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89 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Normally, kidneys excrete approximately 1 ml of urine per kg of body weight per hr, which is about ___ to ___ L in a 24-hour period for adults.
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1 to 2 liters
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Renal System; ARF
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Acute renal failure occurs when ______ accumulate in the body and urinary output ______.
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metabolites; changes
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Renal System; ARF
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______, ______, and ______ are three phases of acute renal failure.
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Oliguric, diuretic, recovery
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Renal System; ARF
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Electrolytes are profoundly affected by ______ problems.
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kidney
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Renal System; ARF
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There must be a balance beween extracellular fluid and intracellular fluid to maintain ______.
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homeostasis
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Renal System; ARF
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A change in the ______ of ions or in the ______ of fluid will cause a shift in one direction of the other.
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number; amount
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Renal System; ARF
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______ and ______ are the primary extracellular ions.
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Sodium; chloride
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Renal System; ARF
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______ and ______ are the primary intracellular ions.
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Potassium; phosphate
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Renal System; ARF
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↑ BUN, creatinine, potassium, specific gravity (>1.020 g/ml), fluid volume; ↓ sodium, pH indicates diagnostic findings in the ______ phase.
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oliguric
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Nursing Assessment; ARF
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↓fluid volume, potassium, sodium, specific gravity (<1.020 g/ml) indicates diagnostic findings in the ______ phase.
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diuretic
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Nursing Assessment; ARF
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In the ______ phase give only enough fluids to replace losses; usually ___ to ___ ml/24 hr.
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oliguric; 400 to 500
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Acute Renal Failure (ARF); Nursing Plans and Interventions
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Document and report any ______ in fluid volume status
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change
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Acute Renal Failure (ARF); Nursing Plans and Interventions
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Monitor lab values for both ______ and ______ to assess electrolyte status.
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serum and urine
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Acute Renal Failure (ARF); Nursing Plans and Interventions
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Especially monitor for ______ indicated by serum potassium levels >7 mEq/l and ECG changes
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hyperkalemia
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Acute Renal Failure (ARF); Nursing Plans and Interventions
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Assess levels of ______ for subtle changes.
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consciousness
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Acute Renal Failure (ARF); Nursing Plans and Interventions
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______ daily: in oliguric phase, client may gain up to ___ lb/day
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Weigh; 1
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Acute Renal Failure (ARF); Nursing Plans and Interventions
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Prevent ______ - infection.
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cross
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Acute Renal Failure (ARF); Nursing Plans and Interventions
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______ may be prescribed if ↑K+
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Kayexalate
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Acute Renal Failure (ARF); Nursing Planas and Interventions
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Body ______ is a good indicator of fluid retention and renal status.
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weight
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Acute Renal Failure (ARF)
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Obtain accurate ______ of all clients with renal failure; obtain ______ on the same scale at the same time every day.
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weight; weight
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Acute Renal Failure (ARF); Nursing Plans and Interventions
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Dyspnea, tachycardia, and jugular vein distension are examples of ______ fluid symptoms.
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excess
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Fluid volume alterations
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Peripheral and pulmonary edema are examples of ______ fluid symptoms.
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excess
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Fluid volume alterations
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↓urine output, body weight, and skin turgor are examples of ______ fluid symptoms.
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deficient
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Fluid volume alterations
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Dry mucous membranes, hypotension, and tachycardia are examples of ______ fluid symptoms.
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deficient
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Fluid volume alterations
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Potassium has a critical safe range ___ to ___ mEq/l because it affects the heart, and any imbalance must be corrected by medications or dietary modification.
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3.5 to 5.0
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Fluid volume alterations
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Limit high-potassium foods (______, ______, ______, ______) and ______ substitutes, which are high in potassium.
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bananas, avocados, spinish, fish; salt
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Fluid volume alterations; Nursing plans and interventions
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Clients ċ renal failure retain ______. Ċ water retention, the sodium becomes diluted and serum levels may appear near normal. With excessive water retention,the sodium levels appear decreased (dilution). Limit fluid and sodium intake in ___ clients.
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sodium; ARF
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Acute Renal Failure; Nursing plans and interventions
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During oliguric phase, minimize ______ intake.
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protein
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Acute Renal Failure; Nursing plans and interventions
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During oliguric phase, when ______ and ______ return to normal, ARF is determined to be resolved.
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BUN and creatinine
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Acute Renal Failure; Nursing plans and interventions
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A ______ is an infection or inflammation at any site in the urinary tract (kidney, pyelonephritis; urethra, urethritis; bladder, cystitis; prostate, prostatitis)
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UTI
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UTIs
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The most common infectious agent in UTIs is ______ ______.
