ATI Renal

Question 1

Urge Urinary Incontenence

Answer 1

Set an interval for toileting based on previous voiding schedules. Bladder training will teach the pt to hold urine deliberately until the scheduled time.

Question 2

Functional urinary incontinence

Answer 2

Self catheterization

Question 3

Peritonitis

Answer 3

Cloudy dialysate effluent, sign of infection, notify dr immediately.

Question 4

AE of prednisone

Answer 4

Sore throat: can indicate infection. glucocorticoids supress the immune system.

Question 5

Acute pyelonephritis

Answer 5

administer antibiotics for this acute bacterial infection.

drink 2-3 L/d.

Question 6

Chronic renal failure.

BUN: 196

Sodium: 152

Potassium: 7.3

Answer 6

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.

Question 7

Chronic Renal failure diet

Answer 7

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.

Question 8

Acute Glomerulonephritis

Answer 8

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.

Question 9

cyclosporine (Sandimunne) for kidney transplant

Answer 9

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.

Question 10

Urine culture and sensitivity

Answer 10

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.

Question 11

Hemodialysis

Answer 11

at risk for seizures because rapid decrease in fluid. results in cerebral edema and increased intracranial pressure.

Question 12

Chronic Pyelonephritis

Answer 12

Hx of diabetes puts pt at risk.

Question 13

Chronic Kidney Failure

Answer 13

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.

Question 14

Acute Renal Failure

Answer 14

Bun high (80-100).

Urine output low (<30/hr).

Potassium elevated.

Calcium decreased.

Hematocrit decreased (30%).

Question 15

UTI

Answer 15

Pyuria- WBC present in urine, infection.

Urinary urgency.

Dysuria.

Question 16

Hemodialysis

Answer 16

contraindicated for a client who cant recieve anticoagulants. needed to prevent clotting.

Question 17

Acute glomerulonephritis

Answer 17

Urine is dark reddish brown colored.

Sodium and fluid retention- increased BP.

Decreased urine output.

Weight gain.

Question 18

Following lithotripsy for urolithiasis for calcium phosphate renal calculi.

Answer 18

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)

Question 19

Following renal transplant.

Answer 19

Sign of delay in functioning of transplant kidney- urine output 50mL/2 hrs. need 30mL/hr.

Expected findings: incisional tenderness, pink and bloody urine.

Question 20

Postop TURP with continuous bladder irrigation. Upon detecting output obstruction:

Answer 20

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)

Question 21

Continent internal illeal reservoir.

Answer 21

Insert catheter through your stoma to drain the urine on a scheduled basis)

(this also results in impotence in men)

Question 22

After hemodialysis:

Answer 22

assess vitals, greatest risk is hypotension.

Question 23

AV Shunt recently placed

Answer 23

Dont take BP on the shunted arm.

Auscultate bruit q 4 hrs

Elevate shunted arm postoperatively

palpate and assess distal pulses

Question 24

Before intravenous urography

Answer 24

check for allergies to shellfish or iodine.

(other interventions but not priority- NPO after midnight, obtain vital sighsn, administer bowel prep)

Question 25

Infection of diabetic client

Answer 25

WBC 15000, costovertebral angle tenderness, nausea, vomiting.

Question 26

Before lithotripsy for urolithasis

Answer 26

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.

Question 27

Nephrotic syndrome symptom

Answer 27

5g protein in urine/24 hours.

Hypertension due to fluid retention.

Hypoalbuminemia.

Question 28

Nephrotoxic med

Answer 28

gentamicin (Garamycin)- aminoglycoside antibiotics injure cells of the prosimal renal tubules. usually causes acute tubular necrosis.