[Exam 3] Chapters 53, 54, 55 Flashcards
1
Q
Functions of the Kidney: What is the acronym to remember the functions?
A
A Wet Bed
2
Q
Functions of the Kidney: 3-step process for urine formation?
A
Filtration, Reabsorption, Secretion
3
Q
Functions of the Kidney: Blood pressure regulated through what?
A
RAAS System
4
Q
Chronic Kidney Disease: What does this mean?
A
Umbrella term that describes a decreased function of the kidney that has lasted 3 or more months
5
Q
Chronic Kidney Disease: If untreated, this will turn into what?
A
End-stage kidney disease
6
Q
Chronic Kidney Disease - RFs: This includes what Heart issues?
A
Cardiovascular Disease, Hypertension, Decreased Perfusion to Kidneys, Obesity, Diabetes,
7
Q
Chronic Kidney Disease - RFs: Why is Hypertension a problem?
A
This is causing damage to kidney and they are not noticing
8
Q
Chronic Kidney Disease - Stages: What determines the stages?
A
They are five stages, and they are determined by GFR
9
Q
Chronic Kidney Disease - Stages: Normal GFR?
A
> 125
10
Q
Chronic Kidney Disease - Stages: At what level GFR to we determine its end-stage kdiney disease and they need dialysis?
A
When their GFR is < 15. Kidneys can no longer remove bodies waste.
11
Q
Chronic Kidney Disease - CMs: What levels will we see in their lab results?
A
Increased creatinine levels
Decreased RBC levels
Metabolic Acidosis
Electrolyte Imbalance
12
Q
Chronic Kidney Disease - CMs: What is creatinine, what is happening when its increased?
A
This is serum creatine in blood. End product of muscle energy of metabolic muscule breakdown. Measures effectiveness of renal function.
13
Q
Chronic Kidney Disease - CMs: Creatinine shows us what?
A
How effectively are kidneys are doing
14
Q
Chronic Kidney Disease - CMs: Decreased RBC production affects the body how?
A
Anemia.
15
Q
Chronic Kidney Disease - CMs: What signs of Anemia will patient experience
A
Fatigue, potentially impaired gas exchange,
16
Q
Chronic Kidney Disease - CMs: Why does MEtabolic Acidosis occur?
A
Because they lose the acid-base balance regulator relationship. Can’t regulate hydrogen ion
17
Q
Chronic Kidney Disease - CMs: Hydrogen ion is what?
A
Acidic, and kidneys can’t get rid of it.
18
Q
Chronic Kidney Disease - CMs: What electrolyte imbalance may occur
A
Hyperkalemia
Abnormal Calcium/Phosphorus
19
Q
Chronic Kidney Disease - CMs: What to know about calcium and phosphorus?
A
They are inversely related to one another.
Phosphorus goes up and Calcium goes down. And reverse as well .
20
Q
Chronic Kidney Disease - CMs: What must we continue to monitor?
A
GFR, Patients retaining fluid and being edematous.
21
Q
Chronic Kidney Disease - Nursing MX: What are the things we can do?
A
Treat underlying cause
Monitor Labs (GFR)
BP and Weight
22
Q
Chronic Kidney Disease - Types: What are the types that lead to this kdiney disease?
A
Nephrosclerosis
Primary Glomerular Disease
23
Q
Chronic Kidney Disease - Types: What is Nephrosclerosis?
A
This is the hardening of the renal arteires that is caused by hypertension and diabetes
24
Q
Chronic Kidney Disease - Types: What is Primary Glomerular Disease?
A
That is disease that destroys glomerulus of the kidney related to infection.lupus, diabetes.
25
Renal Cancer - RFs: What does this include?
```
Gender (Males)
Tobacco
Occupation Exposure
Obesity
Polycystic Kidney Disease
```
26
Renal Cancer - RFs: Which one is an abnormal RF for this?
Polycystic Kidney Disease
27
Renal Cancer - RFs: What is Polycystic Kidney DiseasE?
Fluid filled cysts that can change shape of kidney and can alter kidney tissue and cause tumor to develop
28
Renal Cancer - CMs: What are these?
Often no symptoms
Palpable Mass
Painless Hematuria
29
Renal Cancer - CMs: How may this be found?