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Escherichia coli
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UTIs
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The persons at highest risk for acquiring ______ are diabetics, pregnant women, men with prostatic hypertrophy, immunosuppressed persons, catheterized clients, anyone with urinary retention, either short term or long term, elderly women (bladder prolapse).
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UTIs
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UTIs
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To diagnose for UTI a ______-______ midstream urine collection for culture to identify specific causative organism, is indicated
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clean-catch
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UTIs
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To diagnose for UTIs an ______ ______ is indicated to determine kidney functioning.
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intravenous pyelogram (IVP)
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UTIs
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To assess for a ______ look for signs of infection including fever and chills, urinary frequency, urgency, or dysuria, hematuria, pain at the costovertebral angle, and ↑ serum WBC (greater than 10,000).
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UTI
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UTIs; Nursing Assessment
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Administer antibiotics specific to infection agent is an intervention indicated in ______.
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UTIs
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UTIs; Nursing plans and interventions
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Instruct client in the appropriate medication regimen is an intervention indicated in ______.
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UTIs (instruct client to finish off meds)
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UTIs; Nursing plans and interventions
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Encourage fluid intake of ___ ml fluid/day is an intervention indicated in UTI's
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3000
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UTIs; Nursing plans and interventions
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Maintain ______ and ______ is an intervention indicated in UTIs.
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I&O
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UTIs; Nursing plans and interventions
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Administer mild ______(acetaminophen or aspirin) is an intervention indicated in UTIs.
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analgesics
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UTIs; Nursing plans and interventions
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The key to resolving UTIs with most antibiotics is to keep the blood level of the antibiotic ______.
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constant
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UTIs; Nursing plans and interventions
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It is important to tell the client to take the antibiotics around the clock and not to ______ doses so that a consistent blood level can be maintained for optimal effectiveness.
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skip
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UTIs; Nursing plans and interventions
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Teach the client to ______ rather than bathe as a preventive measure. If bathing is necessary, never take a bubble or oil bath.
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shower
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Nursing plans and interventions; Implement a teaching plan
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Cleanse from ______ to ______ after toileting (women and girls).
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front; back
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Nursing plans and interventions; Implement a teaching plan
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Avoid ______.
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caffeine
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Teaching about UTIs
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Encourage client to void every ___ to ___ hours to prevent residual urine from stagnating in the bladder.
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2 to 3
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UTIs; Nursing plans and interventions
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To assess respiratory status ______ lung sounds to detect "wet" sounds indicating ______.
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Ausclutate; infection
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Postoperative Care: Kidney; Surgery; Respiratory status; Nursing Interventions
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To assess respiratory status demonstrate method of ______ incision for comfort when coughing and deep breathing.
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splinting
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Postoperative Care: Kidney; Surgery; Respiratory status; Nursing Interventions
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______ incision causes pain with both inspiration and expiration. Therefore, client avoids deep breathing and coughing; this can lead to respiratory difficultites, including ______.
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Flank; pneumonia
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Postoperative Care: Kidney; Surgery; Respiratory status; Rationale
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To assess circulatory status check vial signs to detect early signs of ______, ______.
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bleeding, shock
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Postoperative Care: Kidney; Surgery; Circulatory status; Nursing Interventions
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To assess circulatory status monitor skin ______ and ______.
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color; temperature
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Postoperative Care: Kidney; Surgery; Circulatory status; Nursing Interventions
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To assess circulatory status pallor and cold skin are signs of ______.
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shock
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Postoperative Care: Kidney; Surgery; Circulatory status; Nursing Interventions
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To assess circulatory status urinary ______ (______ with circulatory collapse)
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output; decreases
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Postoperative Care: Kidney; Surgery; Circulatory status; Nursing Interventions
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To assess circulatory status surgical site for flank ______
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bleeding
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Postoperative Care: Kidney; Surgery; Circulatory status; Nursing Interventions
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To assess pain relief status administer narcotic analgesics as needed to relieve ______
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pain
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Postoperative Care: Kidney; Surgery; Pain relief status; Nursing Interventions
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Relief of pain will improve the client's cooperation with ______-______ exercises.
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deep-breathing
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Postoperative Care: Kidney; Surgery; Pain relief status; rationale
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Relief of pain will improve client's cooperation with early ______
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ambulation
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Postoperative Care: Kidney; Surgery; Pain relief status; rationale
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To assess urinary status check urinary ______ and ______ from all tubes inserted during the surgery
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output; drainage
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Postoperative Care: Kidney; Surgery; Assessment; Nursing Interventions
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To assess urinary status maintain accurate ______ and ______
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I&O
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Postoperative Care: Kidney; Surgery; Assessment; Nursing Interventions
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Mechanical ______ of bladder will be implemented after surgery.
