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104 Cards in this Set

  • Front
  • Back
which of the following findings would indicate additional investigation when review an urinary analysis (UA)?

- faint aromatic odor

- specific gravity of 1.015

- pH = 6.0

- dark and amber color urine
which of the following findings would indicate additional investigation when review an urinary analysis (UA)

- faint aromatic odor à normal

- specific gravity of 1.015 à normal

- pH = 6.0 à normal

ANSWER-> dark and amber color urine - abnormal

*** urine specific gravity is the measurement of the concentration of all chemical particles in the urine (normal range = 1.003 – 1.030)
What are the normal constituents of urine (what do we normally have in urine)
what are the normal constituents of urine (what do we normally have in urine)

- urea

- creatinine

- sodium Na+

- potassium K+

- chloride

- 2 RBCs and 4 WBCs (anything above this is abnormal)
what would be abnormal in urine?
what would be abnormal in urine

- protein

- RBC

- WBC

- Esterase (is a hydrolase enzyme that splits esters into an acid and an alcohol in a chemical reaction with water called hydrolysis)

- Glucose
what lab test reflects the kidney’s ability to concentrate urine
what lab test reflects the kidney’s ability to concentrate urine

- specific gravity test
what does it mean when the UA for C&S test have different kind of organisms in the specimen
what does it mean when the UA for C&S test have different kind of organisms in the specimen

- it means the urine specimen is contaminated
what would you do if the urine specimen is contaminated
what would you do if the urine specimen is contaminated

- need to get a clean catch or in/out cat specimen
pt. complains of dysuria (painful urination) and frequency, what is the sign
pt. complains of dysuria (painful urination) and frequency, what is the sign

- sign of UTI
pt. with UTI is self-treating with leftover antibiotic, what do you do?
pt. with UTI is self-treating with leftover antibiotic, what do you do

- tell pt. to stop taking the med

- explain to pt. that it would set pt. up for super-infection or repeat UTI by slowing down some of the organisms and allows others to proliforate
in evaluate urine specimen for kidney disease pt., what electrolytes would be elevated
in evaluate urine specimen for kidney disease pt., what electrolytes would be elevated

- creatinine and BUN are both elevated but creatinine is more specific to kidney
which test is more specific for kidney disease
which test is more specific for kidney disease

- creatinine test
would creatinine be high or low for kidney disease
would creatinine be high or low for kidney disease

- creatinine would be high because kidney is not filtering creatinine out of blood
what blood test is screening for prostate cancer
what blood test is screening for prostate cancer

- PSA (Prostatic Specific Antigen)



*** antigen is any substance that cause your immune system to produce antibodies against it. It can be a foreign substance from the environment such as chemicals, bacteria, viruses or pollen or it may also be formed within the body as with bacterial toxins or tissue cells
pt. came back from cystoscopy, his first voiding is pink tinted urine; what would you do
pt. came back from cystoscopy, his first voiding is pink tinted urine; what would you do

- tell pt. it is normal because he just had a scope go into the bladder and it could cause irritation

- continue monitoring pt. make sure it is not bright red bleeding



*** cystoscopy is a test that allow doctor to look at the interior lining of your bladder by using cystoscope
what is normal range for serum creatinine
what is normal range for serum creatinine

- males: 0.6 – 1.2

- females: 0.5 – 1.1



*** you will be given a range of mL / dL and decide if creatinine is grossly abnormal or mildly abnormal



grossly abnormal > 4

mildly abnormal = 1.2 – 4
What do you need to do before and after the renal arteriography procedure beside explaining the procedure to pt.?
what do you need to do before and after the renal arteriography procedure beside explaining the procedure to pt.

