Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
134 Cards in this Set
- Front
- Back
|
anuria
|
absence of urinary output
|
|
|
polyuria
|
large amount of urine output
|
|
|
oliguria
|
low urinary output
|
|
|
dysuria
|
painful urination
|
|
|
calculi
|
hard inorganic mass; stone
|
|
|
hilus
|
entry into the kidney
|
|
|
nephron
|
functional unit of the kidney
|
|
|
nocturia
|
waking from sleep to void
|
|
|
nephrotoxic
|
harmful to the kidneys
|
|
|
BUN
|
indicator of kidneys' ability to excrete urea
|
|
|
urea
|
end product of protein metabolism
|
|
|
factors which can increase BUN
|
high-protein diet
GI bleeding dehydration drugs (aspirin, diuretics, lithium, morphine, gentamycin, steroids, sulfonamides) renal failure |
|
|
creatinine
|
waste product of skeletal muscle breakdown
|
|
|
serum creatinine
|
indicator of kidneys' ability to excrete wastes
|
|
|
ratio of BUN to Creatinine
|
10:1
|
|
|
serum test elevated only in renal disorders
|
creatinine
|
|
|
normal serum level is low and urine level is high
|
creatinine
|
|
|
normal serume creatinine is _____ and normal urine creatinine is _____.
|
low; high
|
|
|
In renal failure, normal sodiuim levels are_____.
|
elevated
|
|
|
In renal failure, normal potassium levels are _____.
|
elevated
|
|
|
In renal failure, normal calcium levels are
|
decreased
|
|
|
KUB
|
radiograph of abdomen to show general outline , size and contour of kidneys, ureters and bladder
|
|
|
KUB should be done _____ other studies that require contrast media.
|
before
|
|
|
KUB
|
Kidney, Ureter, Bladder radiograph
(flat plate of abdomen) |
|
|
IVP
|
intravenous pyelogram
|
|
|
IVP
|
radiographic contrast medium (dye) injected IVand then KUB radiograph taken at intervals
|
|
|
Contraindications for IVP
|
older adults with known renal insufficiency;
patients with diabetes mellitus; patients with multiple myeloma; allergy to contrast material |
|
|
renal arteriogram
|
study of renal blood vessels
|
|
|
used to diagnose renal artery stenosis, aneurysms, vascular tumors
|
renal arteriogram
|
|
|
Preparation for renal arteriogram
|
check for allergy to contrast medium (dye);
NPO 8-12 hours before test; withhold anticoagulants before test; bowel prep; signed consent; void before test; administer sedation if ordered |
|
|
Nursing care after renal arteriogram
|
assess for signs of bleeding at catheter insertion site;
monitor for bleeding, dyspnea, tachcardia, restlessness, abd or flank pain; monitor CMS in extremity where catheter was inserted; bedrest as ordered; encourage fluids; measure I&O |
|
|
Nursing care after IVP
|
encourage fluids;
monitor for s/s iodine allergy; check injection site for inflammation |
|
|
signs & symptoms of iodine allergy
|
urticaria
rash nausea swollen parotid glands |
|
|
patient preparation for serum creatinine test
|
avoid strenuous exercise for 8 hours before test;
avoid excessive amount of red meat for 24 hours before test |
|
|
Patient preparation for BUN
|
no special prep required
|
|
|
renal scan
|
use of radioisotopes and radiographs to study renal blood flow
|
|
|
Nursing care after renal scan
|
continent pt - no special care;
incontinent pt: gloves when handling urine; pregnant caregivers should avoid these pts for 24 hours after test |
|
|
patient preparation for cystoscopy
|
signed consent required;
done in OR or procedure room; local or general anesthesia; bowel prep as ordered; administer meds for anxiety and to reduce bladder spasm; may have antibiotic for several days before procedure |
|
|
cystoscopy
|
visualization of urethra, bladder and ureteral openings
|
|
|
Nursing care after cystoscopy
|
- safety precautions r/t orthostatic hypotension;
- monitor intake & output; - monitor vital signs; - monitor urine color - wine to pink for 24-48 hrs; - encourage intake of 2-3 liters per day; - sitz bath to relieve pain and urinary frequency; - report severe pain to physician |
|
|
renal ultrasound
|
use of high-frequency sound waves to create images of bladder
|
|
|
patient preparation for abdominal or renal ultrasound
|
- drink 3-4 8oz glasses of water 2 hours before procedure;
- must have full bladder for procedure; procedure is painless except for discomfort from full bladder; |
|
|
residual urine
|
urine remaining in bladder after voiding
|
|
|
normal amount residual urine
|
50 mL
|
|
|
ureteral catheter
|
catheter threaded through ureter into renal pelvis
|
|
|
capacity of renal pelvis
|
3 - 5 mL
|
|
|
care of ureteral catheter
|
-strict aseptic technique
-ensure catheter not kinked or clamped; -irrigate with no more than 5mL sterile solution; -measure output frequently; |
|
|
nephrostomy tube
|
