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Adult I > Adult I Exam 3 - Renal & Urinary > Flashcards

Adult I Exam 3 - Renal & Urinary Flashcards

1
Q

Polyuria

A

Excessive urination >2000mL/24hr

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2
Q

Oliguria

A

Decreased Urination 100-400mL/24hr

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3
Q

Anuria

A

Absence of urination <100mL/24hr

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4
Q

Nocturia

A

Night-time urination >2x/night

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5
Q

Hematuria

A

Blood in the urine

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6
Q

Pyuria

A

Pus in the urine

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7
Q

Dysuria

A

Pain with urination

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8
Q

Diagnostic Testing

A

BUN
Creatinine (serum)
BUN:Creatinine Ratio

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9
Q

BUN

A

The result of broken down protein

10-20 mg/dL

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10
Q

Creatinine (serum)

A

Indicates muscle & protein breakdown
Only renal disease causes increased Cr
Male: 0.6-1.2 mg/dL
Female: 0.5-1.1 mg/dL

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11
Q

BUN:Creatinine Ratio

A

To determine blood flow to kidneys
12:1 to 20:1
Increase together= decreased renal function
BUN increases, Cr doesn’t = blood flow or fluid volume deficit
BUN decreases, Cr doesn’t= fluid vol excess

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12
Q

Renal Changes with Aging

A

Overall = Reduced GFR

Nocturnal polyuria & risk for dehydration

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13
Q

Acute Renal Failure (ARF) Phases

A 
Decrease in renal function = increase in metabolic waste in the body
Onset Phase
Oliguric Phase
Diuretic Phase
Recovery Phase
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14
Q

Onset Phase

A

subtile, hours to days

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15
Q

Oliguric Phase

A

<400mL/24hr

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16
Q

Diuretic Phase

A

> 1000ml/24hr

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17
Q

Recovery Phase

A

Renal function WDL, decrease energy levels, 3-12 months

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18
Q

Types of ARF

A

Prerenal
Intrarenal
Postrenal

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19
Q

Prerenal

A

Happens before the kidney

Ex:

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20
Q

Intrarenal

A

Within the kidney

Ex: Nephrotoxic Meds,pyelonephritis

21
Q

Postrenal

A

After the kidney

Ex: Kidney Stones (depends on location of stone), cystitis, urethritis

22
Q

AFR Clinical Manifestations (Labwork)

A

Cr: 0.6-12 = 25% Nephron Loss
Cr: 2x baseline = 50% Nephron Loss
(Stage 1 kidney failure S/S=Increased BP)
Cr: 8x baseline = 75% Nephron Loss
(Stage 2 kidney failure S/S=edema, renal inssuffiency)
Cr: 10x or > baseline = 90% Nephron Loss
(Stage 3 ESRF, intervention is dialysis)

23
Q

Cystitis

A

Bladder inflammation due to UTI

Mostly from Gram - bacteria (from intestinal tract)

24
Q

Urethritis

A

Urethra infection

gram - bacteria (gonorrhea, chylamydia) or trichomonas vaginalis

25
Pyelonephephritis
Kidney and renal pelvis infection/inflammation due to bladder infection
26
Most common cause of UTI in the hospital setting
catheters
27
Most common bacteria of UTIs
Ecoli
28
S/S of Cystitis & Urethritis
``` Dysuria Urgency Frequency Burning UA= cloudy, pus, hematuria, odor increase WBC & leukoesterase *Elderly may present with confusion ```
28
UTI Prevention
``` Drink 2-3L fluids Empty bladder with urge to void and regularly even if no need to void Nutrition & sleep Proper perineal hygieney Cranberry juice apple cider vinegar vitamin C 500mg daily ```
29
Recurrent UTI Prevention
Take antibiotics as prescribed | Follow-up UA in 10-14 days
30
S/S of Pyelonephritis
``` Fever, chills, tachycardia, tachypnea Flank, back or loin pain Abdominal discomfort Nausea, vomiting, urgency, frequency, nocturia General malaise or fatigue CVA tenderness ```
31
UTI Drug Interventions
``` Antibiotics Urinary aseptics (nitrofurantoin) Analgesics (pyridium) Antispasmodics (Hyoscyamine) Long-term antibiotic therapy for chronic recurring infections. ```
32
UTI Interventions
``` Urinary elimination-maintain pattern Increase fluids to 3L daily Balanced diet Cranberry juice (3-4wks) Avoid: caffeine, carbonated drinks, tomato products Warm sitz baths (20min) ```
33
Pyelolithotomy
The surgical removal of a stone from the renal pelvis
34
Nephrectomy
Kidney removal Partial or Radial (includes surrounding lymph nodes) *Need informed consent*
35
Ureteroplasty
plastic surgery of the ureter
36
Obstructive Disorders
``` Renal Calculi (Kidney stones) Ureteral strictures Torsion (kink in the ureter) BPH Cysts Spasms Trauma (causes obstruction) ```
37
Hydronephrosis
Stretching of the renal pelvis as a result of obstruction to urinary outflow
38
Hydroureter
Distension of the ureter with fluid due to obstruction.
39
S/S Urethral Strictures
``` Obstruction of urine flow -Most common hesitency dysuria bladder distension infection ```
40
Urethral Strictures
Narrowed areas of the urethra | Tx:Surgical tx by urethroplasty (best for longterm), dilation of the urethra (temporary fix)
41
Urethroplasty
Reparative surgery of the urethra to remove strictures
42
Urolithiasis
The formation of kidney stones
43
Urolithiasis Interventions
Pain-relief measures (meds, alternate, lipthotripsy) Surgery **Always strain urine for stones prior to surgery**
44
Lithotripsy
Breaks stones apart with sound/laser/dry shock therapy Conscious sedation used Topical anesthetic cream to site Continuous EKG monitoring Nursing care: strain urine, force fluids (3-4L/day), meds, ambulate PRN, I/O, assess for blood in urine
45
Causes of Nephrectomy
Pyelonephritis Renal cancer Transplant donor
46
Nephrectomy Interventions (Post-op nursing care)
``` Encourage fluids Output q1-2hrs >/= 30mL/hr *Daily weight I/O- assess urine characteristics maintain patency of all tubes label all urinary drainage tubes separately never clamp/irrigate w/o Dr orders Monitor UA (specific gravity), BUN/Cr and possibly collect 24hr urine for Cr clearance. ```
47
Nephrectomy Health Promotion
``` *Take care of remaining kidney Regular exams urinalysis renal function testing: BUN, Cr, GFR Avoid contact sports or extreme activities (wear padding) ```

Adult I (5 decks)

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