Term
|
Definition
Upper left abdomen
Muscular pouch
Fundus, body, antrum
Cardiac and pyloric sphincters
Rugae
3 layers |
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Term
|
Definition
Secretes digestive enzymes, water, hydrochloric acid, intrinsic factor
2-2.5 liters of gastric secretions daily
Gastric mucosa covered by thick mucous gel layer
Impermeable to hydrogen ions
Mucosal cells also secrete bicarbonate
Parasympathetic and sympathetic nerves |
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Term
| about Gallbladder and bile ducts |
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Definition
Pear-shaped organ – lower surface of liver
Can hold 50mL
Stores and concentrates bile
Bile moves to hepatic ducts to common bile duct to pancreatic duct to duodenum (sphincter of Oddi)
Gall bladder not essential for life
Bile helps break down and absorb fats
600 to800 mL produced daily |
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Term
|
Definition
Pancreas
Posterior abdomen, near duodenum and spleen
Exocrine and endocrine (insulin) functions
Groups of secretory cells (acini) make digestive enzymes
Enzymes pass through ducts to ampulla of Vater at sphincter of Oddi
2L enzymes made per day
Trypsin
Pancreatic amylase |
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Term
| about the Small intestine |
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Definition
1 inch wide
20 feet long
Duodenum, jejunum, ileum |
|
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Term
| about the large intestine: |
|
Definition
Large intestine
2.5 inches wide
5 feet long
Cecum, colon, rectum |
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Term
| More about the Small intestine |
|
Definition
Digestion of food and absorption of nutrients
Mucus-secreting glands protect from stomach acid and
pancreatic enzymes
Intestinal mucosa will not absorb large molecules – need to be
further broken down (pancreatic enzymes)
Villi – absorption
90% absorption in small intestine
Peristalsis – churns and moves chyme
3-10 hours from stomach to colon
Parasympathetic increases peristalsis |
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Term
|
Definition
| lower esophagial sphincter |
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Term
|
Definition
|
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Term
|
Definition
| the production of gastric acid in the stomach is absent |
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Term
|
Definition
| Pair of bean shaped brownish-red structures located retroperitoneally on the posterior wall of the abdomen from the 12th thoracic vertebra to the 3rd lumbar vertebra |
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Term
| ADRENAL GLAND lies on top of |
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Definition
| each kidney-They are independent of each other in function, blood supply and intervention. |
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Term
| Each ureter has 3 narrow areas |
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Definition
Ureteropelvic junction
Sacroiliac junction
Ureterovesical junction
The ureteropelvic area is most dangerous due to location to the kidney. |
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Term
|
Definition
| Muscular hollow sac just behind the pubic bone |
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Term
| the capacity of the adult bladder is |
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Definition
|
|
Term
| Central hollow area the, vessicle has __inlets, and __ outlet(s) |
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Definition
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Term
| The bladder wall has 4 layers: |
|
Definition
Adventitia: Outermost layer-connective tissue
Detrusor Muscle: Smooth muscle
Submucosal layer: loose connective tissue
Inner most Mucosal layer: The inner layer contains special transitional cell epithelium- a membrane that is impermeable to water and prevents reabsorption of urine stored in the bladder. |
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Term
|
Definition
| voiding, peeing, weeing, pissing, |
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Term
|
Definition
| Benign prostatic hypertrophy |
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Term
| Urine is formed in the nephron through a complex 3 step process |
|
Definition
Glomerular filtration
Tubular reabsorption
Tubular secretion |
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Term
| ______& _____are usually filtered at the level of the glomerulus and reabsorbed so the NEITHER is excreted in the urine |
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Definition
|
|
Term
| RENAL GLYCOSURIA: occurs if |
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Definition
| the amount of glucose in the blood and glomerular filtrate exceeds the amount that the tubules are able to reabsorb. |
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Term
| Blood flows through the kidney AT |
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Definition
|
|
Term
| Filtration occurs as blood enters the |
|
Definition
| glomerulus from the afferent arterole |
|
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Term
| Normally there is about ___L per day of filtrate-(99% is reabsorbed in the resulting in1-2L of urine daily) |
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Definition
|
|
Term
| Efficient filtration depends on: |
|
Definition
| adequate blood flow that maintains a consistent pressure through the glomerulus. |
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Term
| Both the 2nd and 3rd steps of urine formation occur in the |
|
Definition
|
|
Term
| In tubular reabsorption substances move from the filtrate back into |
|
Definition
| the peritubular capillaries or the vasa recta. |
|
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Term
| In tubular secretion; substances move from peritubular capillaries or the vasa recta into the |
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Definition
