Gu Nursing Test 3 - Renal System

Front 1

A NORMAL FUNCTIONING KIDNEY EXCRETES _____ ML OF URINE PER DAY

Back 1

1500

Front 2

FUNCTIONS OF THE KIDNEYS (5)

Back 2

EXCRETION OF URINE
CONTROL BP
PRODUCE ERYTHROPOIETIN
ACTIVATION OF VIT D
REGULATION OF ACID/BASE BALANCE

Front 3

WHAT IS THE ORDER IN WHICH A PHYSICAL ASSESSMENT OF THE KIDNEYS SHOULD BE CONDUCTED ?

Back 3

INSPECTION
AUSCULTATION
PALPATION
PERCUSSION

Front 4

IF A LOW SWISHING SOUND IS HEARD OVER THE UPPER QUAD OF THE ABDOMEN, WHAT IS THAT INDICATIVE OF?

Back 4

COULD BE A BRUIT, WHICH IS INDICATIVE OF IMPAIRED BLOOD FLOW TO THE KIDNEYS (AKA RENAL ARTERY STENOSIS).

Front 5

IF THE COSTOVERTEBRAL ANGLE IS PERCUSSED AND IS TENDER OR PAINFUL, WHAT COULD THIS INDICATE?

Back 5

GLOMERULONEPHRITIS
PYELONEPHRITIS

Front 6

NORMALLY,THE BLADDER IS NOT PERCUSSABLE UNTIL IT CONTAINS _____ML OF URINE

Back 6

150

Front 7

IF THE BLADDER IS FULL, WHAT TYPE OF SOUND IS HEARD OVER THE SYMPHYSIS PUBIS?

Back 7

DULL

Front 8

WHAT IS THE AVERAGE GFR AFTER AGE 65

Back 8

65 ML/MINUTE

Front 9

WHAT IS ONE OF THE REASONS ELDERLY PEOPLE HAVE NOCTURIA.

IS THIS NORMAL WITH AGE

Back 9

DECREASED ABILITY TO CONCENTRATE URINE, WHICH IS A NORMAL AGE RELATED CHANGE.

Front 10

WHY IS GFR LOWER IN THOSE OVER AGE 65?

Back 10

DECREASED # OF FUNCTIONING NEPHRONS

DECREASED RENAL BLOOD FLOW DUE TO CARDIO CHANGES.

Front 11

THE ELDERLY HAVE A TENDENCY TO HAVE URINARY RETENTION AND FRQUENCY OF VOIDING DURING THE DAY AND AT NIGHT. WHAT NORMAL AGE RELATED CHANGES CAUSE THIS?

Back 11

WEAKENED MUSCLES WHICH DECREASE BLADDER TONE AND LEAD TO WEAKENED URINARY SPHINCTERS

Front 12

IN FEMALES, WHAT AGE RELATED CHANGE PREDISPOSES HER TO URINARY INFECTIONS?

Back 12

THE SHORTENING OF THE URETHRA WITH AGE.

Front 13

WHAT COLOR SHOULD NORMAL URINE BE?

Back 13

AMBER YELLOW

Front 14

WHAT SHOULD NORMAL ODOR OF URINE BE?

Back 14

AROMATIC

Front 15

WHAT IS NORMAL PROTEIN LEVEL IN URINE?

PERSISTANT PROTEINURIA IS INDICATIVE OF WHAT?

Back 15

0-150MG/24 HR.

PERSISTANT PROTEINURIA IS CHARACTERISTIC OF ACUTE AND CHRONIC RENAL DISEASE, ESPECIALLY INVOLVING THE GLOMERULI.

Front 16

IS IT NORMAL TO HAVE GLUCOSE IN URINE?

Back 16

NO. IF URINE IS + FOR GLUCOSE, COULD INDICATE DM

Front 17

IS IT NORMAL TO FIND KETONES IN URINE?

Back 17

NO. COULD INDICATE DM OR STARVATION

Front 18

IS IT NORMAL TO FIND BILLIRUBIN IN URINE?

Back 18

NO. PRESENCE IS INDICATIVE OF JAUNDICE.

Front 19

WHAT IS NORMAL URINE SPECIFIC GRAVITY?

WHAT IS NORMAL SPECIFIC GRAVITY OF URINE IN THE AM?

WHAT DOES LOW SPECIFIC GRAVITY INDICATE?

WHAT DOES HIGH SPECIFIC GRAVITY INDICATE?

