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Adult Health 2 > exam 2 > Flashcards

exam 2 Flashcards

1
Q

uti is often caused by

A

gram negative bacteria e. coli

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2
Q

kidney functions

A

filter, regulate, remove waste products (urea), balance glucose/electrolytes, water levels in blood

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3
Q

urinary system

A

kidneys, ureters, bladder, urethra

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4
Q

generally ascending

A

uti

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5
Q

first line of treatment for uti

A

bactrim and macrodantin

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6
Q

helps sooth discomfort of painful urination; uti

A

pyridium; turns urine dark orange

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7
Q

if UTI is fungal what med do you give

A

diflucan

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8
Q

hall mark sign of acute pyelonephritis

A

fever, flank pain, high wbc

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9
Q

causes include bacterial, viral, trichomonas, chlamydia, gonorrhea

A

urethritis

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10
Q

what does HOUDINI stand for

A 
hematuria 
obstruction- urinary 
uro, gyn or perineal surgery 
decubitus ulcer - open wound with incontinence 
I and O- hourly management 
No code/ comfort/ hospice 
immobility due to physical limitations
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11
Q

less than 100 ml in a day

A

anuria

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12
Q

someone 300-500 ml of urine in 24 hours

A

oliguria

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13
Q

promotes kidneys to reabsorb water

A

ADH - antidiuretic hormone

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14
Q

lack of ADH

A

large amounts of diluted urine

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15
Q

when is adh produced

A

when patient is dehydrated, high sodium intake, decrease in blood volume

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16
Q

increase in potassium leads to

A

increase in aldosterone

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17
Q

pulls potassium in the gut so patient can have a BM

A

Kayexalate

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18
Q

normal BUN

A

8-25

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19
Q

Evaluates how well the kidneys are working to remove creatinine from the blood

A

creatinine clearance

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20
Q

what is the best estimate of GFR

A

creatinine clearance

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21
Q

The most common cause of intrarenal AKI?

A

Acute tubular necrosis (ATN)

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22
Q

Shock waves are delivered to break up renal calculi?

A

Lithotripsy

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23
Q

Priority intervention with a patient with a kidney stone?

A

pain

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24
Q

single most important risk factors for UTI in hospitalized patients?

A

catheter use

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25
Q

Indicative of a patient with AKI is in recovery phase?

A

decrease bun and decrease creatinine

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26
Q

Patient has a K level of 7. What is your priority?

A

heart rate and rhythm

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27
Q

Urine is cloudy with WBC, nitrates, and a PH of 8.2?

A

uti

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28
Q

What does erythropoietin secretion do?

A

Increase RBC production

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29
Q

which foods should be avoided in renal patients

A

high potassium, high sodium

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30
Q

Strep throat may proceed which kidney issue?

A

Glomerulonephritis

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31
Q

Chemical waste that is generated from muscle metabolism?

A

creatinine

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32
Q

Assessment finding that indicates a urinary tract infection has ascended to the kidneys?

A

Costovertebral angle tenderness

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33
Q

Enlargement of prostate gland resulting from increase in number of epithelial cells and connective tissue

A

bph

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34
Q

Symptoms due to urinary retention
Decrease in caliber and force of urinary stream
Difficulty in initiating urination
Intermittency
Starting and stopping stream several times while voiding
Dribbling at end of urinating

A

obstructive symptoms

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35
Q 
Urinary frequency and urgency
Dysuria
Bladder pain
Nocturia
Incontinence
A

irritation

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36
Q

appropriate treatment option for individuals who have moderate to severe symptom scores on the AUA symptom index.; decreases the size of the prostate

A

Finasteride

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37
Q

risks with Finasteride

A

othro hypotension and pregnant women should not touch the drugs, decrease libido

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38
Q

decreased prostate size but can also be used for kidney stones in male or female

A

tamsulosin (Flomax)

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39
Q

Promotes smooth muscle relaxation in prostate, facilitates urinary flow
Improvement in 2 to 3 weeks
Offer symptomatic relief but do not treat hyperplasia

A

tamsulosin (Flomax)
doxazosin (Cardura)
silodosin (Rapaflo)

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40
Q

side effect of tamsulosin (Flomax)
doxazosin (Cardura)
silodosin (Rapaflo)

A

orthostatic hypotension

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41
Q

effectively reduces symptoms of both BPH and ED.

A

cialis

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42
Q

ED drug taken daily, ED drug taken prn before sex

A

cialis; viagra

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43
Q

what can obstruction lead to

A

Hydronephrosis- swelling and damage to one or both kidney d/t retention.