|
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Term
|
Definition
| the ratio of solute to water |
|
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Term
|
Definition
| number of osmoles dissolved per kilogram of solution |
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Term
| Sodium regulation is controlled by |
|
Definition
| aldosterone- it fosters(renal) reabsorption of sodium |
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Term
| Release of Aldosterone is largely under control of |
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Definition
|
|
Term
| Vasa Recta vessels of the kidney |
|
Definition
| constantly monitor blood pressure as blood begins its passage into the kidneys- |
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Term
| When Vasa recta recognize an increase in BP, _____ secretion stops… |
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Definition
|
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Term
| is the primary test of renal clearance |
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Definition
| A 24 hour urine collection |
|
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Term
|
Definition
| an endogenous waste product of skeletal muscle that is filtered at the glomerulus, passed through the tubules with minimal change and excreted in the urine. |
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Term
| Creatinince Clearance is a good measure of |
|
Definition
| the glomerular filtration rate (GFR) |
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Term
| Factors affecting renal clearance: |
|
Definition
1. how quickly the substance is filtered across the glomerulus
2. how much of the substance is reabsorbed along the tubules
3. how much of the substance is secreted into the tubules |
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Term
| The GFR can vary normal = |
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Definition
|
|
Term
| Creatinine Clearance is an excellent measure of |
|
Definition
renal function
as renal function declines creatinine clearance decreases |
|
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Term
| Glomerular filtration rate (GFR) |
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Definition
| describes the flow rate of filtered fluid through the kidney |
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Term
| Creatinine clearance rate (CCr or CrCl) is |
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Definition
| the volume of blood plasma that is cleared of creatinine per unit time and is a useful measure for approximating the GFR. |
|
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Term
|
Definition
| is a break-down product of creatine phosphate in muscle, and is usually produced at a fairly constant rate by the body (depending on muscle mass). |
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Term
| When the kidneys detect a decrease in oxygen in renal blood flow they release |
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Definition
|
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Term
|
Definition
| is a glycoprotein hormone that controls erythropoiesis, or red blood cell production. |
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Term
| Kidneys are responsible for the final conversison of inactive Vit D to its active form-Vit D is necessary for mantaining |
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Definition
|
|
Term
| The major waste product of protein metabolism is |
|
Definition
| UREA, 25-30 gms are produced and excreted daily |
|
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Term
| Other waste products that must be excreted are: |
|
Definition
Creatinine
Phosphates
sulfates |
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Term
| Initiation of voiding occurs when |
|
Definition
| the efferent pelvic nerve stimulates the bladder to contract- |
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Term
| Causes of Urinary Dysfunction |
|
Definition
Increase in urine volume
Decreased bladder capacity
Inflammation with increased sensitivity of urinary tract
Pressure from abdominal masses
Incomplete bladder emptying
Anxiety |
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Term
|
Definition
Painful or difficult urination, usually accompanied by frequency and urgency
Suggests inflammation or irritation of lower urinary tract
When discomfort occurs is important:
-beginning- problem with urethra
-during or after- problem in |
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Term
|
Definition
May suggest decreased function in the renal paranchyma
Often occurs when no disease is present |
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Term
|
Definition
Large amount of fluid in evening
Diuretic effect of coffee and alcohol
Medication induced
Elderly with generalized fluid retention during day will have nocturia caused by movement of fluid at rest
Should be investigated if occurs more than twice per night |
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Term
|
Definition
Involuntary release of urine during sleep, Bedwetting
In adult: highly suggestive of neurologic disorder |
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Term
|
Definition
Primary: children who have never been dry at night for prolonged periods
Secondary: a child who starts bedwetting when previously dry
Daytime control comes before nighttime
Girls mature before boys |
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Term
|
Definition
Inability to effectively empty the bladder
Acute: happens frequently post-op, S/P SVD, medication induced or result of lower back or pelvis injury
Chronic: obstruction to urinary tract, neurologic or psychologic disorders
Most pt’s who experience this are completely unable to void
Retention is also considered present if more than 50 cc PVR |
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Term
|
Definition
Assess pattern of urinary elimination
How often, amount, frequency, urgency, fullness?
