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64 Cards in this Set
- Front
- Back
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Tell whether the following statement is true or false. |
False, K is king of the cell,
Na is extracellular |
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Where is vitamin D activated?
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Kidneys
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How much urine does the bladder hold before detrusser muscles tell you you have to urinate?
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300-500 mL
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How many renal arteries do we have taking blood to each kidney?
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1 per kidney
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Where is urine made?
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In the nephrons
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Normal Na level?
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135-145
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Normal K level?
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3.5-5.0
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What is the functional unit of the kidney?
Pelvis Ureter Bladder Nephron |
Nephron
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How long is a urine specimen good for?
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1 hr
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How much urine to collect for a urinalysis?
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no less than 10 mL (unless pt not making urine)
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urolithiasis
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stones in kidneys
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nuclear scans
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inject with dye to look at blood flow through kidneys
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Endoscopic procedures
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Looking through urinary meatus at bladder
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retrograde pyelography
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dye in veins to look at blood flow of kidneys
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Which of the following renal function tests evaluates ability of the kidneys to concentrate solutes in urine?
BUN Urine osmolality Specific gravity Creatinine clearance |
Specific gravity
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Normal urine specific gravity level?
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1.000 to 1.030
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What type of restriction may a dialysis pt be placed on?
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Fluid restriction
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Which of the following imaging modalities provides an image of the renal arteries?
Retrograde pyelography Renal angiography Cystography Biopsy |
Renal angiography
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How often is f/c care necessary?
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Q shift
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The second most common reason for seeking health care
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UTIs
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Lower UTIs
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Cystitis
Prostatitis Urethritis |
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Upper UTIs
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Pyelonephritis: acute and chronic
Interstitial nephritis Renal abscess and perirenal abscess |
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Function of glycosaminoglycan (GAG) and UTIs
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protein prevents bacteria from sticking to bladder wall
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Urethrovesical reflux
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Reflux of urine from urethra to bladder
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Ureterovesical reflux
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Reflux of urine from bladder to ureters
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Most common bacteria to cause a UTI
(Uropathogenic bacteria)? |
E.Coli
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Why do women have UTIs more often than men?
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Shorter urethra in women
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Why do post menopausal women have greater chance for UTIs?
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estrogen keeps the peritoneal muscles tighter/toner
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S/S of UTI
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Symptoms include pain and burning upon urination; frequency; nocturia; incontinence; suprapubic, pelvic, or back pain; hematuria; or change in urine or urinary pattern
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Do all UTI pts have symptoms?
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No, about half are asymptomatic
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What to assess for pts with UTIs?
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Assess voiding patterns,
Association of symptoms with sexual intercourse, Contraceptive practices, and Personal hygiene |
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How will elderly present with UTIs?
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confusion
dehydration hypernatremia |
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Nursing care plans for UTIs
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Acute pain-pain meds
Deficient knowledge Sepsis- urosepsis Renal failure- esp from kidney infections |
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Trimethoprim (Bactrim)
Sulfonamides |
Drug that kill/reduce bacteria in the urinary tract,
Drink full glass of H2O with dose and at least 3L water/day (can form crystals in kidney tubules) Keep out of sun/ photosensitivity Complete med even if symptoms are relieved |
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Cipriflozacin (Cipro)
Levofloxacin (Levaquin) Quinolones |
Drug that kill/reduce bacteria in the urinary tract,
Irregular heartbeats, teach how to monitor pulse Keep out of sun/ photosensitivity Complete med even if symptoms are relieved |
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Amoxacillin
Penicillins |
Drug that kill/reduce bacteria in the urinary tract,
Penicillin allergies? Take with food Call HCP if diarrhea develops Use another form of BC while on med Complete med even if symptoms are relieved |
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Nitrofurantoin
Urinary antiseptics |
Reduce bacteria by inhibiting reproduction
Shake bottle well Calibrated spoon Drink full glass of water with dose and at least 3L /day Complete med even if symptoms are relieved |
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Phenazopyridine (azo-dine)
Bladder anaglesics |
Drug reduces bladder pain- topical analgesic
Drug does not treat infection, only symptoms Take with or imm after a meal Will turn urine bright red or orange- will stain clothes |
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Cystospaz
antispazmodics |
Relieves bladder spasms
Notify HCP if blurry vision, confusion, dizziness, fainting, tachycardia, fever, difficulty passing urine Wear dark glasses in sunlight/ photosensitive |
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How much fluid intake for pts with UTIs?