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44
Q

golden standard to treat obstructing BPH

A

TURP

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45
Q

biggest complication with TURP

A

bleeding

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46
Q

post op care

A

CBI - flushes sterile fluid through cath and into the bladder to prevent blood clots
administer antispasmodics
teach kegel exercises

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47
Q

diagnostics for prostatitis

A

UA and culture
CBC
PSA

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48
Q

tightening or constriction off the foreskin; cause by poor hygiene. Ice pack for edema, topical corticosteroid 2-3 x day.

A

Phimosis

49
Q

tightening of the foreskin in the retracted position. Warm soaks, cleaning glans and foreskin, antibiotics, and possible circumcision

A

paraPhimosis

50
Q

A painful erection that lasts more than 6 hours.

Is a medical emergency

A

priapism

51
Q

Curved or crooked penis cause by plaque formation of the cavernosa of the penis or possible trauma. May have pain.

A

Peyronie’s disease

52
Q

tx for Peyronie’s disease

A

collagenase Clostridium histolyticum to break down collagen

53
Q

Men under 40 cause often gonorrhea or chlamydial infection; older men often UTI and prostatitis

A

epididymitis

54
Q

tx for epididymitis

A

Tx: Elevate scrotum, ice packs, and analgesics.

55
Q

Acute inflammation of the testis. Can be bacterial or viral infection (mumps, pneumonia, TB, syphilis. Also trauma, influenza, complicate UTI, and catheterization

A

orchitis

56
Q

Non-tender, fluid filled mass. Lumph interference

A

hydrocele

57
Q

tx for hydrocele

A

nothing unless scrotum becomes large and uncomfortable then aspiration or surgical drainage

58
Q

Sperm filled cyst in epididymis

A

spermatocele

59
Q

tx for Spermatocele

A

surgical removal

60
Q

Twisting of the spermatic cord that supplies blood to testes and epididytimis

A

testicular torsion

61
Q

tx for testicular torsion

A

Surgical emergency within 4-6 hours or ischemia to testes

62
Q

what are you going to tell patient who had a vasectomy

A

Total of 10 ejaculations or 6 weeks to evacuate sperm. Advise contraception

63
Q

Gradual decline in male hormone with aging

A

andropause

64
Q

labs to draw for andropause

A

testosterone. 280-1000 is normal; replace at 200

65
Q

dysuria, increased frequency >q2 hrs, urgency, suprapubic pain, hematuria, cloudy urine

A

UTI

66
Q

used in complicated UTIs but has a risk of tendon rupture

A

Fluroquinolines

67
Q

if UTI is fungal

A

Diflucan

68
Q

Begins in lower urinary track and ascends the urethra; unresolved bacterial infection can cause bacteremia that can lead to urosepsis (can be fatal)

A

acute pyelonephritis

69
Q

tx for pyelonephritis

A

Place pt on broad spectrum abx until culture sensitivity is back from lab (24+ hours maybe)

70
Q

result of obstruction and rupture of the periurethral glands

A

urethral diverticula

71
Q

dysuria, post void dribbling; urinary frequency and urgency, suprapubic discomfort, feeling of incomplete bladder emptying,

A

urethral diverticula

72
Q

symptoms of a UTI without the presence of a positive urine culture, bacteremia, or pyuria.

A

Interstitial Cystitis/Painful Bladder Syndrome (IC/PBS)

73
Q

what to suggest for a person who has Interstitial Cystitis/Painful Bladder Syndrome (IC/PBS)

A

keep a food diary when voids and when pain comes on; eliminate bladder irritating foods i.e.- caffeine, alcohol, citrus, aged cheese, foods with vinegar, hot peppers and curry ; avoid high-potency vitamins as they irritate the bladder

74
Q

generalized body edema, periorbital edema, hypertension, oliguria, hematuria with a smoky or rusty appearance, and proteinuria; fluid retention d/t decreased glomerular filtration.

A

Acute Post Streptococcal Glomerulonephritis

75
Q

to assess for renal trauma

A

IVP- contrast with X-ray to see where the blockage is

76
Q

a life-threatening genetic disease. It is characterized by cysts that enlarge and destroy surrounding tissue by compression.

