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NURS 363 > FINAL > Flashcards

FINAL Flashcards

1
Q

Kidney pain character

A

dull, constant to sharp stabbing

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2
Q

kidney pain signs and symptoms

A

NV
Diaphoresis
Pallor
Shock

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3
Q

etiology of kidney pain

A 
obstruction
stones
clot
pyelonephritis
trauma
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4
Q

bladder pain character

A

Dull, constant, intense w/ void

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5
Q

bladder pain signs and symptoms

A
  • Urgency

- Terminal pain

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6
Q

bladder pain etiology

A
  • Distention
  • Infection
  • Cystitis
  • Tumor
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7
Q

ureteral character pain

A

Severe, sharp, stabbing, colicky

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8
Q

ureteral signs and symptoms

A
  • N/V

- Paralytic ileus

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9
Q

ureteral pain etiology

A
  • Stone
  • Edema
  • Clot
  • Stricture
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10
Q

prostatic character pain

A

Vague, feelings of fullness

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11
Q

prostatic pain signs and symptoms

A
  • Suprapubic tenderness

- Altered voiding

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12
Q

prostatic pain etiology

A
  • Prostate cancer

- Prostatitis

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13
Q

urethral character pain

A

Variable, associated with voids

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14
Q

urethral pain signs and symptoms

A
  • Altered voiding

- Discharge

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15
Q

urethral pain etiology

A
  • Irritation
  • Infection
  • Trauma
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16
Q

cystography

A

– insert cystoscope w/ fibro-optic light & lens into urethra to assess for bladder injury

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17
Q

renal angiography

A

looks at renal blood vessels to assess for renal blood flow

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18
Q

intravenous pylography (IVP)

A

XR of kidney and urinary tract after IV injection of dye

o If any allergies to shellfish or dye  pre-medicate w/ Benadryl

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19
Q

stress incontinence

A

result of sneezing, coughing, laughing or changing position

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20
Q

urge incontinence

A

strong urge to void that cannot be suppressed

 Patient is aware of the need to void but is unable to reach a toilet in time

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21
Q

reflex incontinence

A

(-) normal sensation (usually r/t spinal cord injury)

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22
Q

overflow incontinence

A

result of over-distended bladder

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23
Q

functional incontinence

A

physical challenges or cognitive impairment that make it difficult to get to the bathroom on time
 Know you have to go to bathroom but physically unable to go
 Lower urinary tract function is intact but other factors make it difficult for the patient to identify the need to void

24
Q

iatrogenic incontinence

A

medication related

25
Q

mixed incontinence

A

several types of urinary incontinence that causes involuntary leakage associated w/ urgency and also w/ exertion, effort, sneezing or coughing

26
Q

bacterial prostatitis

A

organism reaches prostate via urethra or bloodstream

27
Q

abacterial inflammation

A

occurs following viral illness or decrease in sexual activity

28
Q

suprapubic prostatectomy

A

abdominal and bladder incisions made to remove prostate tissue

29
Q

retropubic prostatectomy

A

low abdominal incision made without opening bladder

  • -> Avoids bladder incision
  • less bleeding, drainage and bladder spasms
30
Q

perineal prostatectomy

A

incision b/w scrotum and anus made to access prostate
 Most common side effects = higher incidence of impotence, infection, rectal damage
 Lower risk for bleeding

31
Q

assessment for chronic pyelonephritis

A

*** Frequently diagnosed incidentally when being evaluated for HTN
o Poor urine-concentrating ability
o Pyuria – pus in urine
o Proteinuria – excess protein in urine
o Azotemia – nitrogen or urea in urine
o Anemia – damaged kidneys not secreting enough erythropoietin to produce RBC
o Acidosis

32
Q

interventions for chronic pyelonephritis

A

o Monitor VS (esp. BP), strict I&O & weight
o Encourage fluids up to 3L/day
o Encourage adequate rest
o Instruct on high-calorie, low-protein diet (d/t sx of proteinuria)
o Warm moist compresses to flank area
o Encourage taking warm baths
o Antibiotics, analgesics, antipyretics, urinary antiseptics & antiemetics as rx
o Monitor for s/sx of renal failure

33
Q

education for chronic pyelonephritis

A

o Prevent further infection – adequate fluid consumption, regular bladder emptying, perineal hygiene, taking meds as prescribed
o Keep follow-up appointments

34
Q

Manifestations of chronic pyelonephritis

A

1) fatigue and headache
2) poor appetite w excessive thirst
3) weight loss
4) polyuria

