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116 Cards in this Set

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renal arteriogram
catheter inserted to femoral artery and ran to renal artery; successive x-rays are taken; assess blood flow to distant to insertion site after procedure and apply pressure to site.
diagnostic test to measure profusion of kidneys
renal biopsy
used to detect renal disease, malignancy and transplant status; percutaneous--aided by US thru skin; incisional--surgical incision
glomerulonephritis
inflammation of kidney; more freq. in children who have had a recent case of strep throat
*MOST COMMON KIDNEY DISEASE*
pylonephritis
bacterial infection that can either start in the bladder and work up or can enter thru the bloodstream
hydronephritis
H2O accumulates in kidney; urine flow is obstructed and backs up into the kidney; can happen during pregnancy
polycystic kidney
hereditary fluid filled sacs/cysts; treatment includes controlling BP
renal failure
acute--insult/injury to kidney; chronic--gradual build up of waste causes failure
kidney stones/calculi
caused by dehydration, infection, diet, urinary stasis
cystitis
lower UTI; inflammation of bladder; more common in women or ppl. w/ diabetes
uti
urinary tract infection; can be upper or lower
incontinence
F=functional--unpredictable passage of urine; O=overflow--overdistended, voluntary or involuntary; U=urge--involuntary after a strong sense of urgency to void; R=reflex--involuntary occuring @ somewhat predicatable intervals; S=stress--sudden increase in pressure caused by laughing, sneezing, coughing
FOURS
3 types of urine sample
1=routine/random
2=clean catch/mid-stream
3=sterile
routine/random sample
clean, voided sample; not sterile; measures glucose, specific gravity, ketones
clean catch/mid-stream
checks for bacteria; use sterile specimen cup
sterile sample
straight or indwelling (Foley) cath; can take out of bag one time only, after that you must take it out of port w/ needle and syringe
timed urine sample
have pt. tell you when they need to void; start time and FLUSH first voided urine; save all other voids for 24 hours
types of catheters
straight (in & out); indwelling (Foley)
Factors affecting urination
disease, age, meds, foods, social/cultural factors, surgery, social/cultural issues
diagnostic tests for urinary systems
Blood--BUN (blood, urea, nitrogen), creatinine level, electrolytes (salt & potassium) and radiologic
KUB
kidneys, ureters, bladder x-ray
IVP
intravenous pylogram; IV radio-opaque dye and series of x-rays
renal scan
nuclear IV; pictures taken w/ gamma ray camera
cystoscopy
endoscopic test; used for biopsy, removal of calculi, measures bladder capacity, stent placement
top complications are 1)infection 2)perforation 3)hematuria
retro-grade pylogram
uses cystoscopy to complete an IVP; Dr. puts catheters into ureters and injects dye to assess kidney and ureter function
renal CT
non-invasive cross section view of kidneys
renal US
high frequency sound waves; differentiates cysts from tumors; identifies kidney stones
3 basic homeostatic mechanisms of the urinary system
P=regulate blood pressure
V=regulate blood volume
C=controls composition of blood
PVC
renin
secreted by kidneys when BP is too low to increase vasoconstriction and raise BP
Erythropoietin
secreted by kidneys to stimulate RBC production when hypoxia is sensed
ADH
anti-diuretic hormone; secreted by anterior pituitary gland to tell kidneys to reabsorb more H2O
diuresis
producing a lot of fluid
diabetes insipidus
insufficient ADH; a lot of urination
30mL
the amount of urine a body should produce every 24 hours
properties of urine
A=amount--1 1/2-2L/day
C=clarity--clear
C=color--straw, yellow, amber
C=Concentration 1.005-1.030
O=odor--slightly aromatic
P=pH--4.8-8; 6 is normal
S=STERILE
G=glucose--no
K=ketones--no
P=protein--no
C=cast--no
ACCCOPSGKPC
oliguria
low amount of urine; 100-400mL/day
anuria
absence of urine; <100mL/day
capacity of bladder
600mL
urge to void
150-200mL
pathogenicity
is it capable of causing disease?
virulence
ability to produce disease
modes of transmission
contact--direct/indirect
air--droplet/airborne
vehicles--inanimate objects/equipment
vector--animate/internal, mosquitoes, louse, flea, tick
four stages of infection
1) incubation period--from entrance to body until 1st symptom
2) prodromal stage--general symptoms, turning into more specific symptoms
3) illness stage--manifest signs and symptoms specific to type of illness
4)convalescence--acute symptoms disappear
inflammation response
one of the body's defenses against infection. This is a non-specific response.
