Ams Test 4 Scc Renal/urinary

Front 1

What are some risk factors for bladder cancer/urothelial cancer?

Back 1

exposure to toxins, tobacco use(greatest factor), long term use of cyclophosohamide

Front 2

What is the greatest risk factor for getting bladder cancer?

Back 2

tobacco use

Front 3

What is a common clinical manifestation in regards to bladder cancer?

Back 3

hematuria, but can also experience dysuria and changes in frequency and urgency

Front 4

What is the most definative test for the diagnosis of bladder cancer?

Back 4

bladder biopsy done during cystoscopy

Front 5

How are superficial bladder cancers treated?

Back 5

with intravesical instillation (through a cath into the bladder) of BCG
Non surgical

Front 6

How is bladder cancer treated if there is metastasis?

Back 6

with chemotherapy with multi agents

Front 7

What type of surgical treatment would be performed for bladder cancer?

Back 7

cystectomy (removal of bladder), either an ileal conduit or a continent pouch (usually one),bladder reconstruction or ureterosigmoidostomy

Front 8

What are the different types of urinary diversions?

Back 8

ureterostomies, conduits(ileal or colon), sigmoidostomies, reservoir (kocks pouch)

Front 9

When a pt. has nephrotic syndrome they lose large amts of protein in the urine, what can this cause?

Back 9

edema and decreased plasma albumin levels

Front 10

What are some clinical manifestations of nephrotic syndrome?

Back 10

severe proteinuria, hypoalbuminemia, hyperlipidemia, lipiduria, edema, hypertension

Front 11

When you get your lab work back for your pt. with nephrotic syndrome what would expect to be pronounced?

Back 11

proteinuria, hypoalbuminemia and hyperlipidemia

Front 12

What is a definate test for diagnosing nephrotic syndrome?

Back 12

a positive renal biopsy

Front 13

How would you treat your pt. for nephrotic syndrome?

Back 13

treat the cause

Front 14

What will renal cell carcinoma cause?

Back 14

anemia OR erythrocytosis (not both), hypercalcemia, liver dysfunction withelevated liver enzymes, hormonal effects, increased sedimentation rate, hypertension

Front 15

What are the causes of renal cancer?

Back 15

unknown but are at increased risk with tobacco use, and lead, phosphate and cadmium use

Front 16

What are the s/s of renal cancer?

Back 16

asymptomatic initially then dull aching flank pain, abd. mass in flank area, renal bruit - late signs: hematuria, pallor, darkening of nipples, breast enlargement in males, muscle wasting, weakness, poor nutritional status, weight loss

Front 17

What type of labs could you expect from your pt with renal cancer?

Back 17

decr. H/H, incr. calcium, ESR, ACTH, Human chorionic gonadotopin, cortisol, renin, parathyriod hormone

Front 18

What are some non-surgical treatments for renal cancer?

Back 18

radiofrequency ablation

chemo has limited effectiveness

Front 19

What are some surgical treatments for renal cancer?

Back 19

nephrectomy, radical nephrectomy

both followed by radiation therapy

Front 20

What post operative care would you perform for your pt who has just had either a nephrectomy or a radical nephrectomy?

Back 20

routine T,C,DB , monitor for hemorrhage and adrenal insufficiency, monitor UO hourly, monitor labs for 1st day, VS, weight

Front 21

What meds are used to help prevent complications after surgery for renal cancer?

Back 21

antibiotics and steroid therapy

Front 22

What is polycystic kidney disease?

Back 22

an inherited disorder where fluid filled cysts develop in the kidneys

Front 23

Why do pt. with polycystic kidney disease develop abdominal pain, discomfort and pressure?

Back 23

because as the cysts in the kidneys get larger so does the kidneys and they start displacing other organs in the abdomen

Front 24

Why do you want to monitor your post op nephrectomy pt for urinary output?

Back 24

because you need to be sure that the remaining kidney is functioning properly

Front 25

Why is it important for you to monitor the H/H in your post op. nephrectomy pt?

Back 25

because they are at risk for hemorrhages (kidney is very vascular)

Front 26

What is an early sign of a hemorrhage in your post op nephrectomy pt?

Back 26

decreased BP

Front 27

What are some clinical manifestations of polycystic kidney disease?

Back 27

hypertension, abdominal or flank pain with intermittent discomfort, distended abdomen/incr.abd. girth, nocturia, constipation, bloody or cloudy urine, kidney stones

Front 28

You receive your urinalysis back on your polycystic kidney disease pt.. What would you expect to see?

Back 28

proteinuria, hematuria and bacteria in the urine

Front 29

What labs would you see incr/decr in your polycystic kidney disease pt.?

Back 29

incr. BUN and creatinine (blood test)
decr. creatinine clearance (urine test)

Front 30

What are some diagnostic tests for polycystic kidney disease?

Back 30

urinalysis, labs, renal sonogram, CT scan/MRI

Front 31

What type of things would you do for pain control in your polycystic kidney disease pt.?

Back 31

pain meds with caution, distraction/diversion, heat/massage

Front 32

What does sharp abdominal flank pain indicate in your polycystic kidney disease pt?

Back 32

indicates rupture

Front 33

How would you prevent constipation in you polycystic kidney disease pt.?

Back 33

fluids and hight fiber diet/roughage

Front 34

If any of the obstructive disorders (hydronephrosis, hydroureter, uretheral stricture) are not recognized and acted on ASAP what can result?

Back 34

kidney damage can result if these disorders within 48 hours or less

Front 35

What obstructive disorder is caused by an obstruction in the upper part of the ureter allowing urine to back up into the kidneys?

Back 35

hydronephrosis

Front 36

What obstruction disorder occurs in the lower part of the ureter and allows urine to back up into the ureter?

Back 36

hydroureter

Front 37

What can cause either hydronephrosis or hydroureter?

Back 37

tumors, stones, trauma, structural defects, fibrosis

Front 38

What is a urethral stricture?

Back 38

blockage in the urethra which causes bladder distention and eventually ureter and kidney distention

Front 39

What are some s/s of an obstructive disorder?

Back 39

UTIs, flank/abdominal pain, change in color, amount and/or smell of urine, asymmetry of flank

Front 40

What diagnostic tests will be able to show the obstruction in your pt. with a uretheral stricture? Which will show a dilitation?

Back 40

CT scan or Ultrasound will show the obstruction

Intravenous urography will show a dilitation

Front 41

If your pt. obstructive disorder is caused by a stricture what might your intervention be?

Back 41

may have a nephrostomy tube inserted which diverts urine

tube is place into the kidney and urine is drained from there

Front 42

As the nurse what would you do for your pt. with a nephrostomy tube?

Back 42

measure output
assess:
for bleeding around the tube
for urine leaking around the tube
for signs of UTI