Discomfort above the symphysis?
Palpate the bladder
I & O for the past 24 hours
Bladder scan post void or straight cath |
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Term
|
Definition
|
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Term
|
Definition
| spontaneous vaginal delivery |
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Term
|
Definition
Urinary retention r/t post-op complications
-assess pt
-I & O should be equal within 48
hours of surgery
-Teach pt to void when urgency is
felt
-Provide privacy, warm water, run
water, void q 2-3 hours |
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|
Term
|
Definition
Symptom not a disease
Involuntary loss of urine
Social and health problem
Can be urologic or neurologic related
Aging and childbearing are two factors
Causes stress and embarrassment, people often avoid seeking care |
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Term
|
Definition
Total
Reflex
Urge
Stress
Functional |
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Term
|
Definition
| caused by a problem in the central nervous system |
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Term
|
Definition
|
|
Term
Reflex incontinence
Treatment |
|
Definition
First-line: intermittent catheterization
Second-line: indwelling catheterization
Third-line: suprapubic catheterization |
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Term
| Urge Incontinence/definition |
|
Definition
overactive bladder
Results when the feeling to urinate is so strong and so severe that uncontrolled bladder emptying occurs
May be caused by bladder inflammation, tumor or infection
Sometimes due to uninhibited bladder contraction r/t neurologic disorders, such as spinal cord injury
Usually results from idiopathic inability to suppress bladder contractions |
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Term
|
Definition
Results when the feeling to urinate is so strong and so severe that uncontrolled bladder emptying occurs
May be caused by bladder inflammation, tumor or infection
Sometimes due to uninhibited bladder contraction r/t neurologic disorders, such as spinal cord injury
Usually results from idiopathic inability to suppress bladder contractions |
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Term
| Urge incontinence/Treatment |
|
Definition
First-line: behavioral therapies such as bladder training and bladder drill
Second-line: meds such as oxybutynin (Ditropan), or imipramine (Tofranil) |
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Term
|
Definition
Unexpected loss of small amounts of urine with rapid increase of intra-abdominal pressure ie coughing, laughing, sneezing, straining or physical activity
Most cases: the pelvic muscles supporting have weakened and normal anatomic position of bladder and urethra has changed
Most common in women |
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Term
| Treatments for Stress Incontinence |
|
Definition
First-line: behavioral therapies such as Kegel’s exercise and bladder training
Second-line: meds such as alpha-adrenergics (prazosin, doxasosin) These drugs help the bladder to retain urine by constricting the sphincter muscle and relaxing the bladder wall. These actions reduce urine leakage due to abrupt increases in pressure on the bladder.
