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NURS122 > GU > Flashcards

GU Flashcards

1
Q

Questions to assess when a pt has kidney/urinary issues

A

OPQRST pain
frequency
amount
hematuria
dysurea (pain)
change in color or odor

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2
Q

anuria vs. oliguria vs. polyuria

A

anuria - no urine
oliguria - little urine
polyuria - lots of urine

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3
Q

ideally, when should urinalysis sample be collected?

A

1st catch in the morning

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4
Q

what is KUB test

A

kidney, ureter, bladder x-ray

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5
Q

what is IVP test

A

intravenous pyelogram which uses contrast dye to view kidneys, ureters, bladder, and urethra

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6
Q

what is cystoscopy

A

examine the bladder lining and urethra

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7
Q

how does the GU change with age

A
  • kidney size decrease
  • decreased renal blood flow, GFR
  • decreased ability to conserve Na, excrete acid, dilute/con. urine
  • increased prostates
  • decreased bladder elasticity
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8
Q

how does change in bladder elasticity affect urine output

A

increased residual volume

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9
Q

cause of nocturia

A

change in dilution and concentration of urine

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10
Q

what is vesicoureteral reflux

A

blockage or failure of bladder muscle and leading to urine flowing backward into ureters and kidneys

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11
Q

signs of an elderly pt having GU issues

A
  • mental confusion or frequent unexplained falls
  • sudden onset of incontinence
  • fever, tachycardia, tachypnea, hypotension (without urinary symptoms)
  • loss of appetite, nocturia/dysuria
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12
Q

causes of cystitis

A
  • not emptying bladder completely
  • damage or irritation around urethra
  • bacteria transfer to urethra
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13
Q

signs of cystitis

A
  • increased frequency/urgency with burning urination
  • hematuria
  • cloudy/smelly urine
  • pelvic discomfort
  • pressure in lower abdomen
  • low-grade fever
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14
Q

treatment of cystitis

A

antibiotics and pain meds
encourage fluids

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15
Q

what can pyelonephritis lead to

A

sudden severe kidney infection
leading to kidneys swelling
can cause permanent kidney damage

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16
Q

cause of chronic pyelonephritis

A

pts with urinary obstructions

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17
Q

upper vs. lower UTI symptoms

A

upper - fever, chills, flank pain
lower - dysuria, urgency, hesitancy

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18
Q

bacteria that cause most UTIs

A

E. coli

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19
Q

pyelonephritis meaning

A

inflamed renal parenchyma & collecting system

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20
Q

cystitis meaning

A

inflammation of bladder

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21
Q

urethritis meaning

A

urethra inflammation

22
Q

name 1 urinary tract analgesic

A

pyridium (Phenazopyridine)

23
Q

what does cranberry juice do

A

prevents attachment of pathogens to bladder wall

24
Q

what is renal colic

A

sudden acute pain in kidneys from obstruction of urine flow from kidneys to bladder

25
Q

signs of renal colic

A

sharp, severe pain in lower back and can radiate to groin
can have hematuria

26
Q

how does urine pH help diagnose renal calculi

A

acidic - uric acid/cystine stones
alkaline - calcium phosphate stones

27
Q

treatment of renal calculi

A

3-4 L water a day minimum (ideally want 2L urine output per day)
most will pass unless larger than 4mm

28
Q

teaching for post-op lithotripsy (stent)

A

hematuria for several days, bruising or discomfort to back/abdomen
avoid aspirin or anti-coagulant drugs
will have discomfort from more stones passing

29
Q

nurse interventions for any post-operation

A

encourage fluids, movement
strain all urine & check urine pH
pain management
change in diet

30
Q

what foods to avoid for renal calculi

A

avoid high purine foods such as red meat, organ meats, alcohol, sardines/anchovies/shellfish

31
Q

3 phases of acute renal failure

A
  • oliguric-anuric
  • diuretic
  • recovery
32
Q

causes of prerenal failure

A

hypotension or poor blood flow to kidneys secondary to other source

33
Q

causes of intrarenal failure

A

inflammation, drugs, infection, decreased blood flow to kidneys

34
Q

causes of postrenal failure

A

sudden urine obstruction from enlarged prostate
kidney stones
bladder tumor
or injury

35
Q

what labs can be expected from oliguric-anuric stage of ARF (acute renal failure)

A
  • 1-7 days
  • increased BUN, creatinine
  • decreased urine output, possible fluid overload (hypervolemia) leading to decreased Hgb, Hct, RBC count
  • changes in electrolytes: hyperkalemia, hyponatremia
  • metabolic acidosis
  • fatigue/malaise
36
Q

what precautions should oliguric stage of acute renal failure should a pt be placed on

A

seizure precautions - low Na
pulmonary edema - hypervolemia
risk for growth disturbance - lack of appetite, disturbance to diet

37
Q

what is happening anatomically during oliguric-anuric stage of ARF

A
  • renal tubule damage leading to decreased urine output
38
Q

what happens anatomically during diuretic phase of ARF

A
  • kidneys attempt to heal but results in damage or scarring
  • increased GFR, daily urine ideally over 400ml, poss electrolyte imbalance still
  • creatinine/BUN still elevated
  • poss anemia: kidneys make erythropoietin
  • dehydration/hypovolemia
39
Q

what happens anatomically during recovery phase of ARF

A
  • can take months to yrs
  • decreased edema
  • renal fxn improves
40
Q

signs and symptoms of ARF

A

fluid build up/edema
chest pain
muscle weakness

41
Q

interventions for ARF

A

surgery
meds
nutrition
dialysis

42
Q

what is differential diagnosis?

A

other diagnosis besides the first thing you can think of/relate it to

43
Q

what 3 factors are the most important to look at for a urine dipstick

A

nitrates
blood
leukocyte esterase

44
Q

what is normal GFR

A

less than 60

45
Q

what abx to use for UTI

A

fluoroquinolone - ciprofloxacin
sulfonamide - TMP-SMX (septra)
nitrofurantoin
bactrim

46
Q

contraindication for hemodialysis

A

hemophilia (major bleed risk)

47
Q

what to do when a kidney pt has hyperkalemia

A

infuse regular insulin with D10W or D20W to get K into cells and sugar to prevent hypoglycemia

48
Q

normal urine pH

A

4.5 -8.0 okay

49
Q

WBC normal range

A

4,000 - 12,000

50
Q

normal Hct range

A

35-50

51
Q

when is shockwave delivered with extracorporeal shock wave lithotripsy (ESWL)

A

ECG placed and shockwave synced to R wave

52
Q

rapid decrease in fluid post hemodialysis can cause what

A

seizures from cerebral edema, and increased intracranial pressure

NURS122 (28 decks)

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