35
Q

acute pyelonephritis

A

enlarged kidneys, abscesses on or within renal capsule

-eventual atrophy and destruction of tubules glomeruli

36
Q

stage 1 of CRF

A

Slight damage – GFR >90

37
Q

stage 2 of CRF

A

Mild decrease in function – GFR 60-89

38
Q

stage 3 of CRF

A

Moderate decrease – GFR 30-59

39
Q

stage 4 of CRF

A

Severe decrease – GFR 15-29

40
Q

stage 5 of CRF

A

End Stage renal disease – GFR <15
o Occurs when the kidneys cannot remove the body’s metabolic wastes or perform their regulatory functions
o May be on dialysis or be require kidney transplant to sustain life

41
Q

clinical manifestations of CRF

A 
o	Elevated serum creatinine levels 
o	Anemia – d/t decreased erythropoietin production by kidneys 
o	Metabolic acidosis 
o	Ca and phosphorus imbalance 
o	Fluid retention ---> edema + CHF 
o	Abnormalities in electrolytes 
o	HF and HTN
42
Q

Goals of CRF

A

o Maintain ideal body weight w/o excess fluid
o Adequate nutritional intake/encourage nutritious foods
o Increase knowledge
o Absence of complications
o Maintain daily fluid restrictions
o Identify sources of fluid and explain why they are on a fluid restriction
o Good oral hygiene
o Adjust meds if needed
o Patient/family response to illness and treatment  coping patterns

43
Q

acute intermittent peritoneal dialysis

A

nurse warms, spikes, and hangs each container of dialysate
 Routine = hourly exchanges that involve 10-minute infusion, 30-minute dwell time, and 20-minute drain time
 Requires strict aseptic technique
 Assessments: VS, weight, I&O, labs and overall patient status
 Additional assessments: skin turgor and mucous membranes to evaluate fluid status/presence of edema
• Make sure patient isn’t in fluid overload!!
 If dialysate does not drain properly  facilitate draining by turning the patient from side to side or raising HOB
 NEVER push the catheter further into the peritoneal cavity

44
Q

continuous ambulatory

A

performed at home by patient or a trained caregiver
 Performed at home 4-5 times per day EVERY day
 Advantages:
• Longer dwell time – better results
• Allows reasonable freedom & control over daily activities

45
Q

continuous cyclic PD

A

: uses a machine called a cycler to perform the fluid exchanges
 Combines overnight intermittent PD with a prolonged dwell time during the day
 Advantages:
• Lower infection rates d/t fewer bag changes & tubing disconnections
• Greater freedom to work b/c occurs while sleeping
 ** These may require home visits by nurses, follow-up phone calls, or visits to out-patient settings to be sure the dialysate is correct
• BP is also monitored carefully

46
Q

uretheral colic manifestations

A

 Acute, excrutiating, colicky wave-like pain that radiates towards the genitalia and the thigh
 Sharp, severe sudden onset of pain
 Dull, aching kidney(s)
 N/V, pallor & diaphoresis during acute pain
 Urinary frequency with alternating retention

47
Q

what will be the top nursing diagnosis for urinary stone disease

A

PAIN

48
Q

what is the goal for urinary stone disease

A

o Relieve pain of renal colic

 Immediate objective = to relieve pain until its cause can be eliminated

49
Q

what is the best medication for urinary stone

A

NSAIDS bc the pain is associated with inflammation

50
Q

acid ash foods

A

cranberries, plums, grapes, prunes, tomatoes, eggs, cheese, whole grains, meats & poultry

51
Q

alkaline ash foods

A

legumes, milk & milk products, green vegetables, rhubarb

52
Q

high calcium

A

milk & other dairy products, beans, lentils, dried fruits, flour, chocolate, cocoa, canned/smoked fish (not tuna)

53
Q

high oxalate

A

asparagus, beets, celery, cabbage, nuts, tea, fruits, tomatoes, green beans, chocolate, beer, cola, dark green leafy vegetables

54
Q

high purine

A

organ meats, sardines, herring, venison, goose

55
Q

bacterial prostatitis symptoms

A

1) fever and chills
2) dysuria, urethral discharge when prostate palpated
3) boggy, tender prostate
4) WBCs found in prostate secretions

56
Q

abacterial prostatitis symptoms

A

1) backache
2) dysuria
3) pernineal
4) frequency and hematuria may be present
5) irregularly enlarged , firm, and tender prostate

57
Q

causes of acute renal disease

A

1) hypotension
2) reduced CO and HF
3) obstruction of kidney or lower urinary tract
4) hypovolemia
5) obstruction of renal arteries or veins

NURS 363 (3 decks)

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