localized--edema, errythmia, pain, tenderness, lower fx. of area
systemic--fever, malaise, nausea, vomiting,
immune response
specific response; cell mediated immunity, humoral immunity, passive immunity
cell-mediated response
t-lymphs go to infected area and release antigens to fight
humoral immunity
B cells stimulated and cause antibody to be formed
formation of antibodies
active immunity--antibodies are produced by our own body due to exposure; natural active--you had the illness; artificial active--vaccines; passive immunity--antibody is produced at another source and given to you; natural passive--mother to child; artificial passive--immunoglobulins
complement
inactive blood proteins activated by antigens
interferon
chemicals always in our body, they prevent viral replication and suppress tumor growth
nosocomial infection
an infection acquired in a hospital #1 is UTI, #2 is pneumonia
latrogenic infection
typre of nosocomial that results from diagnostic and therapeutic procedure
asepsis
absence/decrease in organisms
medical asepsis
clean technique
disinfection
use chemicals to eliminate microorganisms (not spores)
surgical asepsis
sterile technique; gets rid of everything (including spores)
purpose of drug therapy for infection control
to lower # of pathogens in a pt. body until pt. own immune system can take over
a system of moral principles or stds. that determine conduct/character in an individual
ethics
conduct/character relationships between different human beings
morality
abstract standards that give people a sense about what is right and wrong
values
difficult issues that arise in healthcare settings
bioethics
process of becoming more aware and able to name the values we deem worthy to us
values clarification
self control; freedom to make decisions that will impact welfare and to take action
autonomy
preventing harm
non-maleficence
emphasis on doing what is best for the pt.
beneficence
remaining faithful to ethical commitments and beliefs
fidelity
fair and equitable appropriate tx. for pt.
justice
telling the truth
veracity
speaking up for pt. welfare
advocacy
accept ownership for what you did/did not do
accountability
maintaing privacy of pt. and family
confidentiality
be answerable to actions we have taken; reliability and dependability
responsibility
powers of free action
rights
code of ethics for nurses
est. by ANA in 1950; provides us w/ guidelines
pt. bill of rights
est. by AHA in 1973 to affirm pt. rights
rights of a pt
respectful, considerate care
privacy and confidentiality
information re: tx. and dx.
to refuse any and all tx.
analysis of ethical dilemma
ask "is this an ethical dilemma?"
gather info
values stmt
verbalize problem
consider course of action
negotiate outcome
what kind of laws are healthcare laws?
CIVIL
standards of care
legal guidelines for nsg. practice
intentional tort
assault/battery, defamation of character, false imprisionment, invasion of privacy
a willfull attempt (no touching)
assault
touching w/o consent
battery
unintentional tort
negligence, malpractice
conduct that falls below the std. of care; omission to do something that a reasonable person would/would not have done
negligence
professional negligence or unreasonable amount of skill
malpractice
to prove malpractice
1)there must be a duty
2)nurse did not carry out duty
3)pt. was injured
4)the nurse's failure to carry out duty caused pt. injury
debt to pt.
liability
nutrition
study of food and health
nutrient
elements used by body for growth, dev, activity, repro, maint, recovery of health
essential nutrient
not made in body
macronutrients
carbs--4k/cal
proteins--4k/cal
fats--9k/cal
essential macrominerals
greater than 100mg/day (Na, Ca, K, Phosphorous)
micronutrients
vitamins, trace minerals
fat soluble vits
a, d, e, k
non-essential nutrients
body makes it; vit. D and cholesterol
6 classes of nutrients
carbs
proteins
fats
minerals
vits
h2o
bmi
18-25 normal
26-30 overweight
over 30 obese
carbs
carbon, oxygen, hydrogen; most abundant, least expensive, prevents ketosis
proteins
carbon, oxygen, hydrogen, nitrogen; amino acids, key of life, repair muscles
fats/lipids
carbon, hydrogen, oxygen; insoluble in blood and water, concentrated energy source;
water soluble vits
not stored
fat soluble vits
stored in body
nutritional assessment
D--disease
E--eating poorly
T--tooth, mouth pain
E--economic hardship
R--reduced social contact
M--Meds
I--involuntary weight loss/gain
N--needs help
E--elderly
anthropometry data
measuring system of the size and make-up of body; BMI, head circumference, skin folds
clear liquid diet
clear fluids @ room temp, coffee w/ no cream, broth, popsicles, clear juice; low in calories
full liquid diet
contains milk; plain frozed desserts, eggs, cream of wheat, creamy soups, ice cream
soft diet
modified reg. diet, eliminates foods hard to digest or chew; eliminates high fiber foods; low in fiber and residue
npo diet
nothing by mouth
enteral nutrition
directly to GI
parental nutrition
TPN; not thru GI tract; into a large vein;
salem sump
suctions out; use saline to flush
fats
most concentrated energy source in the body
saline
isotonic
alcohol
depletes vit. B store
what plant protein contains all essential amino acids necessary to support growth?
SOY
triamterene
used to prevent CHF; avoid foods high in K
strawberries
high in vit. C