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drainage
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Postoperative Care: Kidney; Surgery; Assessment; Rationale
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Void every ___ to ___ hours during the day
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2 to 3
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UTIs; Nursing Plans and Interventions
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Wear ______ undergarments and ______ clothing to help drecrease perineal moisture
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cotton; loose
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UTIs; Nursing Plans and Interventions
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Practice good ______ technique
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handwashing
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UTIs; Nursing Plans and Interventions
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Obtain ______-______ care
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follow-up
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UTIs; Nursing Plans and Interventions
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Location of the ______ can help to determine the locatin of the stone
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pain
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Urinary tract Obstruction
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Flank pain usually means the stone is in the ______ or upper ______
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kidney; ureter
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Urinary tract Obstruction
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If the pain radiates to the abdomen or scrotum, the stone is likely to be in the ______ or ______.
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ureter; bladder
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Urinary tract Obstruction
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Excruciating, spastic-type pain is called ______.
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colic
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Urinary tract Obstruction
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During kidney stone attacks, it is preferable to administer pain medications at ______ scheduled intervals rather than PRN to prevent ______ and optimize comfort
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regularly; spasm
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Urinary tract Obstruction
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Urinary tract obstruction is partial or complete ______ of the flow of urine at any point in the urinary system.
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blockage
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Urinary tract Obstruction
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Urinary tract obstruction may be caused by ______, ______, ______, or ______.
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foreign body [calculi], tumore, strictures, functional [neurogeenic bladder]
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Urinary tract Obstruction
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When urinary tract obstruction occurs, urine is retained ______ the point of obsruction
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above
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Urinary tract Obstruction
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In a urinary tract obstruction ______, usually quite sever, acute
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pain
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Urinary tract Obstruction; Nursing Assessment
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Symptoms of a urinary tract obstruction are ______/______, ______/______/______, and ______ ______.
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Fever/chills, nausea/vomiting/diarrhea; abdominal distention
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Urinary tract Obstruction; Nursing Assessment; Symptoms
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In a urinary tract obstruction changes in voiding pattern include ______/______, ______/______/______/______/______, difficulty in starting a ______, ______.
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dysuria/hematuria, urgency/frequency/hesitancy/ nocturia/dribbling; stream; incontinence
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Urinary tract Obstruction; Nursing Assessment
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With urinary tract obstruction the single most important intervention is to administer ______ ______.
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narcotic analgesics
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Urinary tract Obstruction; Nursing Plans and Interventions
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Apply moist ______ to the painful area unless prescribed otherwise
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heat
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Urinary tract Obstruction; Nursing Plans and Interventions
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Encourage high oral ______ intake to help dislodge the stone
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fluid
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Urinary tract Obstruction; Nursing Plans and Interventions
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Administer ______ antibiotics if infection is present
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intravenous
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Urinary tract Obstruction; Nursing Plans and Interventions
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______ all urine
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Strain
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Urinary tract Obstruction; Nursing Plans and Interventions
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Send any ______ found when straining to the laboratory for analysis.
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stones
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Urinary tract Obstruction; Nursing Plans and Interventions
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Accurately document ______ & ______
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I&O
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Urinary tract Obstruction; Nursing Plans and Interventions
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Cystoscopy, cystolitholopaxy, ureteroscopy, and percutanneous nephro -lithotomy are examples of ______ procedures.
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endourologic
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Urinary tract Obstruction; Nursing Plans and Interventions
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Ultrasonic, elecrohydraulic, laser, and extracorporeal shock-wave are examples of different types of ______.
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lithrotripsy
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Urinary tract Obstruction; Nursing Plans and Interventions
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Nephrolithotomy, pyelothitomy, ureterolithotomy, and cystotomy are examples of different types of ______ therapy.
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surgical
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Urinary tract Obstruction; Nursing Plans and Interventions
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Pursue follow-up care, because stones tend to ______.
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recur
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Urinary tract Obstruction; Nursing Plans and Interventions; Implement a teaching plan
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Maintain a high fluid intake of ___ to ___ L/day.
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3 to 4
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Urinary tract Obstruction; Nursing Plans and Interventions; Implement a teaching plan
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Follow prescribed diet (based upon composition of ______).
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stone
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Urinary tract Obstruction; Nursing Plans and Interventions; Implement a teaching plan
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Avoid long periods of remaining in ______ position.
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supine
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Urinary tract Obstruction; Nursing Plans and Interventions; Implement a teaching plan
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