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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) |
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What are the normal constituents of urine (what do we normally have in urine)
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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) |
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what would be abnormal in urine?
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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 |
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what lab test reflects the kidney’s ability to concentrate urine
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what lab test reflects the kidney’s ability to concentrate urine
- specific gravity test |
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what does it mean when the UA for C&S test have different kind of organisms in the specimen
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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 |
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what would you do if the urine specimen is contaminated
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what would you do if the urine specimen is contaminated
- need to get a clean catch or in/out cat specimen |
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pt. complains of dysuria (painful urination) and frequency, what is the sign
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pt. complains of dysuria (painful urination) and frequency, what is the sign
- sign of UTI |
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pt. with UTI is self-treating with leftover antibiotic, what do you do?
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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 |
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in evaluate urine specimen for kidney disease pt., what electrolytes would be elevated
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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 |
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which test is more specific for kidney disease
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which test is more specific for kidney disease
- creatinine test |
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would creatinine be high or low for kidney disease
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would creatinine be high or low for kidney disease
- creatinine would be high because kidney is not filtering creatinine out of blood |
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what blood test is screening for prostate cancer
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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 |
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pt. came back from cystoscopy, his first voiding is pink tinted urine; what would you do
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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 |
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what is normal range for serum creatinine
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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 |
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What do you need to do before and after the renal arteriography procedure beside explaining the procedure to pt.?
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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 |
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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 |
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what position would you put the pt. just had a needle biopsy
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what position would you put the pt. just had a needle biopsy
- laying on his back with the pillow underneath to tamponade the bleeding |
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pt. is going for a flat plate of the abdomen also known as KUB (Kidney Ureter Bladder) Xray, what do you need to do?
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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 |
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if the KUB xray is a dye KUB, what do you need to find out before the procedure
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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 |
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what might pt. expect when getting a dye KUB xray
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what might pt. expect when getting a dye KUB xray
- warm flush feeling - metallic taste in mouth |
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what should you advice pt. to do when he experience shortness of breath, difficulty in breathing
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what should you advice pt. to do when he experience shortness of breath, difficulty in breathing
- notify doctor |
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what do you find in urine sample of cystitis (bacterial infection of the bladder)
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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 |
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what do you monitor after the cystoscomy procedure
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what do you monitor after the cystoscomy procedure
- urinary retention - back pain - pink tinted urine |
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what is the urinary retention catheter in place?
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what is the urinary retention catheter in place
- foley catheter |
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pt. with foley catheter, complaining of discomfort in bladder and urethra; what do you need to do?
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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 |
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how do you check for patency
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how do you check for patency
- flush the tube with sterile normal saline (50mL) |
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when should you consider using a foley catheter?
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when should you consider using a foley catheter
- use it as last resource |
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while inflate the baloon for a foley, pt complains about pain; what should you do
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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 |
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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 |
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what kind of activities that make pt. with stress incontinence dribble urine
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what kind of activities that make pt. with stress incontinence dribble urine
- laughing - coughing - weight bearing - sneezing |
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why do women have a higher risk of developing cystitis than men
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why do women have a higher risk of developing cystitis than men
- because women have shorter urethras - anatomically urethra is closer to the anus |
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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 |
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what make urine green
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what make urine green
- medication |
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an older pt. developed UTI, what is S/S
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an older pt. developed UTI, what is S/S
- mentally confusion |
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what do you do with the urine specimen if you cannot send to the lab right away
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what do you do with the urine specimen if you cannot send to the lab right away
- keep in the biohazard fridge |
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S/S of UTI?
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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 |
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male client diagnosis with urethritis (bacterial infection of the urethra), would he has penile discharge
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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 |
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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 |
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what is risk factors for pyelonephritis or who is at risk?
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what is risk factors for pyelonephritis or who is at risk
- pregnancy - urinary retention - obstruction - kidney stones - bladder tumor - enlarged prostate |
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pt. with kidney stones, what would you do for this pt.
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pt. with kidney stones, what would you do for this pt.