- need to mark pedal pulse



*** arteriography (angiography): tube is puncture through the femoral vein going into abdominal aorta and renal artery
pt. is gone for a needle biopsy for kidneys, comes back and complains about mild pain at the biopsy site, is that normal

What are you going to monitor him?
pt. is gone for a needle biopsy for kidneys, comes back and complains about mild pain at the biopsy site, is that normal

- YES, it is normal

What are you going to monitor him

- Bleeding on his back
what position would you put the pt. just had a needle biopsy
what position would you put the pt. just had a needle biopsy

- laying on his back with the pillow underneath to tamponade the bleeding
pt. is going for a flat plate of the abdomen also known as KUB (Kidney Ureter Bladder) Xray, what do you need to do?
pt. is going for a flat plate of the abdomen also known as KUB (Kidney Ureter Bladder) Xray, what do you need to do

- explain the procedure so he knows what to expect
if the KUB xray is a dye KUB, what do you need to find out before the procedure
if the KUB xray is a dye KUB, what do you need to find out before the procedure

- check if pt. is allergic to iodine or shellfish
what might pt. expect when getting a dye KUB xray
what might pt. expect when getting a dye KUB xray

- warm flush feeling

- metallic taste in mouth
what should you advice pt. to do when he experience shortness of breath, difficulty in breathing
what should you advice pt. to do when he experience shortness of breath, difficulty in breathing

- notify doctor
what do you find in urine sample of cystitis (bacterial infection of the bladder)
what do you find in urine sample of cystitis (bacterial infection of the bladder)

- elevated WBC (causing cloudiness in urine)

- might see RBC from the inflammation

- specific gravity is a little bit high
what do you monitor after the cystoscomy procedure
what do you monitor after the cystoscomy procedure

- urinary retention

- back pain

- pink tinted urine
what is the urinary retention catheter in place?
what is the urinary retention catheter in place

- foley catheter
pt. with foley catheter, complaining of discomfort in bladder and urethra; what do you need to do?
pt. with foley catheter, complaining of discomfort in bladder and urethra; what do you need to do

- check for placement and patency



*** patency is the state of being opened, expanded or unblocked
how do you check for patency
how do you check for patency

- flush the tube with sterile normal saline (50mL)
when should you consider using a foley catheter?
when should you consider using a foley catheter

- use it as last resource
while inflate the baloon for a foley, pt complains about pain; what should you do
while inflate the baloon for a foley, pt complains about pain; what should you do

- stop and deflate the balloon then advance it a little further
why do we do catheter care

what does that entail?
why do we do catheter care

- prevent infection

what is that entailed

- cleaning around the meatus and tubing with normal saline only
what kind of activities that make pt. with stress incontinence dribble urine
what kind of activities that make pt. with stress incontinence dribble urine

- laughing

- coughing

- weight bearing

- sneezing
why do women have a higher risk of developing cystitis than men
why do women have a higher risk of developing cystitis than men

- because women have shorter urethras

- anatomically urethra is closer to the anus
what task can you assign to UAP (unlicensed assisting personnel)

- measure output from catheter?

- encourage pt. to drink water?

- assist pt. to bedside commode every couple of hours?

- check VS?

- can they tell pt. it is abnormal when pt. has urine with green color?

- can they perform procedure beside VS?
what task can you assign to UAP (unlicensed assisting personnel)

- measure output from catheter - yes

- encourage pt. to drink water - yes

- assist pt. to bedside commode every couple of hours - yes

- check VS - yes

- can they tell pt. it is abnormal when pt. has urine with green color - NO

- can they perform procedure beside VS - NO
what make urine green
what make urine green

- medication
an older pt. developed UTI, what is S/S
an older pt. developed UTI, what is S/S

- mentally confusion
what do you do with the urine specimen if you cannot send to the lab right away
what do you do with the urine specimen if you cannot send to the lab right away

- keep in the biohazard fridge
S/S of UTI?
S/S of UTI

- frequency of urine (have to go often)

- urgency

- lower back pain

- flank pain (from the back to groin)

- burning from dysuria
male client diagnosis with urethritis (bacterial infection of the urethra), would he has penile discharge
male client diagnosis with urethritis (bacterial infection of the urethra), would he has penile discharge

- YES

*** penile discharge: abnormal loss of fluid that is not urine or semen from the urethra
why should pt. with pyelonephritis need to drink 2 or 3 litter of fluid a day?

