Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Adult Health Nursing II > Exam #7 > Flashcards

Exam #7 Flashcards

1
Q

Common GU Symptoms

A

Pain

Changes in voiding

Gastrointestinal symptoms

Unexplained anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Glomerular Filtration Rate

A

Amount of plasma filtered through the glomeruli per unit of time

125-200 mL/hour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

BUN

A

10-20 mg/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Creatinine

A

Waste product of skeletal muscles

0.7–1.4 mg/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Anuria

A

Urine less than 50 mL in 24 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Oliguria

A

Urine less than 0.5 mL/kg/hour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

GU Diagnostic Exams

A 
UA/Urine culture
Specific gravity
Osmolality
BUN/Creatinine
KUB
Ultrasonography
CT/MRI
Nuclear scans
Intravenous urography
Renal angiography
Cystoscopy
Biopsies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Cystoscopy Nursing Care

A

NPO Status

Post procedure: tell them to expect burning with urination, hematuria, polyuria, high risk for UTI, monitor for urinary retention

Treat with sitz bath, antispasmodics, intermittent catheter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Kidney Biopsy

A

Percutaneous or open biopsy

Check coags before procedure

Pre-op urine specimen

NPO/IV

Post-op: IV to keep urine clear, pain control

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Gerontological Considerations

A

GFR decreases
More susceptible to ARF and CRF due to sclerosis of glomeruli and renal vasculature
Renal reserve is decreased
Higher risk for adverse drug effects/interactions
Prone to hypernatremia and fluid volume deficit
Decreased bladder wall contractility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Chronic Kidney Disease

A

Damage to kidneys without signs/symptoms, related to acute inflammation

5 is end-stage renal failure

Screening and early intervention is important; prevent progression by decreasing risk, help eliminate HTN, treat anemia, decrease hyperglycemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

S/S of CKD

A

Elevated creatinine
Anemia
Metabolic acidosis, abnormal calcium and phosphorus levels
Fluid retention, edema, S/S of CHF, increase in potassium
Electrolyte imbalances
Difficult to control HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Treatment of CKD

A

Find the cause and eliminate it

Keep BP below 130/80

Prevent complications by controlling hyperglycemia, managing anemias, decreasing salt intake

Diet: low protein, low sodium, low potassium, low phosphate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Primary Glomerular Diseases

A

Acute nephritic syndrome

Chronic glomerulonephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Major Clinical Manifestations of Primary Glomerular Diseases

A

Proteinuria, hematuria

Decreased GFR

Decreased excretion of sodium, edema

Hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Acute Nephritic Syndrome

A

Acute glomerulonephritis

Caused by immune respone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Signs/Symptoms of Acute Nephritic Syndrome

A

Hematuria, edema

Azotemia, proteinuria

Oliguria, hypoalbuminemia, hyperlipidemia, urinary casts, BUN and CRE increased, urine output decreases, Hgb and Hct decreased, hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Treatment of Acute Nephritic Syndrome

A

Biopsy of kidney

Prognosis is excellent

Some need dialysis if it becomes a chronic problem

Treat the symptoms, steroids to help with inflammatory process, low sodium diet, keep track of intake and output, antibiotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Complications of Acute Nephritic Syndrome

A

Hypertensive encephalopathy

Heart failure

Pulmonary edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Chronic Glomerulonephritis

A

Kidneys decrease in size and increase in fibrous content

Glomeruli and tubules are scarred

Renal arteries are thickened

Leads to stage 5 CKD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Cause of Chronic Glomerulonephritis

A

Repeated episodes of acute nephritic syndrome, hypertensive nephrosclerosis, glomerular sclerosis

Secondary: lupus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Signs/Symptoms of Chronic Glomerulonephritis

A

May not have any at first

Increased irritability, increased nocturia, headache, dizziness, digestive problems, look chronically ill/poorly nourished, yellow-gray pigmentation, retinal hemorrhage, heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Treatment of Chronic Glomerulonephritis

