What are the functions of the kidneys?
Regulation of blood pressure; regulating blood osmolarity; removal of toxins; blood filtration; activate vitamin D
What are the clinical manifestations of benign prostatic hypertrophy?
dribbling; difficulty initiating urine stream; hesitancy; urinary retention, decreased stream
What substance controls the reabsorption of water from the collecting ducts?
ADH- Anti Diuretic Hormone
What is type 2 diabetes characterized as?
peripheral tissue insulin resistance
What are the clinical manifestations of Graves’ disease?
Exophthalmos (bulging eyes), goiter, enlarge thyroid, heat intolerance, anxiety- hyperthyroidism
What processes occur during fasting?
glucogenesis; glycogenesis
What type of tissue is accessed to promote energy production in type 1 diabetes?
adipose/ fat
What are the clinical manifestations of hypothyroidism?
myxedema, fatigue, cold sensitivity, constipation, weight gain
What are the clinical manifestations of hyperthyroidism?
Goiter, fatigue, weight loss, infertility, memory loss, hair loss, muscle pain
What are the clinical manifestation of hyper para thyroidism?
fatigue, body aches, bone pain, depression, headaches, memory loss
What are the clinical manifestations of hypo para thyroidism?
numbness, tetany, parathesis, muscle spasms
What are the clinical manifestations of ketoacidosis?
fruity breath, drowsiness, nausea, thirst, confusion, lethargy, vomiting
What mechanisms control hormone release and regulation?
negative feedback loop
What hormones are released by the anterior pituitary gland?
Growth Hormone, prolactin, follicle stimulating hormone, thyroid stimulating hormone, LH, ACTH and endorphins
What is diabetes insipidus?
a disorder caused by inadequate amounts of ADH which causes excessive water loss
clinical manifestations of diabetes insipidus
polyuria, nocturia, continuous thirst, and polydipsia
clinical manifestations of Cushings syndrome?
Excessive secretion of cortisol causes redistribution of fat, “moon face”, “buffalo” hump on the back and pendulous abdomen. –
Facial skin is flushed (high blood pressure), skin covering abdomen develops stretch marks – •
ndividual bruises easily and wound healing is poor –
Approximately 1/2 develop mental status changes from irritability to severe psychiatric disturbance –
Females may experience changes due to increased androgen levels
clinical manifestations of secondary hypothyroidism
Weakness. –
Fatigue. –
Cold intolerance. –
Constipation. –
Weight gain. –
Depression. –
Joint or muscle pain. –
Brittle fingernails.
clinical manifestations of primary hypothyroidism
fatigue. –
lethargy. –
sensitivity to cold. –
depression. –
muscle weakness.
clinical manifestations of primary aldosteronism
hypertension and hypokalemia
clinical manifestations of secondary aldosteronism
High blood pressure. –
Low level of potassium in the blood. –
Feeling tired all the time. –
Headache. –
Muscle weakness. –
Numbness.
What is myxedema?
severe hypothyroidism; non pitting edema
What are the causes of hypothyroidism?
Hashimoto’s disease: most common when the immune system attacks the thyroid cells
- after surgical or radioactive treatment for hyperthyroidism
- head or neck radiation for cancer
- iodine deficiency
What are the three p’s in diabetes?
polydipsia, polyuria, polyphagia
What is the difference between primary and secondary endocrine disorders?
Primary endocrine disease inhibits the action of downstream glands, malfunction of the hormone producing gland; Secondary endocrine disease is indicative of a problem with the pituitary gland.
What is the cause of Cushing syndrome?
Excessive corticosteroids
What is acute gastritis?
Transient inflammation of the gastric mucosa
What is chronic gastritis?
Chronic mucosal inflammatory changes leading to atrophy and intestinal metaplasia. This is mostly due to H. Pylori, but in some cases it can be autoimmune.
What causes gastritis?
Acute – circulatory disturbances (shock) and exposure to exogenous irritants (drugs [aspirin], alcohol, chemicals, lactose intolerance)
Chronic – cause is unknown
is probably mediated by immunologic mechanism or related to infection with H. pylori
What is amenorrhea?
- absence of menstruation
What is metrorrhagia?
- bleeding between periods
What is dysmenorrhea?
- painful periods
Costal vertebral angle (CVA)
angle formed by the 12th rib and the vertebral column on the posterior thorax, overlying the kidney; percuss for kidney tenderness
What causes flank pain?
kidney stones
When is enuresis abnormal?
after age 5
People with polycystic kidney disease should do what?
increase fluid intake, measure blood pressure regularly
What is polyuria?
frequent urination
Female Mutilation
risks for uti, trouble urinating
What hormone causes bleeding during menopause?
estrogen
Where does exchange occur in the kidneys?
As the filtered fluid moves along the tubule, the blood vessel reabsorbs almost all of the water, along with minerals and nutrients your body needs. The tubule helps remove excess acid from the blood. The remaining fluid and wastes in the tubule become urine.
What increases the risk for bladder cancer?
smoking
What is the kidney filtration path?
Bowmans capsule>proximal tubule>loop of henle>distal tubule
What causes increase in glumerial filtration?
increase capillary hydrostatic pressure
What is cystitis?
inflammation of the urinary bladder; UTI, painful burning, itching,
What is a hydrocele?
Fluid collection within the tunica vaginalis
What are the symptoms of prositis?
pain, fever, trouble urinating, trouble with urine retention
What is renal colic?
kidney stone related pain
What is the bacteria associated with syphilis?
anaerobic spirochetes
What are complications of syphilis?
vascular problems, cardiovascular, aortic stenosis, inflamed aorta, aorta necrosis, brain aneurysm, blindness, numbness, tingly, loopyness
What end periods?
anorexia, menopause, pregnancy, hypothyroidism, adenomas and carcinomas
When is RAS activated?
low BP
Treatment for herpes
Acyclovir, sitz bath, dry heat
symptoms of post streptococcal glomerulonephritis
dark urine
What causes acromegaly?
excessive GH during adulthood
Primary hypothyroidism levels
low T4, high TSH
Secondary hypothyroidism levels
low T3, T4 and TSH
What is gigantism?
hypersecretion of GH in children
What is diabetes insipidus?
a disorder caused by inadequate amounts of ADH which causes excessive water loss
What is SIADH?
syndrome of inappropriate antidiuretic hormone; too much sodium secretion
What is the tumor of the adrenal gland?
Pheochromocytoma
Acromegaly/Gigantism
coarse facial features, deepening of voice, increased ring or shoe size
Graves disease
unexplained weight loss, goiter, bulging eyes
Myexdema coma is associated with hyperthyroidism
false
Patient with dysmenorrhea
assess pain in pelvic area and upper thighs
What is the sign of acute prostatitis?
tender prostate
CVA is pain is another description for flank pain?
True
A client has flank pain of 6 on a scale from 0-10. This flank pain is likely because of what reason?
possible pyelonephritis, with inflammation and stretching of renal caps
Which is indicative of secondary hypothyroidism?
Low TSH and LOW T3/T4
What is indicative of primary hypothyroidism?
High TSH and Low T3/T4
What are the two stress hormones that increase glucose production in the liver?
Corticosteroids
- catecholamines
A client presents with right lower abdominal pain and occasional diarrhea. This is likely?
Appendicitis
A female arrives at the clinic complaining of bleeding between menstrual periods. The nurse identifies this as?
Metrorrhagia
A good explanation for myxedema in thyroid deficiency is?
Lack of thyroid hormone contributes to non- pitting edema
An example of a genetic defect in young children with cystitis is?
Vesicoureteral reflux
Diabetes insipidus is caused from?
too little ADH production
Helicobacter pylori (H.pylori) is often a cause of?
peptic ulcer disease
In response to a respiratory infection and a high fever, the kidney tubules maintain a normal ph of body fluids by?
secreting acids and reabsorbing bicarbonate ions
Metabolic acidosis develops with bilateral kidney disease for what reason?
tubule exchanges are impaired
The client has gallstones obstructing the cystic duct. What would the nurse anticipate in the assessment of the client?
severe upper right quadrant pain
The glomerular filtration will increase by which of the following?
increase hydrostatic pressure in the glomerular capillaries
Cardinal signs of pheochromocytoma?
hypertension
The nurse expects which of the following in an assessment of a client with ketoacidosis?
deep fast respirations and lethargy
The nurse is aware that cushings syndrome is caused by which of the following?
hypercortisolism
What causes Hirschsprung Disease?
inadequate innervation of the colon
What would the nurse expect to assess in a client with Addisons disease?
severe fatigue, muscle joint pain, nausea, vomiting, abdominal pain, darkening areas of the skin
Which of the following results from obstruction of the left ureter by a renal calculus?
severe renal colic
What are the clinical manifestations of appendicitis?
right lower abdominal pain, nausea and occasionally diarrhea
What is the cause of pseudomembranous colitis?
overgrowth of Clostridioides difficile (C difficile) bacteria; overexposure to antibiotics
What is the nonpharmacologic treatment for pseudocolitis?
fecal transplant, colectomy, antibiotics
What is the cause of Helicobacter pylori (H. pylori)?
bacteria spread from person to person; bacteria penetrates the stomach mucous lining and generates substances to neutralize stomach acids
What are the clinical manifestations of gastric carcinoma?
No early signs; later signs are anorexia weight loss and GI bleeding
What causes gastroenteritis due to Salmonella?
Raw or under cooked chicken or eggs
What are complications of a perforated gallbladder?
Sepsis infection
What causes jaundice?
Increased serum bilirubin over 2.5 mg/dL
What disease is associated with jaundice?
Cirrhosis of the liver; hepatitis
What is dysphasia?
difficulty swallowing
What is occult blood?
Blood that is not visible to the naked eye
What should patients with newly diagnosed pancreatitis avoid?
Alcohol
What causes greenish- yellow emesis?
Bile
What is the most frequent location of peptic ulcers?
proximal duodenum
What types of hepatitis increase the risk of hepatocellular carcinoma?
Hep B and C
What are the clinical manifestations of chronic gastritis?
inflammation of the stomach lining and anorexia from not eating
What types of things put a patient at risk for developing acute gastritis?
lactose intolerance, regular use of pain relievers, stress, excessive alcohol use
What are the clinical manifestations of acute gastritis?
GI distress, bloat, , nausea, vomiting, anorexia from not eating, postprandial discomfort
What is the cause of hiatal hernia?
Increased intra-abdominal pressure, such as ascites, pregnancy, obesity, chronic straining or coughing
What is the cause of a rigid abdomen in peritonitis?
inflamed peritoneum
What is cryptorchidism?
undescended testes
What are complications of cryptorchidism?
infertility and cancer
What are the clinical manifestations of acute prostatitis?
dysuria, frequency, urgency, painful prostate
What is a complication of removing too much fluid during dialysis?
hemodialysis, low BP
What would you monitor while removing fluid during dialysis?
BP
What are the clinical manifestations of pyelonephritis?
CVA tenderness, fever, chills, N/V, anorexia which increases fever induced dehydration
Individuals with HPV are at risk for developing what disease?
Cervical cancer
What is enuresis?
bed wetting
What is stress incontinence?
Leakage with increased abdominal pressure, effort, exertion, sneezing, or coughing
What is micturition?
urination
What is overflow incontinence?
Leakage due to inability of the bladder to empty itself correctly (thus causing bladder to fill up to max capacity) caused by a urethral blockage
What is a genetic defect in young children with cystitis?
vesicoureteral reflux; back flow of urine from the bladder to the ureter and renal pelvis
How do kidney tubules maintain a normal pH in response to fever and respiratory infection?
secrete acid and reabsorb bicards
Why does metabolic acidosis occur?
excessive production of fixed acids;
- DKA
- lactic acidosis
- low flow states
- loss of buffers, like loss of bicarb from GIT or
- inability of kidney to eliminate acids; ie. renal failure
What is the serum marker ordered when screening fro prostate cancer?
PSA- Prostate specific antigen
What are complications of hydronephrosis?
ischemia and necrosis; swelling and build-up of fluid in the kidney; back flow, swelling pressure
What is the cause of increased glomerular filtration rate?
increase in the glomerular capillary hydrostatic pressure
What is the most common cause of pyelonephritis?
E. coli; ascending UTI
What are the risk factors for developing chronic renal failure?
too much Nsaids, chronic kidney disease; diabetes type 1; hypertension