why do we need to prevent stasis of urine
why should pt. with pyelonephritis need to drink 2 or 3 litter of fluid a day

- to dilute the urine

- keep urine flowing

- prevent stasis of urine

why do we need to prevent stasis of urine

- to prevent infection and stones



*** pyelonephritis : bacterial infection of the kidneys
what is risk factors for pyelonephritis or who is at risk?
what is risk factors for pyelonephritis or who is at risk

- pregnancy

- urinary retention

- obstruction

- kidney stones

- bladder tumor

- enlarged prostate
pt. with kidney stones, what would you do for this pt.
pt. with kidney stones, what would you do for this pt.

- encourage fluid

- give narcotic med.
what do you do with urine specimen for pt. with kidney stones
what do you do with urine specimen for pt. with kidney stones

- filter out the stones

- keep in separate container

- send to the lab to find out what kind of stones
Q1. describe ureteral colic or colicky pain

Q2.where does the pain move to and from
describe ureteral colic or colicky pain

- excruciating pain (very painful)

- spasm of the ureter

where does the pain move to and from

- from flank to groin and might come up to shoulder
should you keep pt with kidney stones on bed rest or ambulation
should you keep pt with kidney stones on bed rest or ambulation

- pt with kidney stones should be ambulated
what kind of diet for pt. with uric acid kidney stones
what kind of diet for pt. with uric acid kidney stones

- should be on low purine diet

- avoid organ meat and nuts
what kind of diet for pt. with calcium phosphate stones
what kind of diet for pt. with calcium phosphate stones

- low calcium diet

- avoid vitamin D and calcium foods
what is your primary priority for pt. with renal colic and nephrolithiasis (stones inside kidney)
what is your primary priority for pt. with renal colic and nephrolithiasis (stones inside kidney)

- pain management

- all of the above
would you withhold fluid on pt with renal calculi
would you withhold fluid on pt with renal calculi

- pt. with renal calculi should be encouraged on fluid 2000-3000mL/day
what is nephrolithiasis?
what is nephrolithiasis

- stone in the kidney itself
what is the most common complication of nephrolithiasis?
what is the most common complication of nephrolithiasis

- hydronephrosis (stone blocked the kidney, urine can’t get out)
what is one of the first symptom of kidney cancer that bring pt. to hospital?
what is one of the first symptom of kidney cancer that bring pt. to hospital

- painless bleeding
what would be include in your discussion with pt. that has polycystic kidney disease (PKD)

what is the most serious complication of polycystic kidney disease, what does it lead to?
what would be include in your discussion with pt. that has polycystic kidney disease (PKD)

- genetic counseling

what is the most serious complication of polycystic kidney disease, what does it lead to

- end stage renal failure
what BPH cause?
what BPH cause

- urinary retention that cause hydronephrosis (urine back up in kidney)


*** BPH : (Benign Prostatic Hyperplasia) enlarged prostate
what kind of urinary pattern does BPH pt have?
what kind of urinary pattern does BPH pt have?

- intermittent pattern (pt. is having trouble starting urinate and once it started it may go off and on)
what is the most common surgery for BPH
what is the most common surgery for BPH

- TURP (TransUrethral Resection of Prostate)
pt. is going for TURP, what color of urine would you expect right after TURP
pt. is going for TURP, what color of urine would you expect right after TURP

- initially urine is red then gradually become pink
what is the purpose of doing irrigation for pt. after TURP
what is the purpose of doing irrigation for pt. after TURP

- to keep the catheter patent (open, not block), get rid of the clot
pt. had turp, has red bloody urine (need to be monitored), complain of bladder spasm (normal), has urine output = 40mL/hr (fine), b/p 90/60 (dropped) and p=130 (high) what is that indicate

what do you need to do?
pt. had turp, has red bloody urine (need to be monitored), complain of bladder spasm (normal), has urine output = 40mL/hr (fine), b/p 90/60 (dropped) and p=130 (high) what is that indicate

- hypotension and shock (he bleeding too much)

what do you need to do

- call the surgeon
what kind of tube do we use for suprapubic prostatectomy
what kind of tube do we use for suprapubic prostatectomy

- cystostomy tube go into the bladder
what is the name of the gland surrounding urethra in male pt.?
what is the name of the gland surrounding urethra in male pt.

