Chapter 33: Urology & Nephrology

Urology- the surgical specialty dealing w/the urinary/genitourinary system. Urinary System- the group of organs that produce urine, maintaining fluid and electrolyte balance for the body. Urine- the fluid made by the kidney and eliminated from the body. Urea- waste derived from ammonia produced through protein metabolism. Genitourinary System- the male organ system that includes reproductive and urinary structures. Benign Prostatic Hypertrophy- a noncancerous enlargement of the prostate associated w/aging. Preventive Strategy- a management plan to minimize further damage to vital tissues. Mechanisms of Non-Traumatic Urologic Disorders Inflammatory or immune-mediated disease Infectious disease Physical obstruction Hemorrhage Types of Pain Visceral Pain- pain arising in hollow organs such as the ureter and bladder. Characterized by; aching or crampy pain felt deep within the body and poorly localized. Referred Pain- pain felt in a location other than that of its origin. Somatic- sharp, localized pain that originates in walls of the body such as skeletal muscles. Renal Emergencies Nephrology- the medical specialty dealing w/the kidneys Renal- pertaining to the kidneys. End-stage Renal Failure- an extreme failure of kidney function due to nephron loss. Dialysis- a procedure that replaces some lost kidney functions. Kidney transplantation- implantation of a kidney into a person without functioning kidneys. Renal Calculi- kidney stones. Lloyds sign- Pain on percussion of the costovertebral angle and is indicative of infection of the kidney and renal pelvis. Patients most at Risk for significant Kidney Problems Older patients Patients w/diabetes Patients w/chronic hypertension Patients w/more than one risk factor Most Common Renal Emergencies Acute Renal Failure (ARF)- the sudden-onset of severely decreased urine production. o Causes of ARF

Prerenal ARF- ARF due to decreased blood perfusion of kidneys. Renal ARF- ARF due to pathology within the kidney tissue itself. Microgangiopathy- a disease affecting the smallest blood vessels. Acute Tubular Necrosis- a particular syndrome characterized by the sudden death of tubular cells. Interstitial Nephritis- an inflammation within the tissue surrounding the nephrons. Postrenal ARF- ARF due to obstruction distal to the kidney. Hyperkalemia- excessive potassium in the blood On ECG characterized by tall, peaked T-waves in the Precordial leads (V-Leads) are an early sign of Hyperkalemia. Hypokalemia- deficient potassium levels in the blood On ECG characterized by the Osborn wave, or J-wave. Chronic Renal Failure (CRF)- permanently inadequate renal function due to nephron loss. o Reduced Nephron Mass- the decrease in number of functional nephrons that causes CRF. o Reduced Renal Mass- the decrease in kidney size associated w/CRF o Isosthenuria- the inability to concentrate or dilute urine relative to the osmolarity of blood. o Glucose Intolerance- the body cells inability to take up glucose from the bloodstream. o Uremia- the syndrome of signs and symptoms associated w/CRF. Types of Dialysis Hemodialysis- a dialysis procedure relying on vascular access to the blood and on an artificial membrane. o Dialysaate- the solution used in dialysis that is hypo-osmolar to many of the wastes and key electrolytes in blood. Peritoneal dialysis- a dialysis procedure relying on the peritoneal membrane as the semipermeable membrane. Renal Calculi- kidney stones.

Urinary Emergencies Urinary Tract Infection (UTI)- an infection, usually bacterial, at any site in the urinary tract. Urinary stasis- a condition in which the bladder empties incompletely during urination. Urethritis- an infection and inflammation of the urethra. Cystitis- an infection and inflammation of the urinary bladder. Prostatitis- infection and inflammation of the prostate gland. Pyelonephritis- an infection and inflammation of the kidney. Intrarenal Abscess- a pocket of infection in the layer of fat surrounding the kidney.

Perinephric Abscess- a pocket of infection in the layer of fat surrounding the kidney. Community-Acquired infection- an infection occurring in a non-hospitalized patient who is not undergoing regular medical procedures, including the use of instruments such as catheters. Nosocomial Infection- an infection acquired in a medical setting.