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82 Cards in this Set
- Front
- Back
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How much CO2 goes to kidneys? What process utilizes it?
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25 %
Urine production |
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How many nephrons are there in an adult <40? What is the rate of loss after 40?
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1 mil
~1 %/yr |
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Ureters function and mechanism?
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Conduct urine from renal pelvis to urinary bladder
Peristaltic contractions |
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What organ is trigone assoc w/ and what is it?
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Bladder
triangular area formed by openings of 2 ureters & urethra |
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How much urine is required before you have an urge to urinate?
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~200 cm3
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What is the normal amt of urinations/day?
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6-8 times
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How much filtrate is formed/minute? How much is excreted in urine?
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125 ml (This is the GFR)
1 ml |
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What common drug class can affect kidney function?
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NSAIDs
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Who is at higher risk for bladder neoplasms?
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Smokers
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What 2 ABX increase risk for renal dysfunction?
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Vanco and gentomycin
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What is entailed in clean catch urine collection? Sterile or nonsterile?
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Clean first, urinate a bit, then stop, the collect; non-sterile
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What happens to Cr levels in glomelular d/os?
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serum Cr increases, urine Cr decreases
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What does serum Cr reflect?
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GFR
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Which is more reliable for testing for renal damage: BUN or serum Cr?
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serum Cr
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What would elevated BUN and nrml Cr indicate?
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likely upper GI bleed r/t metabolized HGb
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BUN synthesis, elimination, & factors of influence?
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Chief end product of protein metabolism
Hepatic Renal Protein intake, GIB, & hydration status |
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Purpose for CrCl?
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Assesses GFR
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What does a radionuclide renal scan assess?
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Renal blood flow, nephron & collecting system function, & renal structure
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What's used for renal artery stenosis?
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Surgical stent
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At what level will glucose start to appear in urine?
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>180 mg/dl
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What is a sitz bath and what is its function?
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Application of warm water to perioneal area
Helps bring circulation (vasodilation) |
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What is the only ix for a renal biopsy?
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Idiopathic renal d/o
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What is anasarca and what is it r/t?
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Generalized edema
Excess fluid |
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What's the most accurate measure of renal paths?
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Weight
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How much weight is lost when 1 l of urine is excreted?
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1 kg
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What is azotemia and what is it r/t?
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Extremely elevated BUN
Acute glomerulonephritis |
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Post-infectious GN is assoc w/ what pathogen?
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Strep, usually of the skin
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Most common form of GN?
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Membranous glomerulonephritis
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What test should be run after acute GN clears?
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ASO test for strep
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Chronic GN etiology (3 main)?
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epeated episodes of acute glomerular
nephritis, hypertensive nephrosclerosis, hyperlipidemia, and other causes of glomerular damage |
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Lab results r/t acute GN?
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Fixed specific gravity, casts, proteinuria, lyte imbalances, and hypoalbuminemia
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What is Nephrotic syndrome?
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Any condition that seriously damages the glomerular
membrane and results in increased permeability to plasma proteins |
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What does nephrotic syndrome result in?
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hypoalbuminemia & edema
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Etiology of nephrotic syndrome?
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chronic glomerulonephritis, diabetes
mellitus with intercapillaryglomerulosclerosis, amyloidosis, lupus erythematosus, multiple myeloma, and renal vein thrombosis |
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Why does hypoalbuminemia lead to edema?
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It decreases oncotic pressure -> generalized edema -> activation of RAS -> Na+ retention -> edema
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What are the pre-renal causes of acute renal failure (ARF)?
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Hypovolemia & HTN
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What are the intrisic causes of acute renal failure (ARF)?
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Autoimmune, infection, post-GN, ABX, & IV contrast
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What are the post-renal causes of acute renal failure (ARF)?
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BPH (prostate enlargement) & stones
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2 most common causes of Chronic Renal Failure?
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DM & HTN
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Most common infection that causes Chronic Renal Failure? What is it?
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Pyelonephritis
Inflammation of the renal pelvis |
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Where would Continuous renal replacement therapies (CCRT) be used?
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In an ICU
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CKD (staging system for renal failure) is based upon what measure? What stage is ESRD?
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GFR
5 (GFR = ~15) |
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HD access are both venous or arterial?
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Venous
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What do you assess in pts with an Internal Arteriovenous Fistula or Graft?
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Listen for a bruit (should be present)
Feel for a thrill |
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Which lyte doesn't dialyze out?
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PO4 3-
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Peritoneal dialysis is a sterile/non-sterile procedure?
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Very sterile
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What is used as filtration in peritoneal dialysis?
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Blood vessels
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What is done to dialysate post-dialysis?
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Weighed (should be more)
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What must be held on dialysis days?
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anti-HTN meds to prevent hypotension
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How much diasylate is generally used?
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2 L
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What should be avoided in dialysis pt in hospital?
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Meds with K and Mg
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what needs to be mtrd in the dialysis pt?
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Dietary Na, K, protein, & fluid
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Potential problems with dialysis?
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Pericardial d/o
HTN Anemia Bone disease |
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What are all dialysis pts given in terms of meds?
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Heparin
Epo SQ (can be given IV) |
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When do you give blood to dialysis pts?
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During dialysis
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What is the only ix for kidney removal?
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If there's a malignancy
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Post-op concerns for kidney surgery?
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hemorrhage, shock, abd distention, paralytic ileus, infection, and thromboembolism
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1st sign of kidney transplant rejection?
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Oliguria
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How long after transplant before kidney starts functioning?
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2-3 weeks
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What is the second most common reason for seeking health care?
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UTIs
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What type of infection is assoc w/ a UTI?
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nosocomial
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Risk factors for UTI:
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Function of glycosaminoglycan(GAG)
Urethrovesicalreflux Ureterovesicalreflux Uropathogenicbacteria Shorter urethra in women |
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Why do women get more UTIs?
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Shorter urethras
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Most common uropathogenic bacteria?
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E. coli
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What is a major gerontologic concern r/t UTIs?
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urosepsis
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What % of pts with UTIs are asymptomatic?
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~50
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Why does cranberry juice prevent UTIs?
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prevents binding of bacteria to lining of bladder
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How much fluid should a pt with a UTI take in/day?
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2 L
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How do you retrain a bladder in cath pts?
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Clamp cath, allow bladder to fill, then remove
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What is iatrogenic urinary incontinence?
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lost to in-dwelling cath
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What is functional urinary incontinence?
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Unable to get to bathroom
Caused by dementia |
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What grp of pts is most at risk for overflow urinary incontinence?
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BPH pts
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What is urge urinary incontinence?
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spasmodic
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What is stress urinary incontinence? High risk group? Etiology?
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Pressure on bladder
Pregnant women Increased intrabdominal pressure |
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What drugs are used for promoting continence?
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Detrol (anti-spasmodic)
Anti-cholinergics |
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What kind of stones don't show up on X-rays?
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uric stones
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What lab finding could indicate a stone?
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elevated Ca
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What's the highest priority for mgmt of stones?
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Pain mgmt
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What are the terms for stones?
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Urolithiasis and Nephrolithiasis
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What are the ix for a urinary diversion?
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bladder cancer or other pelvic malignancies,
birth defects, trauma, strictures, neurogenicbladder, chronic infection or intractable cystitis; used as a last resort for incontinence |
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What are the biggest concerns r/t BPH?
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retention & UTI
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Tx for BPH?
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Flomax (a-blocker), avodart (5-H reductase inhibitor; shrinks prostate), TURP (surgical[requires CBI {continual bladder irrigation w/ sterile H20}])
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