A

Polycystic kidney disease (PKD)

77
Q

what can we do for Polycystic kidney disease (PKD)

A

no treatment. may need Nephrectomy may be necessary with dialysis or kidney transplant

78
Q

accumulation of waste products in blood

A

azotemia

79
Q

difference between acute injury and chronic kidney injury

A

rapid onset of injury, whereas chronic kidney disease comes on over time and is linked to CV disease

80
Q

why drugs could be toxic to the kidneys, causing intrarenal damage

A

Antibiotics, aminoglyo, NSAIDS, vanco, ace inhibitor

81
Q

phases of AKI

A

oliguria
diuretic phase- kidneys are starting to recover. Diuretic: 1-3 L and up to 5 L per day of output from osmotic diuresis, where the tubules can’t concentrate urine. This can cause hypovolemia and hypotension! This can last 2-6 weeks
recovery- phase continues until the kidney is fully recovered and could take up to a year.

82
Q

how to treat hyperkalemia

A

Regular Insulin IV- Helps to move K+ into cells
Sodium bicarb IV- corrects acidosis and moves K+ into cells
Calcium gluconate IV- raises the threshold for excitation from K+
Hemodialysis- Most effective way to remove K+
Sodium Polystyrene Sulfonate (Kayexalate)- Exchange of Na for K+; oral or retention enema creates diarrhea and removes K+
Dietary restriction- limit intake to 40 mEq day of potassium rich foods and drink

83
Q

what is ERSD

A

GFR is less than 15 and this patient needs dialysis

84
Q

causes of CKD

A

diabetes and hypertension

85
Q

foods high in potassium

A

bananas, avocado, potato, spinach, beans, citrus juices, fish

86
Q

foods high in phosphorus

A

meat, fast food, cheese, soda, seeds, canned fish, milk

87
Q

with bph we are really worried about

A

urinary retention

88
Q

nurses role for CBI

A

titrating to the color of urinary output

monitoring output so we dont rupture the bladder

89
Q

if the bag for CBI is dark red what will we do

A

increase the flow

90
Q

shrinks the prostate tissue for BPH

A

finasteride

91
Q

uti ascending can cause

A

pyelonephritis

92
Q

someone with lithotripsy what do we want to do

A

sprain their urine so we can catch the calculi and send it to the lab

93
Q

in the diuretic phase of aki what are we worried about

A

dehydration because they are putting out a lot of urine

94
Q

know prerenal, intra, and post

A

who is at risk for each

95
Q

GFR and CKD stages

A

know

96
Q

hemodialysis

A

prevent central line infections

dont do bp or sticks in that arm

97
Q

assessment for hemodialysis

A

palpate for a thrill - blood flow

98
Q

biggest risk for hemodialysis

A

hypotension

99
Q

peritoneal dialysis

A

CAPD- stays at home patient can be up and about; pretty independent; hanging bags
APD- automated overnight

100
Q

biggest thing with peritoneal dialysis

A

peritonitis

101
Q

in the peritoneal dialysis what are we looking for in the bag

A

fibrin and cloudiness- signs of infection

102
Q

if you think the urine is infected

A

send for cell count and culture

103
Q

anemia med for CKD

A

erythropoietin - stimulates the bone marrow to produce rbc

104
Q

what to do if patient is on erythropoietin

A

monitor rbc, hgb, hct because they could have too much

105
Q

biggest side effect of binders

A

GI upset

106
Q

when should binders be taken

A

with food otherwise they aren’t doing anything

107
Q

with albumin what are we worried about

A

htn and volume overload because albumin brings fluid back into the cells

108
Q

best determines what stage of CKD

A

GFR

109
Q

influenced by fluid volume status and by the amount of protein in the diet

A

bun

110
Q

if creatinine rises over time what are we thinking

A

kidney damage

111
Q

what is considered a low oxalate diet

A

avoid spinach, dark roughage, asparagus, cabbage, tomatoes, rhubarb tea, chocolate

112
Q

ca phosphate calculi

A

no ca or phosphate foods; animal meat, dairy, dark sodas, broccoli

113
Q

ca oxalate

A

no ca or oxalate foods; spinach, bran, nuts

114
Q

uric acid

A

no red meat, organ meat, shellfish

115
Q

cysteine

A

drink plenty of water, limit sodium

116
Q

draws potassium out through bowel and can treat hyperkalemia

A

kayexalate

117
Q

shifts potassium into cells

A

insulin

118
Q

measures how much is in the blood; product of protein and muscle metabolism

A

creatinine; normal could be different for everyone so you need to trend the patient before jumping to conclusions

Adult Health 2 (7 decks)

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