tube inserted via incision thru flank directly into kidney pelvis
|
|
|
nursing care of nephrostomy tube
|
- ensure tube not kinked or clamped
-sterile dressing chnages -urine leaks around tube - provide skin care; -irrigate with no more than 5mL; -strict asceptic technique; |
|
|
nephrectomy
|
removal of kidney
|
|
|
lithotripsy
|
non-invassive procedure to break up renal calculi
|
|
|
cystectomy
|
removal of bladder
|
|
|
cystostomy
|
incision in urinary bladder
|
|
|
care of patient after urologic surgery
|
monitor urine output;
report urine output <30mL/hr; pain management; encourage cough & deep breathing; ausculate lungs frequently; NPO until bowel sounds return; record output from drains; |
|
|
cause kidneys to excrete water and sodium and lower BP
|
diuretic agents
|
|
|
side effects of diuretics
|
dehydration;
electrolyte imbalances; |
|
|
Thiazide diuretics (drug names)
|
hydrochlorothiazide (HCTZ)
hydroDIURIL Zaroxolyn |
|
|
Osmotic Diuretic
|
Mannitol
|
|
|
Loop Diuretic
|
furosemide (Lasix)
|
|
|
Side effects of loop diuretics
|
orthostatic hypotension;
hypokalemia; hyponatremia; |
|
|
side effects of gentamycin
|
ototoxicity;
hepatotoxicity |
|
|
urethritis
|
inflammation of urethra
|
|
|
risk factors for UTIs
|
female gender
vaginal infections bubble baths & vaginal deodorant sprays dehydration tight fitting synthetic undergarments infrequent voiding first trimester of pregnancy trauma during delivery |
|
|
pathogens move from urethra to bladder
|
ascending urinary tract infection
|
|
|
pathogens move from kidney to bladder
|
descending urinary tract infections
|
|
|
most frequent causative organisms of UTIs
|
Escheria coli
Chlamydia Trichomonas Neisseria gonorrhoeae herpes simplex virus type 2 |
|
|
Signs & symptoms of urethritis
|
dysuria
frequency urgency bladder spasm urethral discharge |
|
|
prevention of cystitis
|
female- wipe front to back
male- clean under foreskin discourage bubble baths, vaginal deodorants void before & after intercourse void after swimming wear loose cotton undergarments maintain high fluid intake empty bladder often |
|
|
cystitis
|
inflammation of urinary bladder
|
|
|
causative factors of cystitis
|
bacterial contamination
prolonged immobility renal calculi urinary diversion indwelling catheters |
|
|
Signs & symptoms of cystitis
|
urgency, frequency, dysuria
nocturia bladder spasm incontinence low-grade fever, fatigue tea colored or cloudy urine pelvic or abdominal discomfort |
|
|
phenazopyridine (Pyridium)
|
decreases bladder spasm associated with cystitis
|
|
|
interstitial cystitis
|
chronic inflammatory disease of the bladder
|
|
|
causes bladder to become scarred and stiff
|
interstitial cystitis
|
|
|
symptoms of interstitial cystitis
|
pelvic pain
urinary frequency and urgency hematuria |
|
|
pyelonephritis
|
inflammation of the renal pelvis
|
|
|
signs & symptoms of acute pyelonephritis
|
high fever & chills
nausea & vomiting dysuria severe painor dull constant aching in flank area |
|
|
polycystic kidney disease
|
hereditary condition in which normal kidney tissue is replaced with clusters of cysts which enlarge and lead to renal failure
|
|
|
acute glomerulonephritis
|
immunologic disease characterized by inflammation of capillary loops in the glomeruli
|
|
|
cause of acute glomerlonephritis
|
group A negative hemolytic streptococcus
|
|
|
signs & symptoms of acute glomerulohephritis
|
elevated BUN & creatinine
proteinuria tea colored urine periorbital edema peripheral edema hypertension hypervolemia |
|
|
treatment of acute glomerulonephritis
|
- diuretics, antihypertensives & antibiotics;
- bedrest during acute phase; - activity restriction until BP normal and no protein or blood in urine; |
|
|
urolithiasis
|
formation of calculi in the urinary tract
|
|
|
factors that facilitate calculi development
|
- concentrated urine;
- excess intake vitamins C & D, animal protein, oxalates, sodium, calcium-based antacids - low dietary calcium intake; - family history; - gout, diabetes, obesity; - immobility, urinary stasis; - sedentary lifestyle; |
|
|
signs & symptoms of renal calculi
|
pain
nausea & vomiting hematuria dysuria |
|
|
medical treatment of renal calculi
|
ambulation
opioid analgesics antiemetics parenteral NSAIDs antispasmodics IV fluids antibiotics |
|
|
procedures to destroy or remove renal calculi
|
placement of ureteral stent;
lithotripsy; cystoscopic stone removal; percutaneous nephrolithotomy |
|
|
renal calculi prevention
|
keep urine dilute
fluid intake 2L/day or more dietary restrictions regular exercise medication to alter urine pH |
|
|
Incision of organ or duct to remove calculi
|
lithotomy