On palpation or the painless hematuria
30
Renal Cancer - CMs: As cancer progresses, what symptoms may you see?
Symptoms of metastasis such as weight loss, weakness,
31
Renal Cancer - Assessment/Diagnostic: What assessments may be performed?
May feel the mass on palpation
32
Renal Cancer - Assessment/Diagnostic: What diagnostic tests may occur?
Renal Angiogram, CT, Cystoscope, Urography
33
Renal Cancer - Assessment/Diagnostic: What is a Renal Angriogram?
Imaging test to look at blood vessels in kidney
34
Renal Cancer - Assessment/Diagnostic: What is cystoscope
Procedure that allows doctor to exmine lining of the bladder and urters
35
Renal Cancer - Assessment/Diagnostic: What is urography (pyelography)
X-Ray technique for producing an image of the renal pelvis
36
Renal Cancer - Med Mx, Surg Mx: What is the preferred method?
Surgery, radical nephroectomy. They will go in where they remove the kidney that is cancereous.
37
Renal Cancer - Med Mx, Surg Mx: Renal artery immobilization may be done, whcih is what?
If you have renal artery thats feeding kidney, they will block and immobilzie the blood supply to the kidney. Kidney will not be fed and will kill the tumor.
38
Renal Cancer - Med Mx, Pharm Mx: What will typically be done?
Chemotherapy, Interleukin II.
39
Renal Cancer - Nursing Mx: What will we have to focus on?
Pain Control
Catheter and Drains
Patient Education
40
Renal Cancer - Nursing Mx: PAtient will be educated on what?
The tubes and drains that are connected to them.
41
Renal Cancer - Nursing Mx: What interventions are typically done after patient has surgery
Turns every 2 hours, cough/deep breath, DVT prophylaxis.
42
Renal Cancer - Nursing Mx: When would radiation be considered?
This is typically more for palliative care to keep them comfortable
43
AKI: What is this?
Rapid loss of renal function due to damage to the kidneys. Some event has caused kidneys to malfunction
44
AKI: What is the other name for this
ACute renal failure
45
AKI: What are some events that may cause this?
If patient hypovolemic, hypotensive, kidneys aren't getting perfused.
46
AKI: What must you treat first?
Whaetever is causing the kidney injury. If dehydrated, give more water.
47
AKI - Classifications: What are the three classifications of this?
Prerenal
Intrinsic
Postrenal
48
AKI - Classifications: What occurs in prerenal?
Marked decrease in renal blood flow
49
AKI - Classifications: What occurs in intrinsic?
Damage to structures within the kidney
50
AKI - Classifications: What occurs in postrenal ?
Obsturction of urine outflow from kidney
51
AKI - Classifications: What may cause prerenal?
Septic, Shock, Vasodilated, Impaired Cardiac Function, Decreased EF.
52
AKI - Classifications: In prerenal , cause is happening before what?
Before the kidney is affected.
53
AKI - Classifications: What is happening in Intrinsic?
Damage to glomeruli or kidney tubules.
54
AKI - Classifications - Intrinsic: What can cause damage to occur?
Antibiotics, Amioglycosides (mycin family)
Contrast for CT.
NSAIDS
Myoglobinurea
55
AKI - Classifications - Intrinsic: How to treat if this is happening due to an antibiotic?
Take away the antibiotic and give them a different one
56
AKI - Classifications - Intrinsic: What happens if Creatinine is at 2 and contrast is needed?
Contrast induced neuropathy can occur . This is why we premedicate with extra solution and give bicarb and bicarb solution for the kidneys.
57
AKI - Classifications - Intrinsic: NSAIDS damage what?
The kidneys
58
AKI - Classifications - Intrinsic: Tyelonol damages what?
The liver
59
AKI - Classifications - Intrinsic: Why does Myoglobinurea occur?
When there is a crush injury . Patient is found down and developed rhabomylosis (due to muscle injury. Results form death of muscle fibers). Myoglobin gets released from muscle and plug kidneys
60
AKI - Classifications - PostRenal: What does this deal with?
Obstruction of urine outflow from kidney. Urine can't go to bladder or if prostate tissue, backs up the kidney. Backup of urine into kdiney
61
AKI - Classifications - PostRenal: What can cause this
Kidney stone, BPH, blood clots within ureter,
62
AKI - Phases: What occurs in first phase?