3rd: surgery |
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Term
|
Definition
Involuntary, unpredictable passage of urine
Cannot control micturition b/c of environmental barriers, physical limitations, or disorientation. Not able to reach in time
Intact lower urinary tract but factors such as immobility, severe cognitive impairment, etc. |
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Term
Functional incontinence/Nursing Process
Assessment |
|
Definition
Voiding history
Time, place, amt. of urine
Awareness of passage of urine
What stimulates voiding
Past history of urologic, neurologic disease including dementia
Past med/surg, OB history
Hesitancy, urgency, polyuria, dysuria, nocturia |
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Term
|
Definition
Total incontinence r/t independent contraction of detrusor reflex r/t trauma or surgery
-bladder regimen
-skin is intact
-decreased episodes of
incontinence
-pt. manage bladder elimination
-pt. shows feelings of self-worth |
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Term
|
Definition
| Originating or taking place in a hospital, acquired in a hospital |
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Term
|
Definition
Colicky and one of the most severe types of pain known
Caused by sudden obstruction such as calculus, which produces hyperperistalsis and spasm of ureter
Stone produces similar symptoms of renal pain but may radiate to testes or labia
In lower ureter may cause suprapubic pain, bladder, penis or urethra |
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Term
|
Definition
| is a type of abdominal pain commonly caused by kidney stones. |
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Term
|
Definition
|
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Term
|
Definition
| refers to clarity of urine. It should be clear |
|
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Term
|
Definition
| presence of ketone bodies |
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Term
| Hematuria/Mid age to elderly |
|
Definition
| cancer! Although can be infection, calculi, BPH, vascular malformation of kidney, meds |
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Term
| Hematuria/characteristics |
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Definition
Hematuria at beginning stream -> bleeding of anterior urethra
End of stream -> posterior urethra, bladder neck
Total hematuria -> bleeding within or above bladder
Painful: associated with infections or stones
Painless: more ominous, associated with urinary tract neoplasm
May occur in renal causes: glomerulonephritis |
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Term
|
Definition
|
|
Term
|
Definition
is the low output of urine between 100-400 ml/24
hours |
|
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Term
|
Definition
excessive excretion of urine
>2500 ml/24 hour period |
|
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Term
|
Definition
| ARF, fluid & electrolyte imbalances, bilateral ureteral obstruction, urethral obstruction |
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Term
|
Definition
| decrease concentrating of kidneys, increase fluid intake, diabetes insipidus, diabetes mellitus, diuretics |
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Term
|
Definition
Inflammation of bladder -> usually results from invasion of bacteria in bladder
Women: bacteria originate from rectum or vagina and ascend upward via urethra, anatomy related
Men: results from another in urinary tract, ie. Prostatitis or BPH
Women > men Can follow medical procedures in urinary tract or incomplete bladder emptying
Also can be associated with sexual intercourse and pregnancy
Occasionally develops when bacteria travel to bladder via vascular or lymphatic systems |
|
|
Term
|
Definition
| a term that refers to urinary bladder inflammation that results from any one of a number of distinct syndromes.[1] It is most commonly caused by a bacterial infection in which case it is referred to as a urinary tract infection.[ |
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Term
|
Definition
Dysuria, frequency, urgency, nocturia, nocturnal enuresis, incontinence, urethral pain, low back pain, suprapubic pain and fever
May also complain of tenesmus (episodes of painful straining that are ineffective in producing urine)
Hematuria and urine with strong odor may be present |
|
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Term
|
Definition
Antibiotics: Amoxicillin, Bactrim (Septra, Sulfamethoprim), Cipro, Cephalosporins
For uncomplicated: 3 day therapy
Men and Peds: 7-10 days
Analgesics, urinary antiseptics, anticholinergics for bladder |
|
|
Term
|
Definition
Drink 2-3 liters of fluid per day
Notify health care provider of symptoms
Empty bladder when urge is felt
Clean perineum from front to back
Avoid bubble baths and scented T.P.
Wear cotton underwear
Finish prescriptions
Repeat urine culture
Empty bladder following intercourse |
|
|
Term
|
Definition
Inflammation of urethra
Presents with similar s/s to cystitis
May be acute or chronic
Occurs in men and women
Most common cause: STD’s Gonorrhea, chlamydia, trichomonas
Can also be caused by irritants such as soaps, perfumed T.P., sanitary napkins |
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Term
|
Definition
Burning, frequency, nocturia, difficulty with urination
Men: usually have discharge from urethral meatus Women: don’t
