RENAL MED SURG STUDY GUIDE MEDICAL SURGICAL NURSING II QUESTIONS WITH VERIFIED ANSWERS 2024 UPDATED
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Course
RENAL MED SURG MEDICAL SURGICAL NURSING
Institution
RENAL MED SURG MEDICAL SURGICAL NURSING
RENAL MED SURG STUDY GUIDE MEDICAL SURGICAL NURSING II QUESTIONS WITH VERIFIED ANSWERS 2024 UPDATEDRENAL MED SURG STUDY GUIDE MEDICAL SURGICAL NURSING II QUESTIONS WITH VERIFIED ANSWERS 2024 UPDATEDRENAL MED SURG STUDY GUIDE MEDICAL SURGICAL NURSING II QUESTIONS WITH VERIFIED ANSWERS 2024 UPDATEDRE...
RENAL MED SURG
STUDY GUIDE MEDICAL
SURGICAL NURSING II
QUESTIONS WITH
VERIFIED ANSWERS
2024 UPDATED
, lOMoAR cPSD| 48519099
Renal
Review of the Renal System
The Basics: blood enters kidney blood is filtered & waste is removed
filtered blood returns to body waste is sent to bladder
Functions of the Kidneys
• Filtration (waste elimination) – any excess electrolytes,
proteins, & solutes not needed in the body
• Fluid & electrolyte balance – the filtration process helps
to maintain the fluid & electrolyte balance
through the use of ADH and aldosterone
• Acid-base balance – kidneys regulate hydrogen and bicarb
reabsorption and secretion o Hydrogen ions
excreted through filtration & forms bicarb to buffer &
maintain the body’s pH
• Blood pressureregulation – regulated through the RAAS system through the use
of aldosterone, renin, & ADH
• Erythropoietin production (for RBC synthesis) –when decreased oxygenation levels
in the arteries, anemia, &/or decreased renal perfusion occurs, kidneys secrete
erythropoietin to help stimulate synthesis of RBC’s
• Vit D conversion and Ca++ balance – kidneys synthesize components to
make vitamin D to help absorb calcium in the GI tract & prevent
calcium from being released from the bones
• Glucose homeostasis – kidneys filter & reabsorb glucose, trying to retrieve as
much as possible o Any excess glucose is
secreted in the urine
*kidneys normallydo NOT filter blood cells or proteins (important
to understand for later)
Anatomy of the Kidneys & Urinary System
• Nephrons: functional unit of the kidneys responsible
for removing waste & excess substances from
the blood (regulation of blood plasma volume &
solute concentration) o Adjusts volume of water lost
in urine
o Stabilized blood pH by controlling loss of hydrogen ions and
bicarb in urine
• Glomerulus: a collection of blood capillaries in each nephron that
filters blood o GFR (glomerular filtration rate): amount of fluid filtered
from the blood into the glomerular capsule
normal rate is 120-125 ml/min
o factors that influence GFR: total surface area available for filtration,
permeability of the membrane, and net filtration pressure
• Proximal convoluted tubule (PCT): reabsorbs chloride, bicarb, glucose, sodium, and
water from the glomerular filtrate
• Loop of Henle: recovers water and sodium chloride from the urine o Descending
loop – has thin and permeable membrane to reabsorb
water into the bloodstream o Ascending loop – thicker and
less permeable to water, but absorbs sodium and chloride o Urine
becomes more concentrated here
, lOMoAR cPSD| 48519099
• Distal convoluted tube (DCT) & collecting ducts: involved w/ secreting
solutes into the filtrate rather than reabsorbing substances into it
o Collecting ducts receive urine and channelsit into renal pelvis &
into ureter
• Ureter: transports urine to bladder (12-18 in long) o Pair of muscular
tubes
o Move urine to bladder by peristalsis
• Urinary bladder: stores urine (up to 1 liter) temporarily prior to elimination
o Muscular organ
o Detrusormuscle expels urine when contracted
• Urethra: conducts urine to exterior o Micturition reflex – 300-500 ml of
urine increases internal bladder pressure internal urethral sphincter relaxes
& signals need to void o External urethral sphincter:
acts as a valve, voluntary muscle relaxes permitting
micturition
o Male urethra divided into 3 (prostatic, membranous, and spongy) o Female
urethra – very short (3-5 cm), extends from bladder to vestibule
Urinary Tract Infections (UTI’s)
Includes cystitis, urethritis, and pyelonephritis
Cystitis
Patho & Etiology S/Sx
• Most common cause is gram • Top 3 = urgency, frequency, dysuria
negative bacteria, specifically • Hematuria, cloudy/foul smelling urine, burning
E. coli • Fever – late stage symptom
• Risk factors: female, pregnancy, DM, age, often more associated w/
immunosuppression, anatomyissues causing pyelonephritis
obstruction or stasis, compromised • In the elderly, increased confusion is
skin integrity, urinary catheterization typically a sign – they are
often asymptomatic otherwise
Predisposing Conditions
• Female – shorter urethra, use of perfumed hygiene products, intercourse,
incomplete wiping or wiping from back to front
• Pregnancy – bladder displacement increased risk for complications like sepsis
or pyelonephritis
• Obstruction & urinary stasis (BPH, renal calculi)
bacterial growth
• Peripheral neuropathy affects bladder innervation
incomplete emptying
• Age
o post-menopausal women have decrease in
estrogenlevels o men > 50 prone
to prostate obstruction and urinary stasis
• Compromised skin integrity r/t injury or tears
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