Diagnostic Procedure Flashcards
-Direct visualization of the urethra and bladder
-A very thin needle will be inserted at the urethra
Cystoscopy
Why do you need to secure consent for cystoscopy
Because it is an invasive procedure
Why do you need to provide laxatives for patient who undergoes cystoscopy
For clearer visualization
Why do you need to do sendation for the patient who undergoes cystoscopy
-To relax the client
-to reduce anxiety
What is the drug of choice for sendation
Diazepam
Valium
What do you need to do if the patient use local anesthesia (cystoscopy)
Increase fluid intake
What do you need to do if the patient us general anesthesia
NPO 6-8 hours before the procedure
Health teaching for the patient (cystoscopy)
Inform that the desire to void is normal
How long is the cystoscopy procedure
15minutes to 1 hours
Why do you need to advice the patient to have a bed rest few minutes after the cystoscopy procedure (standing without assistance)
To prevent orthostatic hypotension and supine hypotensive syndrome
Why is it expected that a burning urination can be felt for 24- 48 hours or 1-2 days after the cystoscopy procedure?
due to irritation pf the urinary tract
Why do you need to monitor vital signs after cystoscopy
To monitor signs of bleeding (hypotension, tachycardia and tachypnea)
Why do you need to observe for retention or low Urine output?
Because low urine output indicates a sign of bleeding
What do you need to do when you’ve discovered that the patient has abdominal pain, chills and fever
Report immediately to the doctor because it is a sign of infection
Is pink-tinged urine normal, 24 hours after the procedure?
Yes
What are the sign of tissue irritation
(A,P,F)
-abdominal tenderness
-pain
-fever and chills
What are the signs of infection
Fever and chills
Why do you need to provide hot sitz bath after cystoscopy procedure
To relieve perineal discomfort
Why do you need to provide warm moist soaks
To prevent leg cramps
What is intravenous pyelogram
uses x-rays to take pictures of the organs of your urinary tract.
Why do you need to asses the patient allergy before intravenous pyelogram
To prevent allergic reaction/ hypersensitive sensitivity reaction
What will you asked the patient regarding his/her allergy
Ask if they are allergic to seafoods
Iodine rich foods
-Seaweed (such as kelp, nori, kombu, and wakame)
-seafoods (seashells,crabs,shrimp)
-Strawberries, Cranberries and Pineapple
-Beans: Green beans and navy beans
Contrast medium is made of_______
Iodine
Should we put the patient into NPO before intravenous pyelogram
Yes
For how many hours does a patient be put in NPO for intravenous pyelogram
6-8 hours
What are the bowel preparations for intravenous puelogram
Laxative and enema
Rationale why we should do bowel preparations
To evacuate feces
To have clear visualization
What is present in the bedside of the patient during intravenous pyelogram
Epinephrine
What would they do after injecting the contrast medium
Do an xray
What are the signs of allergic reaction (I,R,D,D)
Itching
Rashes
Difficult of breathing (bronchospasm)
Dyspnea
Difficulty of breathing way result to?
Bronchospasm
Bronchospasm may result to
Anaphylactic shock
Care after intravenous pyelogram
Monitor vital signs
Npo 6-8 hours
Increase fluid intake
Observe for delayed allergic reaction
The patient should be NPO after intravenous pyelogram or after the return of_____?
Peristalsis movement (passage of flatus)
Why do you need to increase fluid intake after intravenous pyelogram
Because contrast medium are nephrotoxic which can damage the kidney.
Contrast medium are
Nephrotoxic
How many L/mL or fluid should you give to the patient after intravenous pyelogram?
3L/3000mL
Health teaching after intravenous pyelogram
Burning sensation on voiding may be experience
Burning sensation on voiding may be experience because
Contrast medium are nephrotoxic
Sign and symptoms of Delayed allergic reaction (S,P,R,D)
Shortness of breath
Puritus
Rashes
Dyspnea
It is a painless diagnostic procedure
KUB
KUB stands for
Kidney, Ureter, Bladder,
Special note for KUN
Usually no special preparations done
Do we need to put the patient in NPO before KUB
Yes
Before KUB patient should be in NPO for how many hours?
6-8
Do we need to give laxative and enema for patient before undergoing KUB
Yes
What enema should be use in KUB
Cleansing enema
Why should we give laxative and cleansing enema for patient who are to undergo KUB
For clearer visualization
Position of patient in KUB
Supine position
a small sample of kidney tissue is removed with a needle.
Renal biopsy
Do we need a written consent before undergoing renal biopsy
Yes
When will we maintain NPO for patient who is to under go renal biopsy
At midnight few hours before the procedure
What would you meed to check before undergoing renal biopsy
Prothrombin time, hematocrit and hemoglobin
Normal prothrombin time
11-16s
Therapeutic range for prothrombin time
1.5 or 2 X normal
Position of patient before Renal biopsy
Prone
Rationale why prone position for renal biopsy
Because the kidney is retroperitoneal
Why do we need to provide pressure dressing after renal biopsy
To prevent bleeding
Severity of sedation use for renal biopsy
Mild sedation
What laboratory should you obtain 8 before renal biopsy
CBC
If the hematocrit and hemoglobin is decrease should we continue with the renal biopsy?
No
Why do you need to postpone renal biopsy if the patient has anemia or decrease hemoglobin and hematocrit
Because kidney are vascular organ and is prone to bleeding
What anesthesia is use in renal biopsy
Local anesthesia
Why is local anesthesia use in renal biopsy
To numb the area at the site of injection
What sedation is used in renal biopsy
Diazepam and valium
Should the nurse do the renal biopsy procedure
NO, the procedure is done by a physician and nurses and obliged to do the preparation
What are things that are present at the bedside of the patient during an renal biopsy
Biopsy tray and other necessary material
What would you instruct the patient during renal biopsy
Hold breath for 5 to 15 seconds and remain still during the needle insertion
How long is a renal biopsy procedure
15 to 30 minutes
Do you need to put patient in bed rest after renal biopsy?
Yes
For how many hours do you need to put the patient in bed rest after renal biopsy
24 hours
Why do you need to put patient in bed rest after renal biopsy
To prevent bleeding
Do we need to monitor the patients vital signs after renal biopsy
Yes
What vital signs changes should you notify as alarming
Hypotension
Tachycardia
Tachypnea
Why is hypotension, tachypnea and tachycardia an alarming sign
It indicates bleeding
How to you monitor the biopsy site?
Check the dressing
Do you need to check the CBC after the renal biopsy?
Yes
Why do you need to check the CBC after renal biopsy
To detect possibility of bleeding
Do we need to increase the patients fluid intake after renal biopsy
Yes
Why do we need to increase the patients fluid intake after renal biopsy
To prevent ascending urinary tract infection
What should the patient avoid
after renal biopsy
Strenuous excercise
How long should the patient avoid strenuous excercise
2 weeks
Why should the patient avoid strenuous exercise for 2 weeks
To prevent bleeding
a type of treatment that helps your body remove extra fluid and waste products from your blood when the kidneys are not able to.
Dialysis
Purpose of dialysis
-A procedure that remove the end product of protein from metabolism from the blood
-maintain safe levels of electrolytes
-Correct acidosis and replenish the blood bicarbonate
-remove excess fluid from the blood
type of dialysis which uses the peritoneum in a person’s abdomen as the membrane through which fluid and dissolved substances are exchanged with the blood.
Peritoneal dialysis
Site of insertion for peritoneal dialysis
2 inches below the umbilicus
Is the site of insertion for peritoneal dialysis avascular area?
Yes
Is the site of insertion for peritoneal dialysis not risk for bleeding
Yes
Do yo need to explain and get a written consent before the patient undergoes peritoneal dialysis
Yes
Why do you Do yo need to explain and get a written consent before the patient undergoes peritoneal dialysis
Because it is an invasive procedure
Do you need to monitor and record the vital signs before during and after peritoneal dialysis
Yes
Why do you need to monitor and record the vital signs before during and after peritoneal dialysis
To serve as a baseline data
Do you need to weight the patient before and after peritoneal dialysis
Yes
Why Do you need to weight the patient before and after peritoneal dialysis
Because weight is the best indication for dehydration
Why do you need to ask the patient to void before peritoneal dialysis
To provide comfort
What is the temperature for the dialysate solution
Warm
Why is it necessary that the dialysate solution be warm
To prevent abdominal discomfort and to increase capillary permiability
Cycle of peritoneal dialysis
(I,D,D)
Infusion time
Dwell time
Drainage time
It is the time when the dialysis solution be inserted
Infusion time
How long is infusion time
10 minutes
It is the time when the solution is in the peritonium
Dwell time
How long is the dwell time period
4-6 hours
The time when the solution move out to the peritonium
Drainage time
How long is the drainage time?
30 minutes
What is the color that normally comes out to the first few bottle of the peritoneal dialysis
Pink-tinged
Why is pink tinged considered normal?
It may be due to irritation of the peritoneal membrane
What is the indication when the drainage stop?
Check for the kinks
What will you do when the drainage stop?
Turn the patient to the side
Why do you need to Turn the patient to the side when the drainage stop?
The colon may be occulding the catheter lumen
How will you monitor the patient hydration process for patient who undergoes peritoneal dialysis
Check the patients weight
What will you observe the client after peritoneal dialysis?
(F,H,H,D)
Fluid leaks
Signs of Hypovolemia
Hyperglycemia
Disequilibrium syndrome
Do you need to observe sterile techniques when handling dressing and tubing of peritoneum
Yes, to prevent infection or peritonitis
Do you need to monitor the urine and blood glucose levels
Yes, because the solution of the dialysis contains glucose
Incase of hyperglycemia what will you do
Give small amount of insulint
Following the dialysis do you need to apply dressing and observe site for drainage
Yes
What will you watch out after peritoneal dialysis
(P,R)
Peritonitis
Respiratory difficulties
Signs of peritonitis
(B,R,A,A,F,A)
Board like abdomen
Rigid Abdomen
Abdominal pain
Abdominal tenderness
Fever and chills
Abdominal distention
Why do patient undergoes peritoneal dialysis experience difficulty in respiration
Because of the h2o present in the dialysis solution
What will you do if the patient who undertake peritoneal dialysis experience difficulty in respiration
Put the patient in semi-fowler to promote lung expansion
Rapid removal of waste product from the blood than in the brain because of the brain barrier
Disequilibrium
Signs of disequilibrium
(R,H,D,H,I,C,D)
Restlessness
Headache
Decrease LOC
Hypertension
Irritability
Confusion
Disorientation
Position after peritoneal dialysis
Semi fowler
a machine filters wastes, salts and fluid from your blood when your kidneys are no longer healthy enough to do this work adequately
Hemodialysis
Does hemodialysis requires a vascular access
Yes
Frequency of hemodialysis
3-4 times a week
Duration of hemodialysis
2-3 hours per day
Duration of initial hemodialysis
30 minutes
Why is the duration of initial hemodialysis only for 30 minutes
To prevent disequilibrium
Do you need to ask the client void before hemodialysis
Yes, to provide comfort
Do you need to check the weight of the patient
Yes, weight is the best indication for dehydration
Do you need to asses the patients bital signs before hemodialysis
Yes
Will you asses the patient vitals signs during the procedure?
Yes, every 5-15 minutes
Should we ensure bed rest with frequent position change for comfort
Yes
Does headache and nausea normally occur after hemodialysis
Yes, because of possible disequilibrium
Should you take the blood pressure at the affected side?
No, it may damage the potency
What should you observe after the patient has hemodialysis
Impaired circulation
What are the signs of impaired circulation
Pale
Arm pain
Is it necessary to have an arm precaution when the patient has ab fistula or av shunt
Yes
While auscultation for the patency of the av fistula what sound would you hear?? And palpable for____
Swish and thrill (vibrations)
Is it necessary to have blood transfusion to be administered during the hemodialysis
Yes, cause the patient experienced anemia
What medication should you omit during hemodialysis
Anti-hypertension
Is a ‘do it yourself’ option that does not require a machine. It involves a tube permanently inserted through the abdomen to allow a fluid called dialysate to be emptied and replaced every day.
Continuous ambulatory peritoneal dialysis
Do you adhere to well balance diet during continuous ambulatory peritoneal dialysis
Yes
Is it important to the periodic blood chemistry during continuous ambulatory peritoneal dialysis
Yes
Is it important to take daily weight during continuous ambulatory peritoneal dialysis
Yes
Duration of continuous ambulatory peritoneal dialysis
3-4 times a day
Frequency when changing continuous ambulatory peritoneal dialysis
6-8 hours
Is continuous ambulatory peritoneal dialysis a take hime peritonium
Yes
Does continuous ambulatory peritoneal dialysis improve edema
No
Does continuous ambulatory peritoneal dialysis improve elevated BUN, serum creatinine
Yes it decreases it
Does continuous ambulatory peritoneal dialysis improve elevated Electrolytes
Yes, it decreases it
Does continuous ambulatory peritoneal dialysis improve elevated Blood pressure
Yes it decreases it
Does continuous ambulatory peritoneal dialysis improve anemia
No
What drug is use for anemia
Epoetin Alfa
Side effect of epoetin alfa
Hypertension
