
  • stroke
  • injury to nervous system
  • frequent uti
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9
Q

incontinence adulthood reflex

A

trauma or damage to nervous system

  • detrusor hyperreflexiaxia
  • increased detrusor muscle contractility
  • urine is released bladder cant relax and fill
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10
Q

incontinence adulthood overflow

A
  • inabilty to empty bladde ror retention
  • chronic distention
  • “nursing/teaching bladder”

causes:

  • bladder damage
  • urethral blockage
  • nerve damage
  • prostate conditons
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11
Q

incontinence adulthood functional

A
  • physical or mental impairment that prevents toileting in time
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12
Q

incontinence transient

A
  • resulting from underlying cause
  • temporary

causes

  • delirium
  • infection
  • use of diuretics and sedatives
  • high urine output
  • alcohol and caffeine consumption
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13
Q

risk factors for incontinence

A
  • female gender- pelvic floor muscle and vaginal wall weakening
  • advancing age- both muscle weaken and urine storage
  • obesity
  • smoking
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14
Q

complications inconteince

A
  • impaired skin integrity
  • recurrent utis
  • impaired body image/ sexual disfunction
  • interruption of usual activities
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15
Q

neurogenic bladder

A

bladder dysfunction caused by an interruption of normal bladder nerve innervation
- results in flaccid or spastic bladder

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16
Q

etiology of neurogenic bladder

A

neurologic

  • brain/spinal cord injury/ infections
  • dementia
  • parkinsons
  • stroke
  • ms

other

  • medications
  • alcoholism
  • herpes zoster
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17
Q

UTI

  • urethritis
  • cystitis
  • pyelonephritis
A

infection within the urinary tract

  • urethritis- urethra
  • cystitis- bladder
  • pyelonephritis- kidneys
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18
Q

uti etiology

A

bacterial invasion

- 75%-95% caused by E.coli (normal intestinal flora)

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19
Q

patho of uti

A
  • bacteria resists normal defenses: urination and acidity
  • adherers to urothelial lining
  • inflammation/redness of wall of urethra/bladder
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20
Q

UTI risk factors

A
  • female
  • immobility
  • bowel/bladder inconteninence
  • urinary obstruction- pooling of urine
  • indwelling urinary catheters- follys
  • antibiotic use- overuse- kills good bacteria
  • improper personal hygiene
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21
Q

uti clinical manifestation

A
  • asymptomatic
  • urgency/ frequency
  • dysuria- burning
  • hematuria- blood in urine
  • cloudy/ foul-smelling urine- more bacteria
  • fever, chills, fatigue
  • back/flank pain- progress to kidneys
  • confusion or sudden change in mental status- do urinalysis
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22
Q

nephrolithiasis

A

presence of renal calculi (kidney stones)

- composed of: calcium, uric acid and magnesium

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23
Q

patho of nephrolithiasis

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A

minerals build up forming crystals that grow in size

24
Q

etiology nephrolithiasis

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A
  • ph changes
  • increase Na concentration
  • stasis of urine
25
risk factors nephrolithiasis
- obesity - HTN - diet ( increased protein, increased an, decrease calcium)
26
hydronephrosis
abnormal dilation of the renal pelvis of one or both kidneys - unilateral renal involvement: indicates an obstruction in one of the ureters - bilateral renal involvement indicates an obstruction in the urethra
27
hydronephrosis patho
- obstruction of urine flow leads to fluid buildup within kidneys - dilation results in obstruction or pressure and compression on surrounding tissues and blood vessels - resulting in decreased glomerular filtration and potentially atrophy/ necrosis
28
hydronephrosis etiology
- urinary obstruction | - stones, tumors, strictures, stenosis, congenital defects
29
renal cell carcinoma
most freqently occurring kidney cancer in adults - increase incidence in men - 50-70 years old 5 year survival rate - localized 93% - distant spread 13% - metastasis to the liver, lungs, bone, or nervous system is common - does not typically respond well to chemo - preferred tx partial or total nephrectomy
30
bladder cancer
cancer that forms in the tissue of the bladder - incidence rates - increase age, increase male, increase Caucasians types: categorized by tissue of origin - recurrence common
31
bladder cancer risk factors
- smoking - chemical exposure - recurrent uti. chronic bladder irritation - chemo/radiation
32
benign prostatic hyperplasia (BPH)
nonmalignant enlargement of the prostate gland
33
benign prostatic hyperplasia (BPH) etiology
- unknown --> decreased testosterone | - common over age 50
34
benign prostatic hyperplasia (BPH) patho
- abnormal proliferation --> enlargement of prostate - compression of urethra --> obstruction of urine flow - urine collects in bladder causing uti and thickening of bladder
35
benign prostatic hyperplasia (BPH) risk factors
``` obesity cardiovascular disease DM2 inactivity ED ```
36
acute kidney injury
sudden loss of renal function - days to weeks - generally reversible
37
acute kidney injury etiology
inadequate renal perfusion - prerenal (before kidney)- decrease bp, HF - intrarenal (within kidney)- inflammation of glomerulus/ compression on internal structures - postrenal (after kidney)- urethral/ bladder obstruction- interfere with the ability to secrete urine
38
acute kidney injury patho
- abrupt onset | - 4 phase process
39
acute kidney injury lab values
creatinine increase - decreased urinary excretion - waste product produced by muscle BUN increase - decreased urinary excretion
40
acute kidney injury phases
- prodromal - oliguric - diuretic - recovery
41
acute kidney injury phases: prodromal
- damage occurs | - pt. asyomptomatic
42
acute kidney injury phases: oliguric
- nephrons are damaged - decreased glomerular filtration - decreased urine output - less than 400 ml/day
43
acute kidney injury phases: diuretic
- renal function begins to improve - tubular damage continues to impair ability to concentrate urine appropriately - leads to diuresis- excess urine output (depletes fluids and electrolytes) - up to 5l
44
acute kidney injury phases: recovery
- can take 3-12 months | - glomerular filtration returns to normal
45
chronic kidney disease
gradual, irreversible loss of renal function - nephrons become injured - replacement by scar tissue - affects 30 million adults
46
chronic kidney disease etiology
- DM- diabetes #1 cause - HTN- affects glomelura - urinary obstruction- increase pressure on kidneys - renal artery stenosis- not good blood flow - nephrotoxic medications- kidney toxic (NSAIDS) - sickle cell disease - SLE- sickle cell attacks cells in nephron - smoking- harden Bu- small Bu in kidneys - aging- less effective
47
chronic kidney disease patho
damaged nephrons --> impaired kidney function - decrease regulation and ability to eliminate waste products and drug exretion - increase bp
48
chronic kidney disease stage 1
kidney damage present by GFR > 90
49
chronic kidney disease stage 2
kidney damage worsens as the GFR falls (60-89)
50
chronic kidney disease stage 3
kidney function is signficantly impaired as GFR is between 30 and 59
51
chronic kidney disease stage 4
kidney function is barley present with GFR dropping between 15 and 29
52
chronic kidney disease stage 5
kidney failure as the GFR drops to less than 15
53
prerenal
(before kidney) | decrease bp, HF
54
intrarenal
(within kidney) | inflammation of glomerulus/ compression on internal structures
55
postrenal
(after kidney) | urethral/ bladder obstruction- interfere with the ability to secrete urine
patho
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