Initiation phase. What causes the original injury
63
AKI - Phases: What occurs in the second phase
Oliguria period. <0.5 mL/kg/hr. Decreased urine output
64
AKI - Phases - 2nd Stage: Decreased urine output leads to what
Increased concentration of potassium, creatinine, uric acid , increase in waste products.
65
AKI - Phases - 2nd Stage: What issues can occur in patient has high potassium level?
Peak T Wave.
66
AKI - Phases - 2nd Stage: How can high potassium be treated?
Kayexelate, works by binding to stool and patient poops out potassium. DEcreases concentration.
Insulin
67
AKI - Phases - 2nd Stage: What does giving insulin for high potassium do for patient?
Forces the potassium back into cell until we can get the potassium down permanently.
Given in emergent siutation.
68
AKI - Phases - 2nd Stage: What must you do if you give insulin for hyperkalemia?
You have got to give dextrose so you don't bottom patients glucose out.
69
AKI - Phases - 3rd Stage: What occurs here?
Diuresis. Gradual increase of urine output and GFR is increasing
70
AKI - Phases - 3rd Stage: What must you watch out for here?
The patients fluid volume levels
71
AKI - Phases - 4th Stage: What is this?
Recovery period. 3-12 months. Lab values normal. May still have slight reduction in GFR.
72
AKI - CMs: Where will the signs appear?
in every body system of the body
73
AKI - CMs: What symptoms will they have?
Will be critically ill, lethargic, dry mucuous membranes,
74
AKI - CMs: What CNS effects may we see?
Headache, drowsiness, muscle twitching, seizures, due to electroltye imbalances and toxins building up
75
AKI - CMs: What tests must you look clcosely at?
Creatinine, BUN, GFR, Creatinine Clearance
76
AKI - CMs: What is Creatinine clearane?
The most reliable indicator of how the kidneys are functioning.
77
AKI Tx - Assessment/Diagnostics: Imaging will consist of ?
KUB, MRI, Ultrasound
78
AKI Tx - Prevention: How can this be prevented?
If you are going to be giving nephrotoxic medications, monitor the kidney function.
This includes antibiotics and amioglycosides.
79
AKI Tx - Prevention: What must you watch out for if patient has contrast?
Contrast induced nephropathy (damage to small blood vessels or to the units in kidneys that clean blood)
Monitor function before this
80
AKI Tx - Pharmacological Therapy: This will focus on what?
Decreasing potassium levels
81
AKI Tx - Pharmacological Therapy: What can be given to decrease potassium?
Kayexelate (reduces potassium content and exchanges sodium ions for potassium in GI tract and patients poop out potassium)
Insulin if unstable (potassium shifted into cell)
82
AKI Tx - Pharmacological Therapy: Important to montior what here?
Potassium levels
83
AKI Tx - Nutritional Therapy: What will their diet consist of?
High calories(help body recover), high carbs
84
AKI Tx - Nutritional Therapy: What will be restricted in their diet?
Potassium and Phosphorus (because kidneys recoveryign and may still have high phosphorus and potassium)
85
AKI Tx - Nutritional Therapy: What foods are avoided with potassium?
Bananas, Citrus Fruits, Coffee
86
AKI Tx - Nutritional Therapy: Once patient starts to recover, what can they increasE?
Their protein levels ,
87
AKI Tx - Nutritional Therapy: Why do you not want to give high protein diets?
It is hard of the kidney and cnanot filter out as well. May cause more damage to kidney.
88
AKI Tx - Nursing Mx: What nursing management should we do?
```
Monitor FLuid/Electrolytes
REduce Metabolic Rate
Promote Pulmonary Function
PRevent Infection
sKin Care
Psychosocial Support
```
89
AKI Tx - Nursing Mx: We want to promote pulmonary function to prevent what?
Atelectasis (Complete or partial collapse of entire lung) and Pneumonia (infection that inflames air sacS)
90
AKI Tx - Nursing Mx: What change will they have on their EKG?
Peaked T Wave
91
ESKD: What stage does this occur in?
5th stage of CKD
92
ESKD: GFR level here?
