ATI Renal Flashcards
Urge Urinary Incontenence
Set an interval for toileting based on previous voiding schedules. Bladder training will teach the pt to hold urine deliberately until the scheduled time.
Functional urinary incontinence
Self catheterization
Peritonitis
Cloudy dialysate effluent, sign of infection, notify dr immediately.
AE of prednisone
Sore throat: can indicate infection. glucocorticoids supress the immune system.
Acute pyelonephritis
administer antibiotics for this acute bacterial infection.
drink 2-3 L/d.
Chronic renal failure.
BUN: 196
Sodium: 152
Potassium: 7.3
Infuse regular insulin in dextrose 10% in water. Moves potassium out of extracellular fluid into intracellular fluid.
Diuretics like lasix wont work to excrete potassium on someone with CRF because their kidneys dont work.
Dont give spironolactone- K sparing. Dont give NS, has sodium.
Chronic Renal failure diet
Low phosphorus (kidneys cant excrete)
Low Protein (phosphorous content in protein becomes higher in CRF and can cause osteodystrophy)
Take calcium supplement and vit D.
Consume food low in sodium due to retention of sodium and fluid in CRF.
Acute Glomerulonephritis
Weigh pt on daily basis to monitor fluid retention.
Drink fluid based on previous 24 hours plus 5-600.
Conserve energy and rest.
Decrease food with phospherous because phospherous levels are increased with glomerulonephritis.
cyclosporine (Sandimunne) for kidney transplant
Need to take it forever. Common SE: Hirsutism.
Renal damage may be intensified by NSAIDS.
Cyclosporine increases the risk of infection.
DCing cyclosporine increases risk of organ rejection.
Urine culture and sensitivity
initiate the flow of urine before collecting the sample.
Collect in a sterile container.
Doesnt need to be first morning void.
Dont need to add preservative to specimen.
Hemodialysis
at risk for seizures because rapid decrease in fluid. results in cerebral edema and increased intracranial pressure.
Chronic Pyelonephritis
Hx of diabetes puts pt at risk.
Chronic Kidney Failure
Weigh each morning. Weight gain= fluid retention caused by poorly functioning kidneys. Weight loss= anorexia from uremic syndrome.
Need more than 1200 calorie diet to prevent protein catabolism.
Dont take milk of magnesia- too much salt.
Dont use salt substitute, contains potassium.
Acute Renal Failure
Bun high (80-100).
Urine output low (<30/hr).
Potassium elevated.
Calcium decreased.
Hematocrit decreased (30%).
UTI
Pyuria- WBC present in urine, infection.
Urinary urgency.
Dysuria.
Hemodialysis
contraindicated for a client who cant recieve anticoagulants. needed to prevent clotting.
Acute glomerulonephritis
Urine is dark reddish brown colored.
Sodium and fluid retention- increased BP.
Decreased urine output.
Weight gain.
Following lithotripsy for urolithiasis for calcium phosphate renal calculi.
strain all urine for possible stone fragments.
Drink at least 3L/d to promote urine flow, decreased risk of stone precipitation, and prevent dehydration.
(dont eat too much animal protein- leads to acidic urine and calcium buildup)
Following renal transplant.
Sign of delay in functioning of transplant kidney- urine output 50mL/2 hrs. need 30mL/hr.
Expected findings: incisional tenderness, pink and bloody urine.
Postop TURP with continuous bladder irrigation. Upon detecting output obstruction:
turn off irrigation system. greatest risk is injury to the bladder, turn off the irrigation to prevent more fluid from entering the bladder.
(other actions that arent priority- irrigate catheter with normal saline uring large syringe, tell dr, provide prn pain medication)
Continent internal illeal reservoir.
Insert catheter through your stoma to drain the urine on a scheduled basis)
(this also results in impotence in men)
After hemodialysis:
assess vitals, greatest risk is hypotension.
AV Shunt recently placed
Dont take BP on the shunted arm.
Auscultate bruit q 4 hrs
Elevate shunted arm postoperatively
palpate and assess distal pulses
Before intravenous urography
check for allergies to shellfish or iodine.
(other interventions but not priority- NPO after midnight, obtain vital sighsn, administer bowel prep)
Infection of diabetic client
WBC 15000, costovertebral angle tenderness, nausea, vomiting.
Before lithotripsy for urolithasis
Apply cardiac monitor. Heart rhythm is monitored during lithotripsy by ECG. Shock waves are delivered in synchrony with the R wave on the ECG monitor.
Supine position on flat xray table with lithopeter aimed at the stone.
Dont need catheter or intubation. Onlt mocerate conscious sedation.
Nephrotic syndrome symptom
5g protein in urine/24 hours.
Hypertension due to fluid retention.
Hypoalbuminemia.
Nephrotoxic med
gentamicin (Garamycin)- aminoglycoside antibiotics injure cells of the prosimal renal tubules. usually causes acute tubular necrosis.
