Exam 2: Renal/Urologic Disorders Flashcards
What is the main clinical manifestation of a urinary tract infection?
Costovertebral tenderness (pain over the area where the kidney is) indicating an upper UTI, which can be more serious/difficult to treat
What should female patients be encouraged to do to prevent a UTI?
Wiping from the front to back
What is one way to prevent a CAUTI?
Removing the catheter as soon as possible (ex: 24 hrs after surgery)
Nursing care for UTI?
Patient should increase fluid intake and empty the bladder every 2-3 hrs while awake to decrease the likelihood of bacteria building up
What lab findings will be seen in a patient with nephrotic syndrome?
Decreased serum albumin which is a common cause of edema
What is expected to be seen in a patient with a new onset of nephrotic syndrome?
Recent weight gain
What are risk factors for developing urinary tract calculi (kidney stones) (4)
- warm climate changes
- metabolic changes
- genetic factors
- excessive amts of food that contain uric acid (sardines, meats/organ meats/red meats, cheeses, wine)
What is the highest priority treatment for a urinary calculi/kidney stone?
Treatment of pain due to the patient possibly passing the stones through their urine without surgery
Care for a patient with renal calculi or kidney stone?
Administer prescribed analgesics and opioids to relieve renal colic pain
What should the nurse teach the patient to expect after a shock wave procedure to break down the kidney stone?
First few times that the patient voids after this procedure may be bright red (hematuria), which is normal and expected
What should be done to avoid the recurrence of renal calculi?
Drinking 2000-3000 mL of fluids/day
What type of exercises should be promoted to a patient who has urinary incontinence?
Kegal pelvic exercises
What are the goals of treatment for urinary incontinence?
Frequent urination every 2-3 hrs and identifying the factors that led to incontinence
A 55- year- old woman who is admitted for shoulder surgery asks the nurse for a perineal pad, stating that laughing and coughing causes leakage of urine. What is an intervention that the nurse can do?
Teach the patient how to perform Kegal exercises
What lab result is expected to find in a patient with acute kidney injury (AKI)?
Increase in serum creatinine levels (indicates that the kidneys are not functioning at the highest capacity)
Causes of?
- prerenal
- intrarenal
- postrenal
Prerenal: reduction of renal blood flow
Intrarenal: direct damage to the kidney tissue
Postrenal: obstruction to the outflow of urine causing backflow into renal pelvis
Clinical manifestations/phases (3) of an AKI?
Oliguric phase: patient is not urinating
Diuretic phase: urine output 1-3 liters but may reach 5 liters (concerns over deydration)
Recovery phase: GFR increases, allowing BUN and creatinine levels to decrease
Main diagnostic study for an AKI?
Increase in serum creatinine and BUN testing
What indicates to the nurse that the patient with AKI is in the recovery phase?
Decrease in BUN and creatinine levels
Clinical manifestations of chronic kidney disease (CKD) and what is its main form of treatment (2)
Anuria: inability to urinate
Treat anuria by:
- placing on immediate dialysis
- strict I&Os
One of the systemic manifestation of CKD is musculoskeletal issues, which serum level is likely to be seen with this?
Decrease in calcium levels because less vitamin D is converted to its active form (patient should not limit calcium intake)
Which serum level (2) should be monitored routinely in patients with CKD and why?
- potassium and sodium levels
- because medications for blood pressure such as beta-blockers, ace inhibitors, and diuretics can greatly affect electrolyte levels
Stages of CKD are based on?
GFR
Which lab value indicates that CKD is getting worse?
GFR
Dialysis removes and re-establishes? (3)
- removes metabolic waste
- re-establishes normal fluid vol and electrolyte imbalance
What complication is the patient at high risk for when undergoing peritoneal dialysis?
Risk for infection is very high at the site of the peritoneal wall of the abdomen
To prevent the most common serious complication of PD, what is the most important for the nurse to do?
Use strict aseptic technique
What 2 indicators show a very serious issue that can indicate occlusion in a patient receiving hemodialysis?
Lack of thrill and bruit
What foods should be limited for a patient with a high risk of renal calculi?
Anchovies and shellfish