< 15 ml/min
93
ESKD: This will require permanent what?
Renal replacement therapy (RRT)
94
ESKD: What is RRT?
This is dialysis
95
ESKD: WHat body systems are affected>?
All of the system s
96
ESKD: Neurological changes?
Weakness/FAtigue/Confusion
97
ESKD: Cardiovascular Changes?
```
Increased BP
Pitting Edema
Periorbital Edema
Increased CVP (normal 2-6)
Pericarditis
```
Because fluid is overloading
98
ESKD: Pulmonary Changes?
SOB, DEpressed COugh, Thick Sputum
99
ESKD: GI Chagnes?
```
Ammonia Odor to breath
Metallic taste
Mouth/gum ulcerations
Anorexia
N/V
```
100
ESKD: Psychological Changes?
Withdrawn
Behavior Changes
Depression
101
ESKD: Hematoligcal Changes?
Anemia
Bleeding Tendencies
Increased Potassium Serum
102
ESKD: Skin changes?
```
Dry, FLaky
Pruirtus (itchy skin bc ur)
Ecchymosis
Purpura
Yellow-gray skin color
```
103
ESKD: Musculoskeletal changes?
Cramps
Renal Osteodystrophy
Bone Pain
104
ESKD: What must you assess for if someone is on hemodialysis
Thrill and Bruit. Evalaute access site fo rpatency.
105
ESKD: What must you not do for hemodialysis site
Take blood pressure or blood samples from the extremity with fistula/graft.
106
ESKD - Assessment: What changes will we assess for?
```
GFR
Na / H2O Retention
Acidosis
Anemia
Ca/Phos Imbalance
```
107
ESKD - Diagnostics: What diagnostic tests can be performed?
Kidney ultrasound
108
ESKD - Complications: What complications may occur?
```
Anemia
Ca/Phos Imbalance
Bone Disease
Hyperkalemia
HTN
Pericarditis
Percardial Effusion/Tamponade
```
109
ESKD - Medical Mx: Waht is the overall goal?
To maintain hemostasis and acid base balance within the body
110
ESKD - Pharmacological Therapay: What will be given?
Calcium and Phosphate Binders to regulate the levels,
111
ESKD - Pharmacological Therapay: What meds are given for phosphorus?
PhosLo , Renvela
This bind to phosphorus and get it down .
112
ESKD - Pharmacological Therapay: What ot know for PhosLo and Renvela?
They must be given with a meal which may raise calcium.
113
ESKD - Pharmacological Therapay: What meds may be given for calcium?
Tums. Will bring up calcium and decrease phosphorus
114
ESKD - Pharmacological Therapay: What meds cna be given ccardio wise?
Antihypertensives to control blood pressure
115
ESKD - Nutritional Therapay: How can this be monitored?
With albumin levels (3.5-5).
116
ESKD - Nutritional Therapay: What happens if albumin is in the 2s?
That will show that they are malnourished. Want to make sure that are taking in large biologic protein
117
ESKD - Nutritional Therapay: They can't take a large amount of protein?
it is hard on the kidney
118
ESKD - Nutritional Therapay: What must we be sure of for protein they are taking in?
We have to make sure its good quality like dairy and meat.
119
ESKD - Nutritional Therapy: What restriction will they be placed on?
Fluid restriction.
120
ESKD - Nutritional Therapy: How much fluid can they have?
500-600 mL intake + whatever output they had the previous day.
121
ESKD - Nutritional Therapy: How much fluid can they have if they had 50 mL of fluid output yesterday
650 mL
122
ESKD - Nutritional Therapy: How will their kidneys be fitlered?
Through dialysis
123
ESKD - Nursing Mx for Education: this includes what?
How much fluid they can take in, when to take their meds, when to go to dialysis
124
ESKD - Nursing Care Plan: This will include what?
```
Based on problems patient has.
Excess Fluid Volume
Imbalance Nutrition
Deficient Knowledge
Activity Intolerance
```
125
ESKD - Nursing Care Plan: How will excess fluid volume be fixed?
Can't give lasix. Must be done through dialysis and must monitor weight. Great indicator to help manage fluid volume.
126
ESKD - Nursing Care Plan: Every pound of weight is how much water?