Back 19

1.003-1.030 NORMAL

1.025-1.030 AM (INDICATES MAX CONCENTRATING ABILITY OF KIDNEYS)

LOW SG INDICATES DILUTE URINE AND POSSIBLE EXCESSIVE DIURESIS

HIGH SG INDICATES DEHYDRATION

Front 20

IF URINE SPECIFIC GRAVITY BECOMES FIXED AT 1.010, THIS INDICATES WHAT?

Back 20

RENAL INABILITY TO CONCENTRATE URINE AND POSSIBLE ESRD.

Front 21

NORMAL OSMOLALITY OF URINE

Back 21

300-1300 MOSM/KG

Front 22

NORMAL URINE PH.

IF HIGHER THAN 8.0 WHAT COULD BE INDICATIVE OF?

IF LOWER THAN 4.0?

Back 22

4.0-8.0 (AVERAGE OF 6.0)

HIGHER THAN 8.0: STANDING OF URINE OR UTI

LOWER THAN 4.0: RESPIRATORY OR METABOLIC ACIDOSIS.

Front 23

IF A URINE SPECIMINE IS COLLECTED, STORED, AND HANDLED PROPERLY, INFECTION IS THOUGHT TO BE PRESENT IF THERE ARE _______ ORGANISMS IN EVERY ML OF URINE

Back 23

>1000,000

Front 24

WHAT IS CREATININE?

THE PURPOSE OF A CREATININE CLEARANCE TEST?

Back 24

WASTE PRODUCT OF PROTEIN BREAKDOWN

TO TEST OVERALL KIDNEY FUNCTION. CREAT. CLEAR. APROXIMATES THE GFR

Front 25

HOW IS A CREATININE CLEARANCE TEST CONDUCTED AND WHAT DO THE RESULTS MEASURE?

Back 25

24 HOUR URINE SAMPLE

THE TEST MEASURES THE AMOUNT OF PLASMA TOTALLY CLEARED OF CREATININE IN 1 MINUTE.

Front 26

AS KIDNEY FUNCTION WORSENS, CREATININE CLEARANCE _____?

Back 26

DECREASES

Front 27

NORMAL FINDING FOR CREAT. CLEARANCE.


FOR ELDERLY?

Back 27

85-135ML/MINUTE

AS LOW AS 65ML/MINUTE

Front 28

BUN AND CREATINE ARE USED TO EVALUATE WHAT?

Back 28

KIDNEY FUNCTION

Front 29

WHAT IS NORMAL BUN?

BUN TEST MEASURES WHAT?

Back 29

10-30 OR 6-20 IN ELDERLY

UREA NITROGEN, THE END PRODUCT OF PROTEIN METABOLISM

Front 30

WHAT ARE SOME REASONS BUN MAY BE HIGH?

Back 30

DEHYDRATION
HIGH PROTEIN DIET
HEMORRHAGE
LIVER/RENAL DISEASE
INFECTION AND TISSUE B/D

Front 31

WHY MIGHT BUN BE LOW?

Back 31

fluid excess

Front 32

SERUM CREATININE TEST MEASURES WHAT

Back 32

THE AMOUNT OF CREATININE IN THE BLOOD.

Front 33

HIGH SERUM CREATININE INDICATES WHAT?

Back 33

THE KIDNEY HAS LOST IT'S FUNCTION.

Front 34

WHAT DOES LOW SERUM CREATININE INDICATE?

WHAT TYPE OF RELATIONSHIP DO SERUM CREAT AND CREAT. CLEARANCE HAVE?

Back 34

DECREASE IN MUSCLE MASS

INVERSE RELATIONSHIP. IF CREAT CLEARANCE IS HIGH, SERUM CREAT WILL BE LOW.

Front 35

WHAT IS THE NORMAL BUN/CREATININE RATIO?

INTERPRET WHAT THE RATIO MEANS AND WHAT THEY INDICATE

Back 35

10/20:1

IF BUN RISES WITHOUT A RISE IN SERUM CREATININE IT USUALLY INDICATES DEHYDRATION. IF THERE IS A PROPORTIONAL RISE OF BOTH, IT INDICATES IMPAIRED RENAL FUNCTION

Front 36

IF A PATIENTS BUN IS 36 AND CREATININE IS 1.2 WHAT IS THIS INDICATIVE OF? WHAT IS THE TREATMENT?

Back 36

DEHYDRATION. GIVE IV FLUID AND SEND HOME.

BUN IS HIGH (NORM IS 10-30)
CREAT IS NORMAL (NORM IS 0.6-1.2)

Front 37

IF A PATIENTS BUN/CREAT RATIO IS 40:2, WHAT COULD THIS INDICATE?

