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NU155 Med Surg > Chapter 33/34 > Flashcards

Chapter 33/34 Flashcards

Exam 1 content: urinary system

1
Q

what factors influence urinary elimination?

A

developmental factors
psychosocial factors
fluid and food intake
medications
muscle tone
pathologic conditions
surgical procedures

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2
Q

some causes of urologic disorders?

A

minimum fluid intake of 2-3L per day
minimum output 30mL/hr
bladder health
controlling blood pressure
nephrotoxicity and medications

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3
Q

examples of potential nephrotoxicity substances

A
  • contrast media dye
    heavy metals like lithium
    pesticides. snake venom
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4
Q

age-related changes in urinary system

A

-kidney function decreases
-The prostate gland can block the flow of urine in men
-hormones secreted by kidneys decrease
-bladder tone decreases
-bladder capacity decreases
-nocturia becomes more common
-decrease in estrogen levels causes the tone to decrease in women so they become more common to infection and incontinence

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5
Q

important assessment aspects of urinary system?

A

normal urine output should equal fluid intake
- approximately 60mL/hr
- minimum 30mL/hr or 0.5 mL/Kg per hour

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6
Q

important aspects of px health hx

A
  • changes in urine quality or quantity, pain
  • px normal urine patterns
  • pain or discomfort
  • problem initiating or controlling urination
  • review all modifiable and non-modifiable risk factors!!!!
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7
Q

diagnostic tests and procedures?

A
  • urinalysis and culture and sensitivity
  • cbc
  • blood urea nitrogen
  • BUN: creatinine ratio
  • KUB
    -angioplasty
  • serum creatinine, creatinine clearance
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8
Q

what do you look at when examining urine?

A
  • volume
  • color, clarity
  • odor
  • sterility
  • pH
  • specific gravity
  • glucose, ketone, proteins
  • measure residual urine
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9
Q

what is urge incontinence?

A

involuntary loss of urine when there is strong urge to urinate

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10
Q

what is stress incontinence?

A

when urethral sphincter fails caused by coughing sneezing laughing and exercise

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11
Q

what is mixed incontinence?

A

combination of different types of incontinence

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12
Q

what is overflow incontinence?

A

poor contractility of muscle or obstruction of the urethra

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13
Q

what is functional incontinence?

A

-cognitive inability to recognize the need to urinate
-self-care deficit extreme depression
-also can be the inability to reach the bathroom because of restraints or out-of-reach walker

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14
Q

what is neurologic incontinence?

A

caused by disorders of the neurologic system like sclerosis or spinal cord injury

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15
Q

symptoms of cystitis?

A
  • urgency, frequency, dysuria
    -hematuria, nocturia
  • bladder spasms, incontinence
    -low-grade fever
  • dark urine
    fatigue
  • pelvic discomfort
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16
Q

what can cystitis be caused by ?

A
  • renal calculi
  • urinary diversion
  • indwelling catheters
  • prolonged immobility
    -inflammation due to infection ( usually bacterial)
17
Q

what us cystitis diagnosed by and treated by?

A

urinalysis and antibiotics

18
Q

what is urethritis caused by?

A
  • infection
  • trauma
  • hypersensitivity to products like bubble baths and sperm jellies
19
Q

symptoms of urethritis?

A

-dysuria, frequency, urgency, and bladder spasms
- urethral discharge

20
Q

how do you diagnosis and treat urethritis?

A

antibiotics and urinalysis test

21
Q

health teachings regarding urinary infections

A
  • cotton underwear
  • clean front-to-back
  • urinate before and after sex
    -void every 4 hours
    -advise to take medications
    -drink plenty of water
22
Q

what can cause acute pyelonephritis?

A
  • bacterial infection
  • infection in kidneys
  • mostly in women 20’s-30’s
  • can be acute or chronic
    -can be due to uti that spread
23
Q

symptoms of acute pyelonephritis

A
  • fever, chills
  • increased wbc
  • fatigue, nausea, vomiting
  • flank pain, nocturia, dysuria, bacteriura, pyuria
  • edema, fluid overload
24
Q

symptoms of pyelonephritis

A
  • chills
  • nausea, vomiting
  • headache
  • flank pain
  • high fever
25
Q

diagnostic tests of pyelonephritis?

A
  • KUB OR CT
  • urinalysis, BUN, creatinine, GFR,
  • blood cultures, WBC count
  • kidney biopsy
26
Q

treatment for pyelonephritis

A

-antibiotics
- hygiene
- encourage fluid intake
- meds
watch sodium intake
- hospitalize if they are septic

27
Q

symptoms of acute glomerulonephritis ?

A
  • fever, chills
  • nausea, vomiting
  • fatigue
  • flank pain
  • nocturia, pyuria, bacteriuria
  • hypertension ( late indicator)
28
Q

what is acute glomerulonephritis?

A

occurs after strep-throat or in response to bacterial, viral, or parasitic infection

29
Q

what is acute pyelonephritis?

A

infection of the kidney from bacteria traveling from the bladder up to ureters to the kidney

30
Q

what to assess for in acute glomerulonephritis?

A

recent infections, surgeries
signs of edema
compare blood pressure baseline
inspect skin for lesions, incisions
-kidney biopsy
- urinalysis, BUN and creatinine, GFR

31
Q

interventions of acute glomerulonephritis?

A

daily weight is taken and vital signs
input and output
diet therapy
drug therapy
cardiac management
urinary assessment
possible dialysis

32
Q

what causes renal calculi? what is it?

A
  • stones in the urinary tract
  • cause: dehydration, urinary stasis, result in obstruction in the urinary tract, immobility
  • ## infection, or genetic
33
Q

symptoms of renal calculi? diagnostic tests? treatment?

A

symptoms: bladder distention, hematuria, flank pain
dx: urinalysis, urine specific gravity, 24-hour urine, CT, KUB, IVP
tx: pain management, ketorolac (Toradol), strain urine, a thiazide diuretic, ambulation. i/o, increase fluid intake
- lithotripsy, stent

34
Q

what is acute renal failure ?

A

abrupt loss of kidney function
- GRF decreases
- can happen in hours to days
- creatinine and bun will increase
- fluid and electrolyte imbalances
- acid-base imbalances occur

35
Q

what are the three types of acute renal failure? description/example?

A

prerenal: issue prior to the kidney like hemorrhage
intrarenal: issue inside the kidney
post-renal: issue after kidney like renal calculi

36
Q

acute renal failure diagnostic tests?

A

i/o’s azotemia
- abg elevated creatinine, increased k
- ultrasound of kidneys
ct of abdomen and pelvis without contrast dye
KUB
cytoscopy
kidney biopsy

37
Q

4 phases of acute kidney injury? describe what happens in each

A
  1. onset phase: starts with the prior event, and continues until oliguric development
  2. oliguric phase: lasts 1-3 weeks, longer the phase lasts poorer the prognosis, dialysis may be required during this phase
  3. diuretic phase: urine output may be 1,000-2,000 ml/day
  4. recovery phase: 3-12 months
38
Q

how to manage acute kidney failure? (medical management)

A
  1. prevent renal failure with adequate hydration
  2. maintain fluid and electrolyte balance (monitor serum and urine electrolytes)
  3. replace renal function with dialysis
  4. prevent infection: a significant cause of death in px with ARF, avoid indwelling catheters \
  5. avoid protein foods, contrast media, and nephrotoxic medications, decrease fluid volume overload, monitor skin integrity, monitor for s/s of infection
39
Q
A

NU155 Med Surg (5 decks)

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