A

Treat symptoms

Sodium/water restriction

Antihypertensives

Daily weight and diuretic medications

Careful protein with a high biologic value

Dialysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Nephrotic Syndrome

A

Type of renal failure with increased glomerular permeability

Caused by damage to glomerular capillary membrane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Signs/Symptoms of Nephrotic Syndrome
Massive proteinuria Edema Hypoalbuminemia Hyperlipidemia
26
Treatment of Nephrotic Syndrome
ACE inhibitors Diuretics Lipid lowering agents
27
Polycystic Kidney Disease
Genetic, numerous cysts in the kidney
28
Signs/Symptoms of Polycystic Kidney Disease
Hematuria, polyuria, hypertension, renal calculi, UTI, proteinuria Abdominal fullness and flank pain as cysts grow
29
Renal Cancer Risk Factors
Men Occupational chemical exposure Tobacco use, obesity Estrogen therapy, polycystic kidney disease
30
Signs/Symptoms of Renal Cancer
Hematuria Abdominal Mass may present Metastasis to lungs, bone, liver, brain, contralateral kidney
31
Nephrectomy
Treatment if a renal tumor can be removed Laparoscopic method is preferred
32
Nursing Interventions after Nephrectomy
Pain relief Promote airway clearance by encouraging TCDB Monitor UO and maintain patency of urinary drainage systems Use strict asepsis Monitor for bleeding Teach leg exercises
33
Renal Failure
Results when kidney cannot remove the body's metabolic wastes or perform their regulatory function Affects endocrine, metabolic functions
34
Acute Kidney Injury
Rapid loss of renal function Potentially reversible, may not necessarily lead to failure
35
Cause of Acute Kidney Injury
Damage to the kidneys Reduced blood flow to the kidneys Decreased perfusion related to heart failure Obstruction May be prerenal, intrarenal, or postrenal
36
Hyperkalemia
Can kill a patient in ESRD ECG changes present with a tall tented or peaked T-wave
37
Signs/Symptoms of Hyperkalemia
Irritability, abdominal cramps, diarrhea, paresthesia, general muscle weakness, slurred speech, difficulty breathing, paralysis
38
Treatment of Hyperkalemia
Kayexalate retention enema IV dextrose (50%), insulin and calcium may shift potassium back into cells temporarily
39
End Stage Renal Disease
Final stage (stage 5) of chronic kidney disease Retained uremic waste Need for renal replacement therapies, dialysis, or kidney transplants
40
Risk Factors for End Stage Renal Disease
CV disease Diabetes HTN Obesity
41
Renal Replacement Therapies
Dialysis (hemodialysis, continuous renal replacement therapies, peritoneal dialysis) Kidney transplantation
42
Protection of AV Fistula
No BP, lab draws, or IV on extremity Palpate for thrill and bruit q4h Do not carry objects or sleep on side of access Monitor for bleeding and infection Assess pulses distal to access
43
Lower UTI
Caused by pathogens in the system May be cystitis, prostatitis, urethritis
44
Upper UTI
Less common May be pyelonephritis, nephritis, renal and perirenal abscess
45
Risk Factors for UTI
Failure to empty bladder Obstructed urinary flow Decreased defenses Instrumentation/inflammation or abrasion Reflux (urethrovesical or ureterovesical) Female, diabetes, pregnancy, neurological disorders, gout
46
Uncomplicated UTI
Community-acquired Burning with urination, frequency, urgency, incontinence, hematuria
47
Complicated UTI
Could be related to urological condition or healthcare-acquired Can lead to shock or urosepsis
48
Gerontologic Considerations of UTI
More likely to have UTI that leads to sepsis Lack the typical symptoms
49
Pyelonephritis
Bacterial infection of the renal pelvis May be in one or both kidneys Caused by spread of infection from the bladder or systemic infection
50
Acute Pyelonephritis
Chills, fever, leukocytosis, bacteriuria, pyuria, low back/flank pain, N/V, headache, malaise, painful urination If it comes back frequently, more testing is warranted
51
Chronic Pyelonephritis
No symptoms of infection/fatigue Headache, anorexia, weight loss, polyuria, thirst End stage renal disease Kidneys become scarred and nonfunctional
52
Stress Incontinence
Involuntary loss of urine; more common in women, especially after vaginal birth
53
Urge Incontinence
Strong urge that cannot be suppressed and cannot reach the toilet in time; related to neurological dysfunction
54
Functional Incontinence
Cognitive impairment (Alzheimer’s); no signals to the brain telling them they need to go
55
Overflow Incontinence
Related to chronic retention, overflows and causes incontinence
56
Iatrogenic Incontinence
Due to medical factors, medications
57
Pharmacologic Therapy for Incontinence
Anticholinergics, tricyclic antidepressants Pseudo-ephedrine: caution with prostate hyperplasia and HTN
58
Assessments for Incontinence
Develop and use a voiding log or diary | Diagnostic exams: residual urine, UA, culture and sensitivity
59
Behavioral Interventions for Incontinence
Kegel exercises, voiding schedule, physical therapy
60
Surgical Interventions for Incontinence
Bladder sling, bladder tac, Botox injections
61
Urinary Retention
When the bladder does not empty completely Common in people older than 60 years old Residual urine is 50-100 mL commonly
62
Causes of Urinary Retention