500 mL
127
Renal Replacement Therapies: What is this>
Dialysis , because they cannot regulate it anymore.
128
Renal Replacement Therapies: Hemodialysis can be used for patients other than ESKD, like who?
Those with AKI who are acidotic. Can correct it quickly by putting them on this.
129
Renal Replacement Therapies: What does dialysis do?
Removes excess fluids, electrolytes, solutes, toxins, from the blood in people who have kidney failure
130
Renal Replacement Therapies: In what scenario can dialysis be run?
Emergent, if patient comes in and are very acidic and potassium 7 . Flash pulmonary edema.
Scheduled, 3x per week.
131
Renal Replacement Therapies - Hemodiaylsis: What are dialyzers?
The dialyzr machine
132
Renal Replacement Therapies - Hemodiaylsis: What is dialysate?
Important because it matches the ideal ECF to pull toxins off the blood. Works off of diffusion, osmosis, toxins move from area of low concentration to high to follow diaylsate.
133
Renal Replacement Therapies - Hemodiaylsis: What is the red thing that hangs off of dialysis machine?
This is the filter, the artificial kidney . They pull out the toxins and excess fluids and return clean blood into patient.
134
Vascular Access - Hemodialysis: Temporary access can be in the form of what?
Permacath that are placed where central line is placed. Can be in IJ, subclavian, femoral vein.
135
Vascular Access - Hemodialysis: If a permacath is cuffed, what does it mean?
There is a cuff further along and tissue will adhere. Places at less risk for infection
136
Vascular Access - Hemodialysis: If going on long term, permacath may be an option way?
They may have poor vascular disease because of the heart problems which would not allow for a fistula or graft
137
Vascular Access - Hemodialysis: Patients with permacath are at big risk for what?
infection, because its big and goes into heart
138
Vascular Access - Hemodialysis: Permanent types include what
fistula and graft
139
Vascular Access - Hemodialysis: What is fistula
they take an artery and vein and join it together. Helps vein get much bigger. Will take 2-3 months to mature. May use permacath in mean time.
140
Vascular Access - Hemodialysis: What is a graft?
Synthetic tubing that is placed between artery and vein.
141
Vascular Access - Hemodialysis: With a fistula and graft, what must you assess for ?
Feel for the thrill (vibrating, swishing, turbulent blood flow) and hear for the bruit. (will ehar for the flow of blood)
142
Vascular Access - Hemodialysis: What does it mean if you can't hear thrill or bruit?
They may not be able to run on dialysis on that day and may negatively impact patient.
143
Hemodialysis - Complications: What complciations can occur before they start?
SOB because fluid that has accumulated. May become hypotensive during dialysis because we are pulling all this fluid out.
144
Hemodialysis - Complications: Why complciations may they experience
Muscle cramping bc electrolyte shift
Dysrhythmias bc electrolyte imabalce
Air embolism (rare)
Dialysis Equilibrium (within brain, have rapid osmotic shift that causes disequilbrium)
145
Hemodialysis - Nursing Mx: How can you promote pharmacologic therapy for these patients?
If its 8am for dialysis , you don't want to rush to get meds in because they'll be dialyzed off.
Best thing to do if call pharamcist to see if meds appropriate to give
146
Hemodialysis - Nursing Mx: How do you promtoe fluid and nutritional therapy?
```
Protein Restriction
Low Potassium (salt substitues)
```
147
Hemodialysis - Nursing Mx: How can you help meet psychosocial needs?
Running 3x a week for hours can be draining. Make sure to support them emotioanlly
148
Hemodialysis - Nursing Mx: How can you promote home and community based care?
Hemodialysis can be ran at home.
149
Continuous Renal Replacement Therapies: What is Continuous Venovenous Hemofiltration (CVVH)
This is basically just pulling fluid off. This is continuous because they are critically ill.
150
Continuous Renal Replacement Therapies: What is Continuous Venovenous Hemodialysis (CVVHD)
This is doing the full dialysis. This will be used for patients who are very critically ill and continuous.
151
Peritoneal Dialysis (PD): This is the treatment of choice for which patient?
The patient who doesn't want hemodialysis or they don't want to end up with kidney transplant.
152
Peritoneal Dialysis (PD): How do waste products move here?
From an area of higher concentration to an area of lower concentration
153
Peritoneal Dialysis (PD): Where does this occur?
The periotneal membrane that covers the abdominal organs and covers the wall. SErves as semipermeable membrane.
154
Peritoneal Dialysis (PD): How does this work?
Dialysate fluid goes into the peritoneal membrane and gravity takes it down. Uric acids are cleared from blood through diffusion and osmosis.
It dwells and dialysate flows out into drainage bag
155
Peritoneal Dialysis (PD) - Procedure: how can you prepare patient for this?
Patients will get peritoneal catheter inserted. Explained the procedure to patient and encourage patient to empty bowel and bladder. REduces risk of internal puncture.
156
Peritoneal Dialysis (PD) - Procedure: What are they put on before the catheter is placeD?
An antibiotic just to make sure infections are prevented.
157
Peritoneal Dialysis (PD) - Procedure: Once catheter is inserted and theyre ready to go, nurse will do what?
Set up equipment and seet up dialysate that will dwell within peritoneum.
158
Peritoneal Dialysis (PD) - Procedure: Temperature for dialysate?
Needs to be at body temperature. If too cold, will cause vasoconstriction and cramping. Won't pull toxins out.
159
Peritoneal Dialysis (PD) - Procedure: What technique is used when accessing cathers?
Septic technique. To prevent infection.
160
Peritoneal Dialysis (PD) - Procedure: What happens as the dialysate is infused?
It dwells in the cavity for a set amount of before you drain the dialysate and pull out all the fluid that was in there into the drainage bag
161
Peritoneal Dialysis (PD) Old School - Procedure: COmplications:?
Peritonitis
Leakage
Bleeding
162
Peritoneal Dialysis (PD) - Procedure: How can you monitor for peritonitis?
Board-Like Abdomen
Abdomen Distention
Abdominal Guarding
Fever
163
Peritoneal Dialysis (PD) - Procedure: What color should drainge be?
Clear or straw colored. If cloudy, indicates infection. If brown, indicates perforation
164
Peritoneal Dialysis (PD) - Procedure: Diagnostic for Peritonitis?
CBC, Xray
Peritoneal Aspiration
Peritoneoscopy
Ultrasound
165
Peritoneal Dialysis (PD) - Procedure: How can you fix peritonitis?
```
Identify Cause
Antibiotics
IV Fluids
Decreased Abd Distention
Surgery to Close Perforation
```
166
Peritoneal Dialysis (PD) - Procedure: If peritonitis not fixed, what will happen to patient?
They will go septic
167
PD Approaches - Types: What is Acute Intermittent PD?
This has to do with fill, dwell, drain method
168
PD Approaches - Types: What is Continuous Ambulatory PD?
Exchanges occur 4-5x per day. 24 hours a day. 7 days a week
169
PD Approaches - Types: What is Continuous Cyclic PD?
Uses a machine called cycler and it can be run at night
170
PD Approaches - Nursing Consideration: How to prevent constipation?
Don't want that because it'll slow the flow of diasylate to peritoneum. Need to be on high fiber and stool softeneres.
171
PD Approaches - Nursing Consideration: What kind of diet do they have
High protein diet because they lose a lot of protein
172
PD Approaches - Nursing Consideration: Why to give Emotional Support?
They have catheters in them. Need the support because its a lot.
173
Special Considerations for Hospitalized Dialysis Patients: What change can occur on the patients skin?
Uremic Frost, which is why they itch.
174
Special Considerations for Hospitalized Dialysis Patients: What is Uremic Frost?
Toxins come onto the surface of the skin and appears as white spots on their skin. usually in metabolic acidosis.
175
Special Considerations for Hospitalized Dialysis Patients: When patients in hospital, what must you do everyday?
Get daily weights. Greatest indicator of their fluid status
176
Special Considerations for Hospitalized Dialysis Patients: What should you do for those with dialysi to protect them?
Protect vascular access (thrill/bruit/no bp/no sticks/) and be careful with iv therapy .
Provide catheter site care
177
Special Considerations for Hospitalized Dialysis Patients: What do you monitor cardiac wise?
Cardiac/respiratory complciations
| monitor blood pressure
178
Special Considerations for Hospitalized Dialysis Patients: What other care cna you provide for their overall body?