Back 37

IMPAIRED RENAL FUNCTION

Front 38

WHAT ARE SOME REASONS BUN MIGHT BE ELEVATED OTHER THAN IMPAIRED RENAL FUNCTION?

DECREASED?

Back 38

BUN WILL BE INCREASED IN:

DEHYDRATION
HIGH PROTEIN DIET
HEMORRHAGE
LIVER/RENAL DISEASE
INFECTION
TISSUE BREAKDOWN

DECREASED IN FLUID EXCESS

Front 39

NORMAL NA+ LEVEL AND IT'S ROLE

Back 39

135-145 - IT CONTROLS BLOOD VOLUME

INCREASED NA+ LEADS TO INCREASED FLUID RETENTION

Front 40

NORMAL K+ LEVEL AND WHAT HAPPENS IF IT IS NOT EXCRETED PROPERLY?

Back 40

3.5-5.0

CAN LEAD TO CARDIAC ARRHYTHMIAS

Front 41

NORMAL CA+ LEVEL AND WHAT EFFECT DOES IMPAIRED KIDNEY FUNCTION HAVE ON IT?Q

Back 41

9-11

IF KIDNEYS CAN'T CONVERT CALCIUM TO VIT D (IT'S ACTIVE FORM), THEN SERUM CA+ WILL BE LOW RESULTING IN BRITTLE BOANS

Front 42

WHAT IS NORMAL PHOSPHOROUS LEVEL AND WHAT HAPPENS WHEN KIDNEY FUNCTION IS ALTERED

Back 42

2.8-4.5

LOW CALCIUM CAUSES PHOSPHOROUS TO COMPENSATE AND LEVELS TO RISE

Front 43

NORMAL BICARB

Back 43

22-26. DECREASE IN METABOLIC ACIDOSIS

Front 44

NORMAL URIC ACID LEVELS

Back 44

2.5-5.5 HIGH INDICATE RENAL CALCULI

Front 45

KUB TEST SHOWS WHAT?

PREP?

POST PROCEEDURE?

Back 45

PLAIN X-RAY OF ABDOMEN AND PELVIS TO SHOW SIZE, SHAPE, POSITION OF KIDNEY

NO PREP

NO POST PROCEEDURE CARE

Front 46

IVP - INTRAVENOOUS PYELOGRAM

PREPROCEEDURE CARE:

POSTPROCEEDURE CARE:

Back 46

ASSESSES KIDNEY SIZE AND ANY OBSTRUCTION USING CONTRAST

PRE:
CONSENT
NPO FOR 8 HR
BOWEL PREP
ASSESS FOR IODINE SENSITIVITY

POST:
FLUIDS TO FLUSH OUT CONTRAST
**ANYTIME CONTRAST IS USED IT CAN CAUSE ARF

Front 47

RENAL ARTERIOGRAM

PREPROCEEDURE CARE

POSTPROCEEDUR CARE

Back 47

INJECT CONTRAST INTO RENAL ARTERY VIA CATHETER INTO FEMORAL ARTERY. USED TO ID PROBLEMS WITH RENAL BV'S.

PREPROCEEDURE:
CONSENT
NPO FOR 8 HR
BOWEL PREP
ASSESS FOR IODINE SENSITIVITY

POSTPROCEEDURE:
#1: ASSESS PT FOR BLEEDING IN THE FEMORAL ARTERY SITE
ASSESS FOR PULSE,WARMTH,AND COLOR TO INVOLVED EXTREMITY
BR X6 HR POST PROCEEDURE

Front 48

CT SCAN OF KIDNEYS IS USED FOR WHAT? WHAT SHOULD THE NURSE ASSESS FOR BEFORE THE PROCEEDURE?

Back 48

TO DIFFERENTIATE MASSES

ASSESS FOR ALLERGY TO IODINE OR CONTRAST MEDIUM

Front 49

RENAL ULTRASOUND DETECTS WHAT

Back 49

KIDNEY SIZE AND ANY OBSTRUCTION TO URINARY TRACT.

Front 50

DO FLUIDS HAVE TO BE PUSHED AFTER A CT SCAN? WHY?