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At least 3L/day
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How can nurses prevent UTIs?
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avoid indwelling catheters; exercise proper care of catheters
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Non medication ways to relieve pain/irritation of UTI?
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Apply heat
Avoid urinary tract irritants such as coffee, tea, citrus, spices, cola, and alcohol |
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Stress Incontinence
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involuntary loss of urine during physical activity, such as coughing, sneezing, laughing, or exercise
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What do estrogen have to do with stress incontinence?
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Low estrogen levels decrease the tighness of perineal muscles
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Urge Incontinence
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the strong, sudden need to urinate due to bladder spasms or contractions
Frequency, not enough time to get to bathroom |
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Reflex Incontinence
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Occurs when the bladder empties due to reflex activity with no control of urination. This may occur with spinal cord lesions such as quadriplegia.
involuntary bladder contractions occur but the urge to urinate is absent, causing unpredictable voiding |
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Overflow Incontinence
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Retention with overflow incontinence occurs when the bladder is full and not able to empty properly, resulting in dribbling, poor stream, hesitancy, nocturia and post micturition dribble
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One main cause of overflow incontinence in males?
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enlarged prostate
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Functional Incontinence
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Functional incontinence refers to passing urine in inappropriate places and incontinence due to an inability to get to the toilet. It may be caused by inability to recognise the toilet (due to cognitive impairment such as dementia), an inability to recognise when bladder or bowels need to be emptied, poor mobility skills affecting the ability to get to an appropriate toileting place or poor dexterity affecting the ability to remove clothing in order to toilet effectively.
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Iatrogenic Incontinence
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medication induced induced incontinence- sedatives, hypnotics, diuretics
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Mixed Incontinence
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Mixed incontinence is a mixture of stress, urge, and overflow incontinence symptoms.
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Which type of incontinence includes the involuntary loss of urine associated with overdistention of the bladder?
Urge Overflow Stress Functional |
Overflow
Overflow incontinence is the involuntary loss of urine associated with overdistention of the bladder. |
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How can patients live with and treat incontinence?
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Develop and use a voiding log or diary
Kegels Bladder training/urinary habit training Maintain normal body weight |
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Urinary Retention
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Inability of the bladder to empty completely
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Residual urine
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amount of urine left in the bladder after voiding
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Causes of urinary retention
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ge (50 to 100 mL in adults older than age 60 due to decreased detrusor muscle activity), diabetes, prostate enlargement, pregnancy, neurologic disorders, and medications
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Urolithiasis and Nephrolithiasis
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Calculi (stones) in the urinary tract or kidney
Anywhere from kidneys down |
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Diet recommendations for Urolithiasis and Nephrolithiasis
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normal calcium diet that is low in animal protein, salt, or both
Avoid over and under hydration Adequate cal intake with a balance of all food groups, fluid enough to dilute urine to a light yellow |
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How do pts save their stones for Dr. to look at?
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Urinate through a strainer
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How to treat stones?
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remove with basket
Lithotripsy Percutaneous stone removal |
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Reasons for Urinary Diversions?
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bladder cancer or other pelvic malignancies, birth defects, trauma, strictures, neurogenic bladder, chronic infection or intractable cystitis; used as a last resort for incontinence
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Cutaneous urinary diversion
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ileal conduit, cutaneous ureterostomy, vesicostomy, and nephrostomy
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Continent urinary diversion
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Indiana pouch, Kock pouch, and ureterosigmoidostomy
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What is important to maintain with content urinary diversions?
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Good skin care
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