Surgery, general anesthesia, diabetes, prostate enlargement, pathology in the urethra, tumors, trauma, neurological disorders such as multiple sclerosis
63
Assessment of Urinary Retention
Last time they voided, how much did they go, how frequently did they go, do they have dribbling in between, pain, feel bladder distention, restlessness/agitation, checking residual
64
Nursing Measures to Promote Voiding
Provide privacy, position patient in normal way that they should void, warmth, hot tea, turn on the faucet, stroking the abdomen, Creed’s maneuver
65
Urolithiasis and Nephrolithiasis
Calculi (stones) in the urinary tract or kidney where there is a concentration of substance such as calcium and uric acid (75% are calcium) Risk factors include dehydration, infection, urinary stasis, immobility
66
S/S of Urolithiasis and Nephrolithiasis
Pain, infection, swelling, blood in the urine, difficulty urinating, incontinence, hesitancy, nocturia
67
Diagnosis of Urolithiasis and Nephrolithiasis
X-ray, blood chemistries, and stone analysis; strain all urine and save stones
68
Calcium Stone Types
Liberal fluid, restrict protein and sodium, thiazide diuretics
69
Uric Acid Stone Types
Low purine diet Allopurinol to prevent recurrence
70
Cystine Stone Types
Low protein diet Increase fluid intake
71
Oxalate Stone Types
Limit oxalate in diet –spinach, strawberries, chocolate, peanuts
72
Medical Management of Stones
Stone may pass spontaneously ``` Ureteroscopy ESWL (extracorporeal shock wave lithotripsy): breaking up the stone Endourologic (percutaneous)-stone removal ```
73
Bladder Cancer
More common over age of 55, more common in men
74
Risk Factors for Bladder Cancer
Cigarette smoking Exposure to carcinogens: rubber, leather, ink, paint, dyes Recurrent bacterial UTI, bladder stones, high urinary pH, high cholesterol intake, pelvic radiation therapy Cancers: prostate, colon and rectum
75
S/S of Bladder Cancer
Hematuria, infection, alterations in urine function, changes in color of urine, pelvic and back pain
76
Diagnosis and Treatment of Bladder Cancer
DX: ureteroscopy, biopsy, cytologic exam of urine TX: Surgery, chemotherapy, radiation
77
Urinary Diversion
Procedure to divert urine from bladder to a new exit site Reasons: bladder is permanently removed, partially resected, pelvic malignancies, birth defects, trauma-induced problems Technique dependent on patient (age, bladder condition, body build, renal status, independence, willingness to participate)
78
Types of Urinary Diversions
Cutaneous urinary diversion: ileal conduit (oldest and most common)—ureters are placed into loop of ileum and have a stoma Continent urinary diversion: catheterize through a stoma, no need for a bag
79
Assessment after Urinary Diversions
Post-Op: hourly urine output Monitor for signs of complications: wound infection, skin irritation, dehiscence, leakage, obstruction, small bowel obstruction, ileus, gangrene of the stoma, chronic reflux, pyelonephritis, stones Hematuria may be normal for 48 hours/urine with mucus—normal due to the ileum Stoma inspection, skin inspection, anxiety
80
Prostatitis
Inflammation of the prostate gland related to infection, urethral stricture, benign prostatic hypertrophy
81
S/S of Prostatitis
Onset of fever, pain, dysuria
82
Treatment of Prostatitis
Antibiotics, anti-inflammatory, alpha adrenergic blockers Sitz baths, comfort measures
83
Diagnostic Tests of Prostatitis
Prostate specific antigen (PSA) (N < 4 ng/ml, > 4 ng/ml = may indicate prostate cancer) Recommend: Baseline level 40-50 yo. Transrectal ultrasound: ask for sedation/pain medicine before procedure Prostate fluid or tissue analysis Tests of male sexual function
84
Benign Prostatic Hypertrophy
Noncancerous enlargement of prostate Common in aging men Leads to incomplete emptying of bladder, which leads to urinary retention
85
Risk Factors for BPH
Smoking, alcohol, obesity, reduced activity, HTN, heart disease Western diet: high in animal fat and protein, refined carbs, low in fiber
86
Risk Factors for Prostate Cancer
Family history, genetic link, diet high in red meat or dairy products high in fat
87
Prostate Cancer
Second most common cancer for men Early stages rarely has symptoms
88
Diagnosis of Prostate Cancer
DRE - digital rectal exam | PSA
89
Treatment of Prostate Cancer
Treatment may include prostatectomy, radiation therapy, hormonal therapy, and/or chemotherapy
90
Radical Prostatectomy
Removal of seminal vesicles, tips of vas deferens and surround fat, nerves and blood vessels
91
TURP
No incision from the outside, done all through the urethra
92
Prostatectomy Complications
Depends on type of prostatectomy Hemorrhage, clot formation, catheter obstruction and sexual dysfunction
93
Relief of Pain after Prostatectomy
Urine: needs to be monitored after prostatectomy; foley will be inserted, monitor urine output, difficult with continuous bladder irrigation Assessment of pain Bladder spasms: lead to pain, leads to feelings of pressure, fullness, urgency Medication and warm compresses or sitz baths Analgesics and antispasmodics Ambulation; avoid sitting Prevent constipation Irrigate catheter as prescribed

Adult Health Nursing II (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions