CCC EXAM 1 QUESTIONS AND CORRECT RATIONALES
Functions cof cthe corgans cin cthe curinary ctract? c- c1. cKidneys: c
cRegulate celectrolytes
cEliminate cwastes
cRegulate cfluid cvolume
cHelp cmaintain cacid-base cbalance
cHelp cregulate cblood cpressure
cRegulate cred cblood ccell cproduction
cTurn cVitamin cD cinto cthe cactive cform
cNephron
cThe c"functional cunit" cof cthe ckidney
cFilters cwaste cout cof cblood
cContains=
cGlomerulus
cBowman's cCapsule
cBlood cvessels
cTubules
2. cUreters
One cfrom ceach ckidney
Urine cpasses cfrom cthe cureters cand cinto cthe cbladder
3. cBladder
Hollow
Muscular
Lined cby ca cmucus cmembrane
4. cUrethra
Brings cthe curine cto cthe coutside cof cthe cbody
Internal csphincter
External csphincter
Functions cof chormones cin cthe curinary ctract? c- c1. cerythropoietin
is creleased cby cthe ckidneys cin cresponse cto clow coxygen. cThis chormone cstimulates cthe cred cbone cmarrow cto cmake cmore cred
cblood ccells cto cincrease coxygen cin cthe cblood. cClients cwith crenal c(kidney) cfailure cwill cbe canemic cbecause cif cthe ckidneys
caren't cfunctioning, cthey ccannot cmake cerythropoietin. cNo cerythropoietin cmeans cthe cbone cmarrow cdoesn't cget cnotified cto
cmake cmore cRBC's. cIn ccontrast, cClients cwho care cchronically chypoxic cwill chave ca cvery chigh chematocrit cbecause cthe ckidneys
ckeep creleasing cerythropoietin cbecause cof cthe cchronically clow cO2- cno cthis cis cnot ca cgood cthing cas cit ccauses cother cproblems.
cAnother cinteresting cfact cabout cthis chormone cis cthat cendurance cathletes coften c"dope" cwith cerythropoietin c(take cit cillegally) cto
cincrease ctheir cred cblood ccell ccount cand chave cmore coxygen. cIt cis ccommonly ccalled c"EPO."
2. cantidiutetic
cis calso cknown cas cADH cor cVasopressin c(because cit calso cconstricts carterioles). cIt cis cmade cby cthe chypothalamus cbut
creleased cby cthe cposterior cpituitary. cLike caldosterone cmakes cthe ckidneys ckeep cwater cso curine cwill cbe cmore cconcentrated
cand cblood cpressure cwill cbe cincreased.
Fun cFact: cAlcohol cnaturally cinhibits cthe cproduction cof cADH. cThat cis cwhy cwhen calcoholic cbeverages care cconsumed curination
cgreatly cincreases.
Life chack: cNever cwear cbutton-fly cjeans cto ca cbar.
Fun cFact: cIncreased csecretion cof cADH cis ccalled cdiabetes cinsipidus.
This cdisorder chas cabsolutely cnothing cto cdo cwith cthe cwell-known cdiabetes cmellitus. cClients cwith cdiabetes cinsipidus cwill cput
cout clarge cvolumes cof curine cand cbecome cdehydrated. cClients cwith cthis cdisorder cwill coften chave chead ctrauma cor ca cbrain
ctumor.
3. crenin-angiotensin
This cis cyet canother cmechanism cto cincrease cblood cpressure. cThis cmechanism ccauses cconstriction cof cblood cvessels. cThe
cRenin-Angiotensin cmechanism chas ca clong cmechanism cof caction cthat cI cwon't cbore cyou cwith c(many cboring csteps
Normal clab cvalues cfor curinalysis? c- cpH= c4.5-6.0
specific cgravity= c1.010-1.030
Negative cfor cprotein, cglucose, cketones, cand cbilirubin.
Causes cof ceach ctype cof cincontinence? c- c-Urge cincontinence
, cInvoluntary closs cof curine cwith ca cstrong curge cto curinate.
-Stress cincontinence
cUrethral csphincter cfails cand cthere cis can cincrease cin cintra-abdominal cpressure.
cSneezing, claughing, ccoughing, caerobic cexercise.
-Mixed cincontinence
cCombination cof cdifferent ctypes.
-Overflow cincontinence
cPoor ccontractility cof cthe cdetrusor cmuscle cor cobstruction cof cthe curethra.
cProstate chypertrophy, cgenital cprolapse.
-Functional cincontinence
cCognitive cinability cto crecognize cthe curge cto curinate cor ca cself-care cdeficit ccaused cby cextreme cdepression.
cInability cto creach cthe cbathroom cdue cto crestraints, cside crails, cor cout-of-reach cwalker.
-Neurological cincontinence
cMultiple csclerosis, cspinal ccord cinjuries.
-Client cEducation cfor cIncontinence:
cPatient chistory cand caccurate creporting cof csymptoms.
cBladder cdiary
cRoutine cUA, cpost cvoid cresidual cvolume, cstress ctesting, curodynamic cstudies, ccystogram, ccystoscopy.
cPelvic cfloor cexercises, cvaginal cweight ctraining, ctopical cestrogen ctherapy, cmedications, cbulking cinjections cfor ctissue
csurrounding curethra, cpessary, cbotox cinjections, cbiofeedback ctherapy, cimplanted celectric cstimulation cdevice cSurgeries cinclude
cretropubic csuspension, cartificial csphincter cimplant cIntermittent ccatheterization, csuprapubic ccatheter, ccondom ccatheters,
cprotective cpads/garments.
Normal cbreath csounds? c- c-Vesicular cbreath csounds
Low cto cmedium cpitch cwith ca csoft cwhooshing cquality; cinspiration cis ctwo cto cthree ctimes cthe clength cof cexpiration
-Bronchovesicular cbreath csounds
Moderate cto chigh cpitch cwith ca chollow, cmuffled cquality; cequal ctime cof cinspiration cand cexpiration
-Bronchial cbreath csounds
High cpitch cwith ca cloud, charsh, ctubular cquality; cinspiration chalf cas clong cas cexpiration
Abnormal cbreath csounds? c- c-Wheezes
Whistling, chigh-pitched
Air cforced cthrough cnarrow cairway
Asthma
-Crackles
Air cpassing cthrough cmoisture cin csmaller cairways
Fine ccrackles-high-pitched; catelectasis, cfibrosis, cpneumonia, cearly cCHF
Coarse ccrackles-louder cand clow-pitch; cbronchitis, cpulmonary cedema, cresolving cpneumonia
-Pleural cFriction cRub
Grating cor cscratching csound
Irritated cvisceral cand cparietal cpleura crub ctogether
-Stridor
"Croaking" csound
Partial cobstruction cof cthe cupper cair cpassages crelated cto cinflammation cor cforeign cbody
Croup cor cupper cairway cobstruction
Requires cprompt cassessment cand cintervention
-Coarse/Sonorous cWheezes
Low-pitched, crattling csound
Caused cby csecretions cin clarger cair cpassages
Formerly cknown cas c"rhonchi"
BUN cranges? c- c7-20 cmg/dL c
depending con csex cand cgender
Creatinine cranges? c- c0.8-1.2 cmg/dL
depending con cgender
Acute cglomerulonephritis? c- c-Primarily cchildren cand cyoung cadults-males cmore ccommon
-2-3 cweeks cafter cgroup cA cbeta-hemolytic cstreptococcal cinfection c(strep cthroat, cimpetigo)Can calso cbe ca cresponse cto cbacterial,
cviral, cor cparasitic cinfections celsewhere cin cbody
-Immunologic cproblem ccaused cby can cantigen-antibody creaction
Antigen-antibody ccomplexes care cdeposited cin cthe cglomerular cbasement cmembrane, ccausing ccell cdamage cand caltered
cpermeability; cleads cto cscarred crenal ctissue cand cimpaired cfunction
-Suddenly cill; cfever, cchills, cflank cpain, cwidespread cedema, cpuffiness caround cthe ceye, cvisual cdisturbances, cand cmarked
chypertension
-Diagnostic ctests cinclude cUA, ccreatinine, cBUN, cCBC; curine cmay cbe csmoky cand ccontain cRBCs cand cprotein cwith cincreased
cspecific cgravity; csevere cconditions cwill cshow canemia
-Sodium-restricted cdiet; cfluid crestriction; clow-protein, chigh ccarbohydrate cdiet; cplasmapheresis
-Patient chistory cof cpast cillnesses, cphysical cassessment, cbaseline cVS cand cweight, cfrequent cmental cstatus cchecks, ccardiac
cand cpulmonary cassessments, cabsolute cbed crest, cfollow cdiet crestriction
Normal cadult curine coutput? c- c30ML/Hr
Functions cof cthe corgans cin cthe curinary ctract? c- c1. cKidneys: c
cRegulate celectrolytes
cEliminate cwastes
cRegulate cfluid cvolume
cHelp cmaintain cacid-base cbalance
cHelp cregulate cblood cpressure
cRegulate cred cblood ccell cproduction
cTurn cVitamin cD cinto cthe cactive cform
cNephron
cThe c"functional cunit" cof cthe ckidney
cFilters cwaste cout cof cblood
cContains=
cGlomerulus
cBowman's cCapsule
cBlood cvessels
cTubules
2. cUreters
One cfrom ceach ckidney
Urine cpasses cfrom cthe cureters cand cinto cthe cbladder
3. cBladder
Hollow
Muscular
Lined cby ca cmucus cmembrane
4. cUrethra
Brings cthe curine cto cthe coutside cof cthe cbody
Internal csphincter
External csphincter
Functions cof chormones cin cthe curinary ctract? c- c1. cerythropoietin
is creleased cby cthe ckidneys cin cresponse cto clow coxygen. cThis chormone cstimulates cthe cred cbone cmarrow cto cmake cmore cred
cblood ccells cto cincrease coxygen cin cthe cblood. cClients cwith crenal c(kidney) cfailure cwill cbe canemic cbecause cif cthe ckidneys
caren't cfunctioning, cthey ccannot cmake cerythropoietin. cNo cerythropoietin cmeans cthe cbone cmarrow cdoesn't cget cnotified cto
cmake cmore cRBC's. cIn ccontrast, cClients cwho care cchronically chypoxic cwill chave ca cvery chigh chematocrit cbecause cthe ckidneys
ckeep creleasing cerythropoietin cbecause cof cthe cchronically clow cO2- cno cthis cis cnot ca cgood cthing cas cit ccauses cother cproblems.
cAnother cinteresting cfact cabout cthis chormone cis cthat cendurance cathletes coften c"dope" cwith cerythropoietin c(take cit cillegally) cto
cincrease ctheir cred cblood ccell ccount cand chave cmore coxygen. cIt cis ccommonly ccalled c"EPO."
2. cantidiutetic
cis calso cknown cas cADH cor cVasopressin c(because cit calso cconstricts carterioles). cIt cis cmade cby cthe chypothalamus cbut
creleased cby cthe cposterior cpituitary. cLike caldosterone cmakes cthe ckidneys ckeep cwater cso curine cwill cbe cmore cconcentrated
cand cblood cpressure cwill cbe cincreased.
Fun cFact: cAlcohol cnaturally cinhibits cthe cproduction cof cADH. cThat cis cwhy cwhen calcoholic cbeverages care cconsumed curination
cgreatly cincreases.
Life chack: cNever cwear cbutton-fly cjeans cto ca cbar.
Fun cFact: cIncreased csecretion cof cADH cis ccalled cdiabetes cinsipidus.
This cdisorder chas cabsolutely cnothing cto cdo cwith cthe cwell-known cdiabetes cmellitus. cClients cwith cdiabetes cinsipidus cwill cput
cout clarge cvolumes cof curine cand cbecome cdehydrated. cClients cwith cthis cdisorder cwill coften chave chead ctrauma cor ca cbrain
ctumor.
3. crenin-angiotensin
This cis cyet canother cmechanism cto cincrease cblood cpressure. cThis cmechanism ccauses cconstriction cof cblood cvessels. cThe
cRenin-Angiotensin cmechanism chas ca clong cmechanism cof caction cthat cI cwon't cbore cyou cwith c(many cboring csteps
Normal clab cvalues cfor curinalysis? c- cpH= c4.5-6.0
specific cgravity= c1.010-1.030
Negative cfor cprotein, cglucose, cketones, cand cbilirubin.
Causes cof ceach ctype cof cincontinence? c- c-Urge cincontinence
, cInvoluntary closs cof curine cwith ca cstrong curge cto curinate.
-Stress cincontinence
cUrethral csphincter cfails cand cthere cis can cincrease cin cintra-abdominal cpressure.
cSneezing, claughing, ccoughing, caerobic cexercise.
-Mixed cincontinence
cCombination cof cdifferent ctypes.
-Overflow cincontinence
cPoor ccontractility cof cthe cdetrusor cmuscle cor cobstruction cof cthe curethra.
cProstate chypertrophy, cgenital cprolapse.
-Functional cincontinence
cCognitive cinability cto crecognize cthe curge cto curinate cor ca cself-care cdeficit ccaused cby cextreme cdepression.
cInability cto creach cthe cbathroom cdue cto crestraints, cside crails, cor cout-of-reach cwalker.
-Neurological cincontinence
cMultiple csclerosis, cspinal ccord cinjuries.
-Client cEducation cfor cIncontinence:
cPatient chistory cand caccurate creporting cof csymptoms.
cBladder cdiary
cRoutine cUA, cpost cvoid cresidual cvolume, cstress ctesting, curodynamic cstudies, ccystogram, ccystoscopy.
cPelvic cfloor cexercises, cvaginal cweight ctraining, ctopical cestrogen ctherapy, cmedications, cbulking cinjections cfor ctissue
csurrounding curethra, cpessary, cbotox cinjections, cbiofeedback ctherapy, cimplanted celectric cstimulation cdevice cSurgeries cinclude
cretropubic csuspension, cartificial csphincter cimplant cIntermittent ccatheterization, csuprapubic ccatheter, ccondom ccatheters,
cprotective cpads/garments.
Normal cbreath csounds? c- c-Vesicular cbreath csounds
Low cto cmedium cpitch cwith ca csoft cwhooshing cquality; cinspiration cis ctwo cto cthree ctimes cthe clength cof cexpiration
-Bronchovesicular cbreath csounds
Moderate cto chigh cpitch cwith ca chollow, cmuffled cquality; cequal ctime cof cinspiration cand cexpiration
-Bronchial cbreath csounds
High cpitch cwith ca cloud, charsh, ctubular cquality; cinspiration chalf cas clong cas cexpiration
Abnormal cbreath csounds? c- c-Wheezes
Whistling, chigh-pitched
Air cforced cthrough cnarrow cairway
Asthma
-Crackles
Air cpassing cthrough cmoisture cin csmaller cairways
Fine ccrackles-high-pitched; catelectasis, cfibrosis, cpneumonia, cearly cCHF
Coarse ccrackles-louder cand clow-pitch; cbronchitis, cpulmonary cedema, cresolving cpneumonia
-Pleural cFriction cRub
Grating cor cscratching csound
Irritated cvisceral cand cparietal cpleura crub ctogether
-Stridor
"Croaking" csound
Partial cobstruction cof cthe cupper cair cpassages crelated cto cinflammation cor cforeign cbody
Croup cor cupper cairway cobstruction
Requires cprompt cassessment cand cintervention
-Coarse/Sonorous cWheezes
Low-pitched, crattling csound
Caused cby csecretions cin clarger cair cpassages
Formerly cknown cas c"rhonchi"
BUN cranges? c- c7-20 cmg/dL c
depending con csex cand cgender
Creatinine cranges? c- c0.8-1.2 cmg/dL
depending con cgender
Acute cglomerulonephritis? c- c-Primarily cchildren cand cyoung cadults-males cmore ccommon
-2-3 cweeks cafter cgroup cA cbeta-hemolytic cstreptococcal cinfection c(strep cthroat, cimpetigo)Can calso cbe ca cresponse cto cbacterial,
cviral, cor cparasitic cinfections celsewhere cin cbody
-Immunologic cproblem ccaused cby can cantigen-antibody creaction
Antigen-antibody ccomplexes care cdeposited cin cthe cglomerular cbasement cmembrane, ccausing ccell cdamage cand caltered
cpermeability; cleads cto cscarred crenal ctissue cand cimpaired cfunction
-Suddenly cill; cfever, cchills, cflank cpain, cwidespread cedema, cpuffiness caround cthe ceye, cvisual cdisturbances, cand cmarked
chypertension
-Diagnostic ctests cinclude cUA, ccreatinine, cBUN, cCBC; curine cmay cbe csmoky cand ccontain cRBCs cand cprotein cwith cincreased
cspecific cgravity; csevere cconditions cwill cshow canemia
-Sodium-restricted cdiet; cfluid crestriction; clow-protein, chigh ccarbohydrate cdiet; cplasmapheresis
-Patient chistory cof cpast cillnesses, cphysical cassessment, cbaseline cVS cand cweight, cfrequent cmental cstatus cchecks, ccardiac
cand cpulmonary cassessments, cabsolute cbed crest, cfollow cdiet crestriction
Normal cadult curine coutput? c- c30ML/Hr