|
|
|
process by which blood is removed from the body and circulated through an artificial kidney
|
hemodialysis
|
|
|
causes reabsorption of water in the renal tubules, decreasing urine volume
|
antidiuretic hormone
|
|
|
released in response to inadequate renal blood flow or low arterial pressure
|
renin
|
|
|
hormone secreted in the kidneys that stimulates bone marrow to produce red blood cells
|
erythropoietin
|
|
|
hormone released from the pituitary gland when stimulated by hypertonic plasma
|
antidiuretic hormone
|
|
|
a general indicator of the kidneys' ability to excrete waste product of protein metabolism
|
BUN
|
|
|
serum lab value raised by high-protein diets, GI bleeding, dehydration, and some drugs
|
BUN
|
|
|
measures rate of urine flow during voiding
|
urodynamic study
|
|
|
condition in which calculi are formed in the kidneys
|
nephrolithiasis
|
|
|
inflammation of the renal pelvis
|
pyelonephritis
|
|
|
hereditary disorder in which grape-like cysts replace normal kidney tissue
|
polycystic kidney disease
|
|
|
removal of calculus from the renal pelvis
|
pyelolithotomy
|
|
|
formation of calculi in the urinary tract
|
urolithiasis
|
|
|
formation of calculi in the kidneys
|
nephrolithiasis
|
|
|
examination of voided or catheter urine specimen for pH, blood, glucose and protein
|
urinalysis
|
|
|
clean-catch or midstreamurine specimen is collected to determine which antibiotics will be effective against the organism found in the specimen
|
urine sensitivity
|
|
|
collection of urine for 12 or 24 hours which is an estimate of the glomerular filtration rate
|
creatanine clearance
|
|
|
a blood test that is indicative oftghe kidney's ability to excrete wastes
|
serum creatanine
|
|
|
a blood test that may show elevated sodium and potassium levels and decreased calcium levels which indicatae renal failure
|
serum electrolytes
|
|
|
most common sign of bladder cancer
|
painless, intermittent hematuria
|
|
|
causative factors for bladder cancer
|
smoking
dyes from industrial compounds tryptophan |
|
|
systolic BP necessary to sustain glomerular filtration
|
70 mm Hg
|
|
|
onset, oliguric, diuretic, recovery
|
4 stages of Acute Renal Failure
|
|
|
potential complications of subclavian dialysis catheter
|
thrombosis
pneumothorax / hemothorax brachial nerve damage increased risk of infection |
|
|
Treatment for hyperkalemia in ARF
|
IV hypertonic glucose & insulin
IV sodium bicarb and calcium gluconate Kayexelate - po or rectally |
|
|
treatment of postrenal ARF
|
rfemoval of cause (typically an obstruction)
|
|
|
causes of prerenal Acute Renal Failure
|
decreased blood flow to glomeruli (systolic BP < 70 mm Hg)
|
|
|
causes of intrarenal failure
|
kidney infections
hypertension antibiotics - especially "mycins" heavy metals (lead & mercury) trauma sickle cell anemia |
|
|
postrenal causes of renal failure
|
obstructions beyond kidneys that cause urine to back up
calculi BPH |
|
|
urine output < 400 mL/day
elevated BUN, creatanine, potassium decreased serum calcium urine specific gravity fixed at 1.010 hypervolemia |
oliguric stage of ARF
|
|
|
urine output > 400 mL/day (may exceed 4L/day)
elevated BUN, creatinine, potassium, sodium |
diuretic stage of ARF
|
|
|
increasing BUN and creatanine
normal to slightly decreased urine output lasts 1-3 days |
onset stage of ARF
|
|
|
electrolytes, BUN and creatanine return to normal
lasts 1-12 months |
recovery stage of ARF
|
|
|
indications for hemodialysis
|
hyperkalemia
severe metabolic acidosis pulmonary edema rising BUN |
|
|
____ mL of fluid = 1 pound
|
500
|
|
|
effective means of assessing fluid status changes in patients with ARF
|
daily weights
|
|
|
uremia
|
end-stage renal disease; kidneys unable to maintain fluid, electrolyte and acid-base balance
|
|
|
azotemia
|
increased nitrogenous waste products inthe blood
|
|
|
progressive destruction of nephrons of bothe kidneys
|
Chronic kidney disease
|
|
|
Indication of need for dialysis or kidney transplantation
|
creatanine clearance below 15mL/min
|
|
|
most common causes of chronic Kidney Disease
|
Hypertension
Diabetes mellitus Atherosclerosis Chronic renal infections |
|
|
Normal BUN
|
10-20 mg/dL
|
|
|
Normal serum creatanine
|
0.5 - 1.5 mg/dL
|
|
|
amount of kidney function which can be lost without renal failure
|
80%
|
|
|
signs & symptoms of chronic kidney disease
|
- azotemia, metabolic acidosis
- hyperkalemia, hypocalcemia, hypernatremia - hypervolemia (hypertenison & edema), CHF - Insulin resistance - hyperglycemia - hyperlipidemia - anemia - immunosuppression - lethargy, irritability, confusion - peripheral neuropathy, foot drop - uremic frost |