Back 50

NO BECAUSE THE DYE IS LOCALIZED AND NOT SYSTEMIC AS IT IS IN IVP

Front 51

#1 ND FOR PT. RETURNING FROM A REAL ARTERIOGRAM

Back 51

RISK FOR ALTERED PERFUSION R/T BLEEDING

CHECK BLOOD SUPPLY TO PEDAL PULSES AND ASSESS THE EXTREMITY BELOW THE FEMORAL ARTERY

Front 52

IF A PATIENT HAS AN ALLERGY TO IODINE, CAN THEY GET A CYSTOGRAM

Back 52

YES. THE CONTRAST MEDIUM IS INSTILLED DIRECTLY INTO THE BLADDER, SO NO SYSTEMIC REACTIONS WILL OCCUR

Front 53

WHAT IS A POTENTIAL COMPLICATION OF A CYSTOGRAM AND CYSTOMETROGRAM?

WHAT SHOULD BE DONE POST-PROCEEDURE FOR BOTH OF THESE TO PREVENT THE COMPLICATION

Back 53

UTI. FORCE FLUIDS

Front 54

CYSTOCOPY - BEFORE PROCEEDURE CARE

Back 54

BEFORE:
FORCE FLUIDS OR GIVE IV FLUIDS IN GA IS TO BE USED
CONSENT
PREOP MEDS.

Front 55

AFTER A PATIIENT HAS A CYSTOCOPY, SHE COMPLAINS THAT SHE HAS URINARY FREQUENCY WITH BURNING AND A PINK TINGE TO HER URINE. WHAT SHOULD THE NURSE DO?

MORE NURSING CONSIDERATIONS FOR THIS PROCEEDURE?

Back 55

TELL HER THOSE ARE NORMAL SIDE EFFECTS OF THE PROCEEDURE.

**IF PERSISTENT BURING AND URINARY FREQ OCCUR, NOTIFY MD B/C UTI COULD BE PRESENT.

BRIGHT RED BLEEDING IS NOT NORMAL

ALSO:
DO NOT LET THE PATIENT WALK ALONE IMMEDIATELY B/C ORTH. HYPOTENSION MAY OCCUR.

OFFER WARM SITZ BATHS,HEAT,AND MILD ANALGESICS TO RELIEVE DISCOMFORT.

Front 56

WHAT IS THE MOST COMMON POST-PROCEEDURE COMPLLICATION OF A RENAL BIOPSY. WHAT SHOULD BE DONE TO PREVENT IT

Back 56

BLEEDING. IMMEDIATE POST PROCEEDURE, KEEP ON AFFECTED SIDE FOR 30-60 MIN

Front 57

WHAT TYPE OF ACTIVITY SHOULD A PATIENT HAVE AFTER A RENAL BIOPSY

Back 57

BED REST FOR 6 HOURS

MAY RESUME GENERAL ACTIVITIES AFTER 24 HOURS

Front 58

WHY SHOULD CAREFUL CONSIDERATION BE GIVEN TO A PATIENT WITH COPD THAT NEEDS TO UNDERGO A RENAL BIOPSY

Back 58

THEY NEED TO BE ABLE TO TOLERATE THE PRONE POSITION FOR 30-45 MINS

Front 59

WHAT IS A COMPLICATION OF UNTREATED UTI, PARTICULARLY IN ELDERLY

Back 59

UROSEPSIS- GENERALIZED INFECTION THAT CAN CONTRIBUTE TO MORTALITY

Front 60

DIFFERENTIATE BETWEEN UTI REINFECTION AND RELAPSE

Back 60

REINFECTION INVOLVES A DIFFERENT MICROORGANISM

RELAPSE INVOLVES THE SAME MICROORGANISM THAT ORIGINALLY CAUSED THE UTI

Front 61

A PERSON WITH A COMPLICATED UTI IS AT RISK FOR WHAT

Back 61

RENAL DAMAGE

Front 62

CYSTITIS IS AN UPPER/LOWER UTI. IT INVOLVES WHAT ORGAN?

Back 62

LOWER. INVOLVES THE BLADDER

Front 63

WHAT ARE THE CLINICAL MANIFESTTIONS OF CYSTITIS

Back 63

BLADDER IRRITABILITY
URINARY FREQUENCY
URGENCY
DYSURIA
FOUL SMELLING/CLOUDY URINE
COMPLAINTS OF NOCTURIA
SUPRAPUBIC PAIN OR PAIN IN URETHRA

Front 64

ELDERLY PT WITH URINARY INFECTION MAY NOT PRESENT WITH THE CLASSIC S/S. INSTEAD, THEY MAY PRESENT WITH WHAT S/S?

Back 64

ANOREXIA
LETHARGY
NEW INCONTINENCE
CONFUSION