- prostate gland
pt. with prostate cancer, has problem voiding or very little; what is the problem?
pt. with prostate cancer, has problem voiding or very little; what is the problem

- he has enlarged prostate that cause urinary retention
pt. complain of low abd pain and hematuria(RBC in urine), no fever; what kind of question should you ask him
pt. complain of low abd pain and hematuria(RBC in urine), no fever; what kind of question should you ask him

- do you have any trauma to bladder or abdomen
pt. with trauma to the bladder, where does the pain go to
pt. with trauma to the bladder, where does the pain go to

- pain go to shoulder because the bladder trauma irritates the phrenic nerve
you about to catheterize pt. and find blood at the meatus; what should you do
you about to catheterize pt. and find blood at the meatus; what should you do

- notify doctor
pt. has nephrotic syndrome(group of symptom), what kind of instruction should you give to pt.
pt. has nephrotic syndrome(group of symptom), what kind of instruction should you give to pt.

- no forcing fluid

- no sodium

- no fatty foods

- yes on protein and carb
what is S/S of nephrotic syndrome?

what do you want to monitor?
what is S/S of nephrotic syndrome

- generalized edema (massive edema, common sign of severely ill)

what do you want to monitor

- daily weight
pt. has hypoalbuminemia, hyperlipidemia what is the cause?
pt. has hypoalbuminemia, hyperlipidemia what is the cause

- too much protein in the urine
what is glomerulonephritis?
what is glomerulonephritis

- inflammation of the kidney capillaries (glomerulus)
how does pt. feel during the stage of acute phase of glomerulonephritis?
how does pt. feel during the stage of acute phase of glomerulonephritis

- fatigue

- anorexia

- mild hypertension
what is your goal for pt. with acute phase of glomerulonephritis?
what is your goal for pt. with acute phase of glomerulonephritis

- small meals

- encourages bed rest
what color of urine for pt. with acute phase of glomerulonephritis
what color of urine for pt. with acute phase of glomerulonephritis

- coca cola color
what is the common cause of glomerulonephritis
what is the common cause of glomerulonephritis

- strep throat moving to kidney
what should pt. with strep throat (problem with upper respiratory tract) do
what should pt. with strep throat (problem with upper respiratory tract) do

- go to doctor to get antibiotic
what is azotemia?
what is azotemia

- elevated BUN and creatinine
pt. with chronic renal failure (CRF)

- NO push fluid

- high sodium intake

- high protein and potassium

- restricting fluid
pt. with chronic renal failure (CRF)

- NO push fluid

- NO high sodium intake

- NO high protein and potassium

- YES restricting fluid
what is uremic frost
what is uremic frost

- is the powder from urea and uric acid salt on the skin due to kidney failed to excrete them
what cause uremic frost?
what cause uremic frost

- kidneys are not working, the body waste products are coming thru the skin therefore the skin smell like urine
what do we need to monitor for pt. with CRF
what do we need to monitor for pt. with CRF

- lung sound, respiratory system
what kind of food should CRF pt. avoid?
what kind of food should CRF pt. avoid

- any food that become liquid at room temperature (such as ice cream, sherbet, jello…)

Angel Food is the answer
select one of the following for CRF pt.

- grapefruid

- orange juice

- apple juice

- prune juice

- cranberry juice
select one of the following for CRF pt.

- NO grapefruid

- NO orange juice

- YES apple juice

- NO prune juice

- NO cranberry juice
what VS that we concern the most in pt. with renal failure
what VS that we concern the most in pt. with renal failure

- B/P (it goes up) and cause hypertension
what lab result that pose the greatest risk (kill) to pt. with CRF?