- encourage fluid - give narcotic med. |
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what do you do with urine specimen for pt. with kidney stones
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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 |
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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 |
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should you keep pt with kidney stones on bed rest or ambulation
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should you keep pt with kidney stones on bed rest or ambulation
- pt with kidney stones should be ambulated |
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what kind of diet for pt. with uric acid kidney stones
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what kind of diet for pt. with uric acid kidney stones
- should be on low purine diet - avoid organ meat and nuts |
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what kind of diet for pt. with calcium phosphate stones
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what kind of diet for pt. with calcium phosphate stones
- low calcium diet - avoid vitamin D and calcium foods |
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what is your primary priority for pt. with renal colic and nephrolithiasis (stones inside kidney)
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what is your primary priority for pt. with renal colic and nephrolithiasis (stones inside kidney)
- pain management - all of the above |
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would you withhold fluid on pt with renal calculi
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would you withhold fluid on pt with renal calculi
- pt. with renal calculi should be encouraged on fluid 2000-3000mL/day |
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what is nephrolithiasis?
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what is nephrolithiasis
- stone in the kidney itself |
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what is the most common complication of nephrolithiasis?
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what is the most common complication of nephrolithiasis
- hydronephrosis (stone blocked the kidney, urine can’t get out) |
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what is one of the first symptom of kidney cancer that bring pt. to hospital?
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what is one of the first symptom of kidney cancer that bring pt. to hospital
- painless bleeding |
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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 |
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what BPH cause?
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what BPH cause
- urinary retention that cause hydronephrosis (urine back up in kidney) *** BPH : (Benign Prostatic Hyperplasia) enlarged prostate |
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what kind of urinary pattern does BPH pt have?
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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) |
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what is the most common surgery for BPH
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what is the most common surgery for BPH
- TURP (TransUrethral Resection of Prostate) |
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pt. is going for TURP, what color of urine would you expect right after TURP
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pt. is going for TURP, what color of urine would you expect right after TURP
- initially urine is red then gradually become pink |
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what is the purpose of doing irrigation for pt. after TURP
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what is the purpose of doing irrigation for pt. after TURP
- to keep the catheter patent (open, not block), get rid of the clot |
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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 |
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what kind of tube do we use for suprapubic prostatectomy
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what kind of tube do we use for suprapubic prostatectomy
- cystostomy tube go into the bladder |
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what is the name of the gland surrounding urethra in male pt.?
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what is the name of the gland surrounding urethra in male pt.
- prostate gland |
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pt. with prostate cancer, has problem voiding or very little; what is the problem?
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pt. with prostate cancer, has problem voiding or very little; what is the problem
- he has enlarged prostate that cause urinary retention |
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pt. complain of low abd pain and hematuria(RBC in urine), no fever; what kind of question should you ask him
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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 |
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pt. with trauma to the bladder, where does the pain go to
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pt. with trauma to the bladder, where does the pain go to
- pain go to shoulder because the bladder trauma irritates the phrenic nerve |
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you about to catheterize pt. and find blood at the meatus; what should you do
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you about to catheterize pt. and find blood at the meatus; what should you do
- notify doctor |
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pt. has nephrotic syndrome(group of symptom), what kind of instruction should you give to pt.
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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 |
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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 |
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pt. has hypoalbuminemia, hyperlipidemia what is the cause?
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pt. has hypoalbuminemia, hyperlipidemia what is the cause
- too much protein in the urine |
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what is glomerulonephritis?
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what is glomerulonephritis
- inflammation of the kidney capillaries (glomerulus) |
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how does pt. feel during the stage of acute phase of glomerulonephritis?
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how does pt. feel during the stage of acute phase of glomerulonephritis
- fatigue - anorexia - mild hypertension |
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what is your goal for pt. with acute phase of glomerulonephritis?
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what is your goal for pt. with acute phase of glomerulonephritis
- small meals - encourages bed rest |
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what color of urine for pt. with acute phase of glomerulonephritis
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what color of urine for pt. with acute phase of glomerulonephritis
- coca cola color |
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what is the common cause of glomerulonephritis
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what is the common cause of glomerulonephritis
- strep throat moving to kidney |
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what should pt. with strep throat (problem with upper respiratory tract) do
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what should pt. with strep throat (problem with upper respiratory tract) do
- go to doctor to get antibiotic |
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what is azotemia?