Both sexes c/o lower abdominal discomfort |
|
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Term
|
Definition
Abnormal narrowing or ureter, can occur at any point however 3 areas most prone:
-uteropelvic junction
-midureter
-just above uterovesical junction |
|
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Term
|
Definition
Pathologic narrowing of urethra
More common in men than women
Can be congenital or acquired
Acquired: chronic infection, STD’s or trauma women: intercourse, childbirth, vaginal surgery or chronic urethritis
Also: instrumentation, longterm use of indwelling catheters, neoplasms, venereal warts, and polyps |
|
|
Term
|
Definition
Most common: decreased force of urinary stream
Hesitancy
Double voiding, post void dribbling
Interrupted urinary stream
Urinary retention
Overflow incontinence
Dysuria, frequency, nocturia, urgency and urge incontinence |
|
|
Term
|
Definition
Goal: relieve obstruction and eradicate existing infection
Mechanical dilation is often used: local anesthetic and curved metal rods (sounds) to gradually open up stricture
Internal urethrotomy: incises strictured area. Requires intermittent self-cath to keep open |
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|
Term
|
Definition
Gross hematuria, lower suprapubic or abd pain
Rectal exam may reveal pelvic hematoma
In multiple trauma not a priority |
|
|
Term
|
Definition
Malignant tumors are most common tumors in urinary system (unless prostate is included, then prostate is)
50,000 new cases diagnosed each year
5 year survival rates are just as good for superficial tumors
5 year survival rate for extensive tumor growth 10-50% |
|
|
Term
|
Definition
Symptoms, history, and diagnostic tests
Want to stage tumor to ascertain treatment
Urine for cytology, excretory urography or CT, cystoscopy to biopsy lesion |
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Term
|
Definition
| reroutes the ureters to the surface of the abdomen forming a small stoma: risk of infection high |
|
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Term
|
Definition
| most common type- small piece of ileum is removed with blood and nerve supply intact- the remainder of the ileum is reconnected so the bowel flow is not disrupted-the free segment of the ileum is sutured closed and the other end is brought out to the abdominal wall and a stoma is created. |
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|
Term
| Continent Urostomy: also called an ileal bladder conduit- or Kock pouch |
|
Definition
| It is a variation of the ileal conduit- Urine drain from the ureters into a surgically created ileal pouch. The stoma created on the abdomen contains a nipple valve to keep urine from leaking. The patient inserts a catheter to drain the urine through the valve. A second valve prevents reflux of urine back into the kidneys. |
|
|
Term
|
Definition
Have patient void and record the time
Discard the first void
Save all the urine for the next 24 hours
Inform the patient
Post signs for other staff to collect the urine
Container usually is supplied by the lab |
|
|
Term
| specific gravity value normal |
|
Definition
|
|
Term
|
Definition
| Application of manual pressure over lower abdomen to promote emptying of bladder. |
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|
Term
|
Definition
Begins at lower level of pharynx
Hollow muscular tube – 10 inches (25 cm)
Smooth and skeletal muscle
Sphincter at both ends |
|
|
Term
| Achlorhydria or hypochlorhydria: |
|
Definition
| refers to states where the production of gastric acid in the stomach is absent or low, respectively. |
|
|
Term
|
Definition
| also known as stomach growling, rumbling |
|
|
Term
|
Definition
| the medical term for the symptom of difficulty in swallowing. |
|
|
Term
|
Definition
|
|
Term
|
Definition
| commonly called stomach pumping |
|
|
Term
|
Definition
| the lining of the stomach becomes inflamed or swollen |
|
|
Term
|
Definition
| also known as gastric flu, stomach flu, and stomach virus, although unrelated to influenza |
|
|
Term
| Hematemesis or haematemesis is |
|
Definition
|
|
Term
|
Definition
| refers to blood in the feces that is not visibly apparent. A fecal occult blood test (FOBT) checks for hidden (occult) blood in the stool |
|
|
Term
|
Definition
|
|
Term
| Percutaneous endoscopic gastrostomy (PEG) is |
|
Definition
| an endoscopic medical procedure in which a tube is passed into a patient's stomach through the abdominal wall, most commonly to provide a means of feeding when oral intake is not adequate. |
|
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Term
|
Definition
| is an opening (a direct translation of the Koine Greek would be "mouth"), either natural or surgically created, which connects a portion of the body cavity to the outside environment. |
|
|
Term
|
Definition
| the serous membrane that forms the lining of the abdominal cavity |
|
|
Term
| GI Changes in the older adult/mouth |
|
Definition
Mouth – teeth darken, may fracture, gums recede
Saliva decreases
Taste lessens |
|
|
Term
| GI Changes in the older adult/below mouth |
|
Definition
Decreased motility
LES less competent - GERD
Achlorhydria
Gall stones increase
Impaired absorption
Chronic constipation |
|
|
Term
|
Definition
| is a medical condition consisting of a paresis (partial paralysis) of the stomach, resulting in food remaining in the stomach for a longer period of time than normal. |
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