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74 Cards in this Set

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What are the 4 parts to a kidney starting with the word renal?
Renal Capsule, Renal Cortex, Renal Medulla, and Renal Pelvis
What is the function of an Erythropoietin hormone and where is it produced?
A hormone that is produced from the kidneys and stimulates bone marrow to produce more Red Blood Cells
What is the function of a Renin hormone and where is it produced?
A hormone that is produced from the kidneys and regulates BP
What is the function of a Aldosterone hormone and where is it produced?
A hormone that is produced from the Adrenals and regulates BP
what is the function of Anti-diuretic Hormone and where is it produced?
A hormone that is produced from the pituitary and regulates BP
what does a urethra do ?
helps transfer urine from the bladder to be eliminated out the body
what does the kidneys do in our body?

extracts waste from the blood, balances body fluids and forms urine


secretes renin and erythropoietin


regulates electrolytes and PH balance, activates vitamin D

what is the function of the urinary bladder?
a reservoir for the urine
How many ureters does the body have and what is the function?

transfers urine from the kidneys to the bladder using peristalsis


2 ureters

What are the signs and symptoms of ESRD patients and what do you monitor for?

Signs and symptoms of oliguria, anuria, azotemia, edema, HTN, anemia, muscle weakness, N&V, I&O, weight daily, Vital Signs, electrolyte imbalance, HGB, RBC level


Diet: high folate (beans/green veggies)

what is ESRD?
End Stage Renal Disease - inability of the kidneys to excrete compounds
What findings may be expected in ESRD patients?
anuria, proteinuria, marked azotemia, hyperkalemia, hypernatremia, fluid volume excess, heart failure, pulmonary edema
why is an ESRD patient at risk for anemia?
blood loss and removal of folate during dialysis may contribute to an existing anemia that often occurs with chronic renal failure due to decreased secretion of erythropoietin
what are included in a nephron?
glomerulus, Bowman's capsule, convoluated tubule and collecting duct
Cause of Glomerulonephritis

bilateral inflammation of the glomerular capillaries, commonly following a strep infection


impetigo, SLE, HTN, sclerosis

What are some treatment for Glomerulonephritis?


Antibiotics: PCN


loop Diuretics: Lasix


Vasodilator: Hydralazine


Corticosteroids: Prednisone


Dialysis


What would a skin and throat culture detect for Glomerulonephritis?

Throat culture detects Group A Beta Hemolytic Strep and positive Azo Titer

Findings for acute Glomerulonephritis


insoluble immune complexes develop and become trapped in the glomerular tissue > swelling and capillary cell death




Signs and symptoms of acute Glomerulonephritis

decreased urination, foamy urine from protein, smokey, cola colored urine, SOB, dysnea, orthopnea, crackles, HTN, fatigue, peripheral edema

Complication for POST - TURP patients:
urethral trauma, urinary retention, bleeding, and infection
Monitor the post TURP patient for:

monitor bleeding, urine output, VS, urgency, flank pain, drainage stops flowing

How do you prevent UTI ?


plenty of fluids, clean perineum area, limit as much moisture in groin/vaginal area, don't hold urine for to long, wipe from front to back


cotton panties



what are risk factors for UTIs?

having a catheter for to long, caused by Klebsiella, proteus, Serratia, pseudomonas, e coli, being a female, frequent use of feminine products, pregnancy, sex, hto tubs, DM, increased age
What foods are recommended with nephrotic syndrome?

low sodium and low potassium frequent small meals, not to restrict fluids, just limit it

what is nephrotic syndrome?

glomerular capillaries are damaged from immune complex deposits, nephrotoxic antibodies

Other S/S with nephrotic syndrome

edema, hematuria, urine output scanty, elevated BP, ABD distended, discomfort, liver increased production of lipoproteins
Name foods high in potassium


dry fruits, nuts, meat, squash, bananas, sweet potatoes, beans (white, kidney, lima), tomato sauces, fish, soy beans, lentils, orange juice, beet greens, whole milk, clams, prunes, carrot juice


What is Pyridium?


Class and generic


Generic: Phenazopyridine


urinary analgesic


to relieve the pain, burning and discomfort caused by the infection irritation of the urinary tract


Doesn't treat sx of UTI

What color does urine turn with taking Pyridium?

orange red

Lab values for BUN and Creatinine


BUN: 10-20


Creatinine: female: 0.5 - 1.1


male: 0.6 - 1.2


what structure that kidneys are behind

protected in front by the contents of the ABD and behind the muscles attached to the backbone

Foods high in uric acid

beer, organ meats (liver, heart, gizzard), poultry, red meat, seafood, sweet bread, asparagus, cauliflower, green peas, mushrooms, spinach

Why does Spironolactone cause Gynecomastia?

sx of an underlying imbalance in hormonal physiology, increase in estrogen action relative to androgen action at the breast tissue level




*testosterone decrease estrogen increase

Post Op patient following Intravenous Pyelogram


require bowel prep, uses IV contrast dye: assess allergies to shellfish and iodine


monitor BUN/Creat, SOB, rash, NPO after midnight, pink tinged urine and dysuria

Another name for kidney stones
Nephrolithiasis
Signs and sx of nephrolithiasis


severe pain, spreads to lower abd and groin, pain on urination, pink red or brown urine, N&V, urge to urinate, fever/chills, frequent small urines

patient teaching for urolithiasis

tell patient on pertinent findings elicited during comprehensive nursing assessment, follow up on support dietary, encourage, reduced animal protein intake, encourage increases in daily fluid intake and weight loss, void diary, show pt how to collect specimen and strain urine

medical management goal for pt with kidney stones

diet- primary control mechanism for stone formulation, stones associated with excess in the patient's diet, namely of salt and protein