Fluid/Eclectrolyte levels
Manage discomfort
PRevent infection
Provide support / give meds
179
Kidney Surgery - PreOp Considerations: What should be done nrusing wise?
Give them fluids, promote excretion of waste products if they can handle it.
Also treat infections beforehand
180
Kidney Surgery - Perioperative Concerns: : What position may they be in?
Flank (On right side, left arm up over head)
Lumbar (leaning more on stomach, right arm over head)
Thoracoabdomianal approach (on right side but leaning more back)
Depends on where on kidney they are trying to get to.
181
Kidney Surgery - Postoperative Mx: What must you monitor for
```
Hemorrhage (very vascular kidneys),
VS
CVP
Urine Output, may not be making urine.
Blood Clot/DVT/Pneumonia
```
182
Kidney Surgery - Postoperative Mx: What does abdominal distention show may be happening?
Paralytic ileus may be forming
183
Kidney Surgery - Postoperative Mx: How may their fluid status be?
They may be hypervolemic or hypovolemia
184
Kidney Surgery - Postoperative Mx - Assessment: This includes all parts of the body, meaning what should be focused on?
Monitoring drainage from incision, drainage tubes, assess skin color, Output, VS,
185
Kidney Surgery - Postoperative Mx - Diagnosis: This incldues what
```
Ineffective Airway Cleanrace
Ineffective Breathing Pattern
Acute Pain
Fever/Axeity
Imapired urinary elimination
```
186
Kidney Surgery - Postoperative Mx - Diagnosis: What compliations can occur?
Bleeding, pneumonia, infection, DVT
187
Kidney Surgery - Postoperative Mx - Interventions: How to do pain relief measures?
Analgesic medications
188
Kidney Surgery - Postoperative Mx - Interventions:How to promote airway clearance and effective breathing pattern?
With appropriate pain relief, deep-breathing, coughing, and incentive spirometer
189
Kidney Surgery - Postoperative Mx - Interventions: What to do when handling catheter?
Strict asepsis with catheter
190
Kidney Surgery - Postoperative Mx - Interventions: Encourage patient to do what early on?
Leg exercises, early ambulation, and monitor for signs of DVT
191
Kidney Surgery - Postoperative Mx, Patient Txing: What should patient be taught since they are going home with drains?
Instruct family
How to care for drainage system, prevent complications
Signs of infection (redness, drainage)
Follow fluid intake
Health promote/health screening
192
Renal Transplant: Most sucessful when?
If we transplant before dialysis
193
Renal Transplant: This is the treamtent of choice for what?
ESKD
194
Renal Transplant: How to tell if this was successful?
If there is urine production
195
Renal Transplant: Where is the kidney usually placed?
Cradled in the ilium in the pelvis. Renal artery sutured to iliac artery.
196
Renal Transplant: What happens to the native kidney?
It is usually just kept in place.
197
Renal Transplant: Management for this after surgery?
Monitor for rejection (anti-rejection meds for life with steroids)
198
Bladder Cancer - RFs: This includes what?
Smoking and bladder stones
199
Bladder Cancer - CMs: This incldues what?
Painless hematuria (presence of blood in urine), may see pelvic back pain , more frequent UTIs,
200
Bladder Cancer - Diagnosed how?
Ureteroscopy (a Scope of the urethra and bladder , can visualzie tumor and get biopsy)
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Bladder Cancer - Surgical Mx: Why will they have surgery?
To remove the tumor
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Bladder Cancer - Surgical Mx: What may occur during surgery?
urinary diversion
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Bladder Cancer - Surgical Mx: What will occur with a urinary diversion?
They will make a stoma , make an ostomy site within bladder will and divert urine.
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Bladder Cancer - Pharmacological Mx: What will be done here?
Chemotherapy. They can do a topical version and can also do BCG Live. Is the most common treatment
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Bladder Cancer - Radiation: This is done why?
To help shrink the tumor
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Bladder Cancer - Investigational: This includes what?
Photodynamic Therapy
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Bladder Cancer - Investigational: How does photodynamic therapy work?
Photosensitizing material injected into the cancer cell. Cells pick it up and is toxic to them and will kill them.
