NURS2700 Genitourinary
Alterations Exam Study Guide
Urinary tract route - Answer kidneys, ureters, bladder, urethra
Which parts of the urinary tract are upper and lower? - Answer Lower urinary tract
includes the bladder and urethra.
Upper tract kidney and ureters.
The urinary tract _______ the bladder is considered sterile. - Answer The urinary tract
above the bladder is considered sterile.
What is the nephron? - Answer The nephron is the functional unit of the kidney and
forms urine by filtering waste products and water from the blood.
What is Glomerular filtration? - Answer Glomerular filtration is the first process in urine
formation. As blood passes from the afferent arteriole into the glomerulus, water,
electrolytes, and other small particles (e.g., creatinine, urea nitrogen, glucose) are
filtered across the glomerular membrane into the Bowman capsule to form glomerular
filtrate. As the filtrate enters the proximal convoluted tubule (PCT), it is called tubular
filtrate or early urine.
Large particles, such as blood cells, albumin, and other proteins, are too large to filter
through the glomerular capillary walls. Therefore these substances are not normally
present in the excreted final urine
What is GFR controlled by? - Answer GFR is controlled by blood pressure and blood
flow. The kidneys self-regulate their own blood pressure and blood flow, which keeps
GFR constant.
What are the functions of the kidneys? - Answer ´Regulate volume and composition of
extracellular fluid.
´Excrete waste.
´Control BP.
´Make erythropoietin.
´Regulate acid base balance.
Most important, they maintain body fluid volume and composition and create urine for
waste elimination
The bladder stores urine, provides continence, and enables voiding. What is
continence? What is Micturition? - Answer Continence is the ability to voluntarily control
,bladder emptying. It occurs during bladder filling through the combination of detrusor
muscle relaxation, internal sphincter muscle tone, and external sphincter contraction.
As the bladder fills with urine, stretch sensations are transmitted to spinal sacral
nerves.
Maintaining continence occurs by the interaction of the nerves that control the muscles
of the bladder, bladder neck, urethra, and pelvic floor, as well as by factors that close
the urethra.
Micturition (voiding, urination) is a reflex of autonomic control that triggers contraction
of the detrusor muscle (closing the ureter at the UVJ to prevent backflow) at the same
time as relaxation of the external sphincter and the muscles of the pelvic floor. Voluntary
urine elimination (voiding) occurs as a learned response and is controlled by the
cerebral cortex and the brainstem. Contraction of the external sphincter inhibits the
micturition reflex and prevents voiding.
Nursing Interventions for changes in the Renal System Related to Aging: Decreased
glomerular filtration rate (GFR). - Answer 1.Monitor hydration status
-The ability of the kidneys to regulate water balance decreases with age.
*2.Ensure adequate fluid intake
-The kidneys are less able to conserve water when necessary.
*3.Use caution when administering potentially nephrotoxic agents or drugs
-Dehydration reduces kidney blood flow and increases the nephrotoxic potential of
many agents
Nursing interventions for changes in the Renal System Related to Aging: Nocturia. -
Answer 1.Ensure adequate nighttime lighting and a hazard-free environment.
-Falls and injuries are common among older patients seeking bathroom facilities.
*2.Ensure the availability of a bedside toilet, bedpan, or urinal.
-Using these items instead of getting up to go the bathroom can help prevent falls.
*3.Discourage excessive fluid intake for 2-4 hr before the patient goes to bed.
-Excessive fluid intake at night may increase nocturia
*4.Evaluate drugs and timing.
-Some drugs increase urine output and increase the risk for falling when toileting.
Nursing Interventions for changes in the Renal System Related to Aging: Decreased
bladder capacity. - Answer 1.Encourage the patient to use the toilet, bedpan, or urinal at
least every 2 hr.
, -Emptying the bladder on a regular basis may avoid overflow urinary incontinence.
*2.Respond as soon as possible to the patient's indication of the need to void.
-A quick response may alleviate episodes of urinary stress incontinence.
Nursing Interventions for changes in the Renal System Related to Aging: Weakened
urinary sphincters and shortened urethra in women. - Answer Provide thorough perineal
care after each voiding.
-The shortened urethra increases the potential for bladder infections.
-Good perineal hygiene may prevent skin irritations and urinary tract infection (UTI).
Nursing Interventions for changes in the Renal System Related to Aging: Tendency to
retain urine. - Answer 1.Observe the patient for urinary retention (e.g., bladder
distention) or urinary tract infection (e.g., dysuria, foul odor, confusion).
-Urinary stasis may result in a UTI, which may lead to bloodstream infections,
urosepsis, or septic shock.
*2.Provide privacy, assistance, and voiding stimulants such as warm water over the
perineum as needed.
-Nursing interventions can help initiate voiding.
*3.Evaluate drugs for possible contribution to retention
-Anticholinergic drugs promote urinary retention.
The nurse percusses a patient that has bladder distention, what will they hear? - Answer
A distended bladder will sound dull when percussed...if you suspect retention, get a
bladder scanner
If the patient has a distended bladder, what do we do? - Answer If patient is distended,
inspect and palpate bladder edges in hypogastric region to assess for distension. If the
bladder is distended, percuss and listen for dullness.
What is urinalysis? - Answer Examination of physical and chemical properties of urine
used to assess the following:
ØUrine color
ØSpecific gravity (the concentration of particles (i.e., electrolytes, wastes) in urine)
ØpH
ØProtein
ØGlucose (may indicate a high level of glucose in the blood, typically greater than 220
mg/dL (12 mmol/L))
Alterations Exam Study Guide
Urinary tract route - Answer kidneys, ureters, bladder, urethra
Which parts of the urinary tract are upper and lower? - Answer Lower urinary tract
includes the bladder and urethra.
Upper tract kidney and ureters.
The urinary tract _______ the bladder is considered sterile. - Answer The urinary tract
above the bladder is considered sterile.
What is the nephron? - Answer The nephron is the functional unit of the kidney and
forms urine by filtering waste products and water from the blood.
What is Glomerular filtration? - Answer Glomerular filtration is the first process in urine
formation. As blood passes from the afferent arteriole into the glomerulus, water,
electrolytes, and other small particles (e.g., creatinine, urea nitrogen, glucose) are
filtered across the glomerular membrane into the Bowman capsule to form glomerular
filtrate. As the filtrate enters the proximal convoluted tubule (PCT), it is called tubular
filtrate or early urine.
Large particles, such as blood cells, albumin, and other proteins, are too large to filter
through the glomerular capillary walls. Therefore these substances are not normally
present in the excreted final urine
What is GFR controlled by? - Answer GFR is controlled by blood pressure and blood
flow. The kidneys self-regulate their own blood pressure and blood flow, which keeps
GFR constant.
What are the functions of the kidneys? - Answer ´Regulate volume and composition of
extracellular fluid.
´Excrete waste.
´Control BP.
´Make erythropoietin.
´Regulate acid base balance.
Most important, they maintain body fluid volume and composition and create urine for
waste elimination
The bladder stores urine, provides continence, and enables voiding. What is
continence? What is Micturition? - Answer Continence is the ability to voluntarily control
,bladder emptying. It occurs during bladder filling through the combination of detrusor
muscle relaxation, internal sphincter muscle tone, and external sphincter contraction.
As the bladder fills with urine, stretch sensations are transmitted to spinal sacral
nerves.
Maintaining continence occurs by the interaction of the nerves that control the muscles
of the bladder, bladder neck, urethra, and pelvic floor, as well as by factors that close
the urethra.
Micturition (voiding, urination) is a reflex of autonomic control that triggers contraction
of the detrusor muscle (closing the ureter at the UVJ to prevent backflow) at the same
time as relaxation of the external sphincter and the muscles of the pelvic floor. Voluntary
urine elimination (voiding) occurs as a learned response and is controlled by the
cerebral cortex and the brainstem. Contraction of the external sphincter inhibits the
micturition reflex and prevents voiding.
Nursing Interventions for changes in the Renal System Related to Aging: Decreased
glomerular filtration rate (GFR). - Answer 1.Monitor hydration status
-The ability of the kidneys to regulate water balance decreases with age.
*2.Ensure adequate fluid intake
-The kidneys are less able to conserve water when necessary.
*3.Use caution when administering potentially nephrotoxic agents or drugs
-Dehydration reduces kidney blood flow and increases the nephrotoxic potential of
many agents
Nursing interventions for changes in the Renal System Related to Aging: Nocturia. -
Answer 1.Ensure adequate nighttime lighting and a hazard-free environment.
-Falls and injuries are common among older patients seeking bathroom facilities.
*2.Ensure the availability of a bedside toilet, bedpan, or urinal.
-Using these items instead of getting up to go the bathroom can help prevent falls.
*3.Discourage excessive fluid intake for 2-4 hr before the patient goes to bed.
-Excessive fluid intake at night may increase nocturia
*4.Evaluate drugs and timing.
-Some drugs increase urine output and increase the risk for falling when toileting.
Nursing Interventions for changes in the Renal System Related to Aging: Decreased
bladder capacity. - Answer 1.Encourage the patient to use the toilet, bedpan, or urinal at
least every 2 hr.
, -Emptying the bladder on a regular basis may avoid overflow urinary incontinence.
*2.Respond as soon as possible to the patient's indication of the need to void.
-A quick response may alleviate episodes of urinary stress incontinence.
Nursing Interventions for changes in the Renal System Related to Aging: Weakened
urinary sphincters and shortened urethra in women. - Answer Provide thorough perineal
care after each voiding.
-The shortened urethra increases the potential for bladder infections.
-Good perineal hygiene may prevent skin irritations and urinary tract infection (UTI).
Nursing Interventions for changes in the Renal System Related to Aging: Tendency to
retain urine. - Answer 1.Observe the patient for urinary retention (e.g., bladder
distention) or urinary tract infection (e.g., dysuria, foul odor, confusion).
-Urinary stasis may result in a UTI, which may lead to bloodstream infections,
urosepsis, or septic shock.
*2.Provide privacy, assistance, and voiding stimulants such as warm water over the
perineum as needed.
-Nursing interventions can help initiate voiding.
*3.Evaluate drugs for possible contribution to retention
-Anticholinergic drugs promote urinary retention.
The nurse percusses a patient that has bladder distention, what will they hear? - Answer
A distended bladder will sound dull when percussed...if you suspect retention, get a
bladder scanner
If the patient has a distended bladder, what do we do? - Answer If patient is distended,
inspect and palpate bladder edges in hypogastric region to assess for distension. If the
bladder is distended, percuss and listen for dullness.
What is urinalysis? - Answer Examination of physical and chemical properties of urine
used to assess the following:
ØUrine color
ØSpecific gravity (the concentration of particles (i.e., electrolytes, wastes) in urine)
ØpH
ØProtein
ØGlucose (may indicate a high level of glucose in the blood, typically greater than 220
mg/dL (12 mmol/L))