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what is azotemia
- elevated BUN and creatinine |
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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 |
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what is uremic frost
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what is uremic frost
- is the powder from urea and uric acid salt on the skin due to kidney failed to excrete them |
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what cause uremic frost?
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what cause uremic frost
- kidneys are not working, the body waste products are coming thru the skin therefore the skin smell like urine |
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what do we need to monitor for pt. with CRF
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what do we need to monitor for pt. with CRF
- lung sound, respiratory system |
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what kind of food should CRF pt. avoid?
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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 |
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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 |
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what VS that we concern the most in pt. with renal failure
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what VS that we concern the most in pt. with renal failure
- B/P (it goes up) and cause hypertension |
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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) |
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what med. is for reducing potassium
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what med. is for reducing potassium
- kayexelate |
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pt. with acute kidney failure, has muscle, fingers and toes twitching, tingling fingers and toes. What electrolyte that responsible for this
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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) |
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pt. with CRF is confused and irritable, what is the cause
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pt. with CRF is confused and irritable, what is the cause
- elevated BUN |
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what nursing intervention is the most important in the oliguric (urine volume go down) phase for CRF pt
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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) |
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pt. with CRF, what is the main reason for hemodialysis.
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pt. with CRF, what is the main reason for hemodialysis.
- to get rid of potassium due to hyperkalemia |
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when receiving hemodialysis, the complication of too much sodium may occur?
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when receiving hemodialysis, the complication of too much sodium may occur
- hyponatremia - irriatability - muscle cramp - confusion |
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what is the most serious complication with an external shunt for hemodyalisis?
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what is the most serious complication with an external shunt for hemodyalisis
- exsanguinations (bleeding out) |
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what technique that you use to care for shunt?
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what technique that you use to care for shunt
- surgical (aseptic) technique (everything sterile) |
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what kind of thing that we cannot do on the arm that has AV shunt or graft
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what kind of thing that we cannot do on the arm that has AV shunt or graft
- B/P - IV - Take blood |
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what is the normal color should the dialysate be
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what is the normal color should the dialysate be
- should be clear, not cloudy |
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what sign that indicate something wrong with the dialysis
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what sign that indicate something wrong with the dialysis
- potassium = 3.9 - loss 2 lbs - anuric (no urine) - cloudy dialysate |
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what is purpose of peritoneal dialysis
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what is purpose of peritoneal dialysis
- to remove toxin waste from body |
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pt. with continuous ambulatory peritoneal dialysis, what is his greatest risk
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pt. with continuous ambulatory peritoneal dialysis, what is his greatest risk
- infection |
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what happen to creatinine level if the dialysis is working properly
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what happen to creatinine level if the dialysis is working properly
- creatinine level is decreased |
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pt. complains of flank pain, what is the assessment do you see on the flank area
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pt. complains of flank pain, what is the assessment do you see on the flank area
- bruises on flank area |
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what is the main complication after nephrostomy
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what is the main complication after nephrostomy
- bleeding from the operative site |
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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 |
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kidney donor with history of hepatitis C, can he still a candidate for donor
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kidney donor with history of hepatitis C, can he still a candidate for donor
- NO |
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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 |
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what are two lifetime medication for long term kidney transplant pt.
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what are two lifetime medication for long term kidney transplant pt.
- corticosteroid - immunosuppressant |
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pt. with bladder cancer, scheduled for cystectomy and ilealconduit, what pre-op do you have to do
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pt. with bladder cancer, scheduled for cystectomy and ilealconduit, what pre-op do you have to do
- cleansing enemas - bowel preparation - laxative |
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what is normal urine output
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what is normal urine output
- 30mL/hr |
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what is the advantage of the koch pouches
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what is the advantage of the koch pouches
- pt. is not incontinent - can have bladder retraining |