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NURS 366 > Adult Genitourinary > Flashcards

Adult Genitourinary Flashcards

1
Q

What can proteins and ketones mean if they are found in urine?

A

diabetic ketoacidosis

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2
Q

Normal hourly output of urine in an adult

A

60 mL/hr

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3
Q

When is action needed for urine output (what amount)?

A

Less than 30mL/hr

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4
Q

When does the urge to void normally happen?

A

at 150-300 mL full in the bladder

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5
Q

If there is a high WBC/RBC concentration in the urine, what may this be a sign of?

A

infection

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6
Q

Normal adult output of urine in 24 hours

A

1500-1600mL

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7
Q

What in the normal SPG for a urinalysis?

A

1.0020-1.0030

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8
Q

What is the normal pH of urine?

A

5-7

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9
Q

Which values should show up as negative on a urinalysis?

A

protein, glucose, ketones, bili, blood, nitrate

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10
Q

Normal WBC/RBC levels in a urinalysis

A

0-2

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11
Q

What are causes of pre-renal failure?

A

decreased perfusion
Caused by:
Altered peripheral resistance
Cardiac pump failure
Hypovolemia
Impaired renovascular blood flow

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12
Q

What are causes of altered peripheral vascular resistance that lead to pre-renal failure?

A

sepsis, anaphylactic rxn

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13
Q

What are causes of a cardiac pump failure that leads to pre-renal failure?

A

MI, HF, and/or cardiogenic shock

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14
Q

What are causes hypovolemia that lead to pre-renal failure?

A

dehydration, blood loss, burns

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15
Q

What happens during intra-renal failure?

A

direct kidney damage such as:
Nephrotoxic agents, transfusion reaction, glomerulonephritis and acute tubular necrosis, renal neoplasms, chronic disease, infection

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16
Q

What are nephrotoxic agents that can lead to intra-renal failure?

A

antibiotics, chemotherapies, and contrast media

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17
Q

What kind of transfusion reaction causes intra-renal failure?

A

hemolytic

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18
Q

Which chronic diseases can lead to intra-renal failure?

A

DM, HTN, SLE, Lupus

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19
Q

What is post-renal failure?

A

outflow obstruction

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20
Q

What causes post-renal failure?

A

outflow obstructions, such as:
obstructions within the urethra, bladder, or ureters
prostatic hypertrophy
neurogenic bladder
pelvic tumors

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21
Q

What are examples of obstructions in the urethra, bladder, or ureters that causes post-renal failure?

A

caliculi, clots, tumors, strictures

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22
Q

What can cause prostatic hypertrophy that leads to post-renal failure?

A

BPH

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23
Q

What should the normal adult GFR be?

A

above 60

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24
Q

What is normal BUN for urinary labs?

A

6-24 mg/dL

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25
What are normal creatinine levels for urinary labs?
.7-1.3 mg/dL
26
If a GFR is less than 15, what does this mean?
Kidney Failure
27
What happens to the urinary system as we age?
decreased GFR, increased renal labs, decreased tissue and function of the urinary tract, decreased ability to concentrate
28
Common urinary issues experienced by older adults
nocturia, urinary frequency, urinary retention
29
Where do sensory impulses come from in regards to urination?
micturition center in sacral spinal cord
30
What parasympathetic impulse happens with micturition?
stimulates detrusor muscle to contact rhythmically
31
What are the steps that happen that lead to the conscious need to void?
bladder contracts --> impulses to spinal cord--> pons--> cortex-->conscious need to void
32
What is micturition?
the action of urinating
33
What element is not able to be filtered by the kidneys in chronic renal failure?
PO4 (soda and eggs)
34
How long does the GFR have to be less than 60mL/hr to have chronic renal failure?
longer than 3 months
35
What causes chronic renal failure?
recurrent infections, Urinary tract obstructions, diabetes (32%), Long-term HTN (28%), glomerulonephritis (1%)
36
What are the stages of chronic renal failure?
renal impairment--> renal insufficiency--> renal failure
37
How much nephron loss is there before renal failure is diagnosed?
>85%
38
What percentage of functional nephron loss is associated with renal insufficiency?
75-80%
39
What is the functional nephron loss for renal impairment?
40-75% and there is a decreased renal reserve
40
What kind of taste will patients report if they have chronic renal failure?
Metallic taste
41
What happens to the CV system of a patient with CRF?
increased BP, pitting edema, periorbital edema, increased CVP, pericarditis
42
If a patient is having CRF, how will they be presenting when you do their pulmonary assessment?
SOB, depressed cough, thick sputum
43
What is an ammonia odor to the breath, mouth/gum ulcerations, and anorexia with n/v associated with?
CRF
44
Which elemental serum level will rise in patients that are in end stage renal failure?
potassium
45
What will be seen on an integumentary assessment of a patient with CRF?
dry, flaky, itchy skin that has ecchymosis and purpura and it has a yellow-gray tint
46
Why do patients in CRF have leg cramps?
hypocalcemia
47
What causes palpitations in patients with CRF?
hyperkalemia
48
What causes SOB in patients with CRF?
fluid overload
49
What are the dietary restrictions on a patient that has CRF?
protein restriction (~.5g/kg/day) Na+ restriction (low sodium foods) K+ restrictions (tomatoes, etc.) PO4 restrictions (soda, eggs, etc.)
50
What vitamin supplementation needs to be given to someone with CRF?
Iron, Folate, B12, Calcium
51
What is the fluid restriction of someone that has CRF?
1000-1500 mL/day
52
What are the electrolyte imbalances associated with CRF?
hyperkalemia hypocalcemia hyperphosphatemia metabolic acidosis
53
How is hyperkalemia treated for CRF?
kayexalate
54
How is hypocalcemia treated for patients with CRF?
calcium supplements
55
How is hyperphosphatemia treated for patients with CRF?
phosphate binding agents
56
How is metabolic acidosis treated for patients with CRF?
bicarbonate solutions
57
How is anemia treated for patients with CRF?
PO erythropoietin or transfusion PRN
58
What happens with uremic syndrome?
increase in nitrogen, creatinine, potassium, phosphorus decrease in calcium and albumin and CNS changes as well as n/v
59
What can emergent hemodialysis lines be used for?
only for dialysis
60
When would an emergent hemodialysis line be placed?
for acute kidney injury
61
What needs to be done as the nurse if someone has an emergent hemodialysis line put in?
Do weights with strict I&Os, hold medications, monitor vital signs Q15 minutes
62
Is peritoneal dialysis a sterile or clean procedure?
sterile

NURS 366 (29 decks)

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