S/S of Interstitial Cystitis

onset usually associated with either UTI or instrumentation of the bladder, urgency, frequent/bladder pain, void not painful, urine free of bacteria, men=penile - tip pain and perineal pain

What food, drinks, etc to avoid when having interstitial cystitis

smoking, alcohol, spices, chocolate, caffeinated and citrus drinks, tyramine foods, artificial sweetener
risk factors for unlikely candidate for kidney transplant


Age 2<, age >70


untreatable cardiac disease, active CA, severe psychosocial problem (schzo), chronic infection or systemic disease (SLE, HIV, Hep C)


doing drugs/ alcohol


What labs should be monitored in renal patients

Bun/ creat, Potassium, Sodium, Proteinuria

S/S of CRF

lethargy, seizures, coma, tremors, ataxia, HTN, peripheral edema, uremic halitosis, tachypnea, sob, crackles, pallor, fatigue, abnormal bleeding, n&v, diarrhea

Foods/drinks with phosphorous and CRF patients to avoid

beer, chocolate drinks, canned ice tea, cheese, milk, cottage cheese, ice cream, custard, cream soups, yogurt, sardines, chicken liver, crayfish, oysters, baked beans

Amphojel is used for what in CRF patients

to reduce phosphate levels in the patient with kidney conditions

Aging bladder in elderly women

frequent UTI, reduction in bladder capacity, unhibited contractions, decreased flow rate, diminished urethral pressure profile

Proscar for, class and generic


Generic: Finasteride


for men, prevents the conversion of testosterone to dihydrotestosterone in the body


Class type II 5 alpha reductase inhibitor

S/S for disequilibrium

muscle cramps, HA, N&V, dizziness during procedure

complication of having peritoneal dialysis

allows micro-organisms into the peritoneum and cause peritonitis, monitor infection, infection at the access site may be r/t leakage of dialysate, age RF, C&S and gram strain if purulent drainage is present at access site
S/S for peritonitis

inflammation in the peritoneal cavity of the abd, distention of the abd, fluid built up
why does potassium decrease after having hemodialysis

potassium and sodium typically move out of the plasma into the dialysate

nephron's purpose

functional units of the kidney, the cells that form urine

glomeruluse's job


blood enters thru renal arteries and leaves renal veins


capillary network inside a cup shaped structure


inside each kidney blood is channels thru the afferent arterioles into filters


glomerulus is located in the kidney cortex


normal content of urine

*yellow 95% water


5% dissolved solids and gases




urea 2%, uric acid 0.03%, creatinine 0.1%, electrolytes, pigment


main source of renin

the juxtaglomerular cells from storage granules within the metanephric kidney

most common cause of pyelonephritis

Escherichia Coli
s/s of pyelonephritis

chills, fever, tachycardia, tachypnea, colicky-type abd pain, flank pain, costovertebral edema or erythema, N&V, malaise, fatigue, HTN

what is pyelonephritis


infection and inflamed of the renal pelvis, calyces, medulla ( kidney infection)


in lower urinary tract


impairs filtration, reabsorption and secretion


septra


class and use


Anti-infective


generic: sulfamethoxazole


decrease the ability of some bacteria to utilize folic acid growing and disrupts the production of tetrahydrofolic acid


Steps in making urine

glomerular filtration, tubular reabsorption. tubular secretion, reabsorption
Describe the goal for hemodialysis and peritoneal dialysis

Rids the body of excess fluid, urea, and electrolytes. Acheives acid base balance (pts that in acidosis with decreased PH). Eliminates waste products. Restores internal homeostatsis by osmosis, diffusion and ultrafiltration. Can sustain life for pts with ARF/CRF. Doesn't replace hormonal functions of the kidney
Describe post op priority care in renal angiogram patients

apply firm pressure with a sandbag or tight pressure bandage to the site. Lie lateral on site to apply more pressure, leg straight. Do not lift head in post op recovery. Catheter inserted.
Define oliguria

diminished urine production
What does an anuria mean?

failure of kidneys to produce urine

What class is Ditropan and what is it used for?


Class: Anticholinergic


Generic: Oxybutynin


suppresses involuntary contractions of the bladder's smooth muscle spasms by blocking the release of acetylcholine

Describe Side effects for Ditropan




Dry mouth, constipation, blurred vision, urinary retention, confusion, increased heart rate, palpations
What is the class for Demerol and what is it used for?


Class: Opioid Analgesic


Generic: Meperidine


to relieve moderate to severe pain

What side effects may to obtain when given Demerol?

blurred vision, chest pain, discomfort, confusion, convulsion, cough
What are other name for a bladder infection?

Urinary Tract Infection
Signs and Symptoms of a bladder infection

dysuria, pyuria, urgency & frequency, cramps or spasms of the bladder, hematuria, suprapubic discomfort, nocturia, uretral discharge

Amino acids produce what waste products

Amine group, hydrogen ion, ammonia
Post Op care for a cystoscopy patient and what s/s may happen?

pink tinged urine and dysuria is normal, push fluids to flush out bladder, monitor for retention after the procedure, monitor for back pain, cystoscope is inserted through the urethra into the bladder. Pt returned to post-anesthesia care unit
Prior and Post Renal Arteriogram


Prior - Stop taking anti-coagulants


drink plenty of fluids the day before the procedure


NPO after midnight


Post - keep site straight


drink fluids


VS regulation


narcotic for pain


avoid hot baths/showers

What is the scope of an UAP?


VS


bathing


oral hygiene/hair hygiene


diaper change


repositioning


*anything else I may have missed lol