- pH = 7.0

- BUN = 40

- creatinine = 40

- potassium = 7.0 (high cause heart problem)
what lab result that pose the greatest risk (kill) to pt. with CRF

- NO pH = 7.0

- NO BUN = 40

- NO creatinine = 40

- YES potassium = 7.0 (high cause heart problem)
what med. is for reducing potassium
what med. is for reducing potassium

- kayexelate
pt. with acute kidney failure, has muscle, fingers and toes twitching, tingling fingers and toes. What electrolyte that responsible for this
pt. with acute kidney failure, has muscle, fingers and toes twitching, tingling fingers and toes. What electrolyte that responsible for this

- too low sodium (hypocalcemia)
pt. with CRF is confused and irritable, what is the cause
pt. with CRF is confused and irritable, what is the cause

- elevated BUN
what nursing intervention is the most important in the oliguric (urine volume go down) phase for CRF pt
what nursing intervention is the most important in the oliguric (urine volume go down) phase for CRF pt

- limit fluid (giving fluid will make the condition worse)
pt. with CRF, what is the main reason for hemodialysis.
pt. with CRF, what is the main reason for hemodialysis.

- to get rid of potassium due to hyperkalemia
when receiving hemodialysis, the complication of too much sodium may occur?
when receiving hemodialysis, the complication of too much sodium may occur

- hyponatremia

- irriatability

- muscle cramp

- confusion
what is the most serious complication with an external shunt for hemodyalisis?
what is the most serious complication with an external shunt for hemodyalisis

- exsanguinations (bleeding out)
what technique that you use to care for shunt?
what technique that you use to care for shunt

- surgical (aseptic) technique (everything sterile)
what kind of thing that we cannot do on the arm that has AV shunt or graft
what kind of thing that we cannot do on the arm that has AV shunt or graft

- B/P

- IV

- Take blood
what is the normal color should the dialysate be
what is the normal color should the dialysate be

- should be clear, not cloudy
what sign that indicate something wrong with the dialysis
what sign that indicate something wrong with the dialysis

- potassium = 3.9

- loss 2 lbs

- anuric (no urine)

- cloudy dialysate
what is purpose of peritoneal dialysis
what is purpose of peritoneal dialysis

- to remove toxin waste from body
pt. with continuous ambulatory peritoneal dialysis, what is his greatest risk
pt. with continuous ambulatory peritoneal dialysis, what is his greatest risk

- infection
what happen to creatinine level if the dialysis is working properly
what happen to creatinine level if the dialysis is working properly

- creatinine level is decreased
pt. complains of flank pain, what is the assessment do you see on the flank area
pt. complains of flank pain, what is the assessment do you see on the flank area

- bruises on flank area
what is the main complication after nephrostomy
what is the main complication after nephrostomy

- bleeding from the operative site
after nephrostomy pt. came back and has 50mL/hr urinary output, is that a concern

What do you do
after nephrostomy pt. came back and has 50mL/hr urinary output, is that a concern

- NO, it’s normal

What do you do

- chart it
kidney donor with history of hepatitis C, can he still a candidate for donor
kidney donor with history of hepatitis C, can he still a candidate for donor

- NO
pt. with kidney transplant that has creatinine level of 3.1; is this normal

What do you expect
pt. with kidney transplant that has creatinine level of 3.1; is this normal

- NO, creatinine is too high (normal creatinine 1.5 – 2.2)

What do you expect

- decreased in urine
what are two lifetime medication for long term kidney transplant pt.
what are two lifetime medication for long term kidney transplant pt.

- corticosteroid

- immunosuppressant
pt. with bladder cancer, scheduled for cystectomy and ilealconduit, what pre-op do you have to do
pt. with bladder cancer, scheduled for cystectomy and ilealconduit, what pre-op do you have to do

- cleansing enemas

- bowel preparation

- laxative
what is normal urine output
what is normal urine output

- 30mL/hr
what is the advantage of the koch pouches
what is the advantage of the koch pouches

- pt. is not incontinent

- can have bladder retraining