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Health Promotion > Kidneys and UTIS > Flashcards

Kidneys and UTIS Flashcards

1
Q

Norm level for BUN and Creatine

A

BUN 7-18

Creatinine 0.6-1.2

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2
Q

Normal Hematocrit MEN and Woment

A

Men 38.8-50

Women 34.9-44.5

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3
Q

Normal Postassium, Sodium, Calcium Levels

A

K 3.5

NA 135-145

CA 8.6

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4
Q

What is the Proper name for Kidney Stones

A

Urolithiasis/ Urinary-Renal Calculi

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5
Q

Kidney Stones are made up of what, And what are some causes of them

A

Calcium Oxalate

Dietary Factors, High Doeses of Vit D, Intestinal Bypass.

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6
Q

Oxalate is found in foods, what are some foods to avoid if you have regular kidney stones to decrease your oxalate levels

A

Nuts, Chocolate, Some fruits and Veggies

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7
Q

What Med might your MD prescribe to Prevent Calicum Stones?

A

A thiazide Diurectic or a Phospate-containing preperation.

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8
Q

Uric acid Stones(GOUT). Your MD may prescribe Zylopirm or Aloprim to treat. What is the generic name for these meds

A

(allopurinaol)

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9
Q

What is a major factor to monitor if a person is developing stones

A

Persons should avoid large intakes of protiens.

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10
Q

Prevention Techniques for Stones

A

Drink Plenty of Water (2-3 Liters) per day

Eat fewer oxalate foods( Rhubarb, beets, okra, spinach, sweet potatoes, nuts, black tea, chocolate, soy)

Diet low in salt

Eat calcium rich foods, but avoid calcium supplements

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11
Q

Clinical Manifestations of Renal Calculi

A

Pain( Severe)

Nausea

Vomiting

Fever

Hematuria

Bladder Distention

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12
Q

Diagnostic Tests For Renal Calculi

A

KUB (xray of Kidneys ureturs and bladder)

IVP( Intravenous Pyelogram) Detremines size and location of stones

Renal Ultrasound reveals obstructions

UA(urianalysis) will reveal issues in urine(blood, odor, turbitity)

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13
Q

Treatment for Stones

A

Analgesia(VIP) Opoids, then NSAIDS/Tylenol(avoid nsaids if pt is to have lithotripsy due to platelet/bleeding)

HYDRATION (2-3 L/day)

Urine straining(24-48 hours)

Minimally invasive surgical procedures may include Stenting nephroliotomy

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14
Q

What is a Nephrolithotomy

A

nephrolithotomy (PCNL) is a minimally-invasive procedure to remove stones from the kidney by a small puncture wound (up to about 1 cm) through the skin. It is most suitable to remove stones of more than 2 cm in size and which are present near the pelvic region.

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15
Q

What are the two types or Urinary tract infections

A

Upper or Pyelonephritis (kidneys) Ureters (Ureteritis).

Lower which consist of the bladder(cystitis) and urethra (urethraitis)

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16
Q

Name some risk factors for UTI’s in everyone.

A

Incomplete emptying of bladder

Obstructed urinary flow from Cogentical abnorms

Intruments being placed in system

Diabetes(due to increased urine glucose)

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17
Q

Some Elderly risk factors for UTI include

A

Frequent use of antimicrobials

immuno compromised

cognetive imparment leading to poor hygine

Immobility and imcomplete emptying of bladder

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18
Q

Routes of infection include

A

Transurethral (ascending) MOST COMMON

Bloodstream(hematogenous spread)

Fistulas from the intestine(direct extension)

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19
Q

Most common organism to cause UTI

A

E. Coli

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20
Q

Upper UTI’s Clinical Manifestations

A

Acutely ill, chills, fever, low back pain, flank pain, n/v.

Physical exam reveals Pain and tenderness in the area of the constovertebral angle

21
Q

Lower UTI SYS

A

Inablility to urinate despite urge, Frequent need to urinate(polyuria), painful urination(dysuria) Suprapubic or pelvic pain.

22
Q

Lower UTIS elderly. Elderly often lack s/s of UTI and Sepsis. although frequency and urgency may occur, non specific s/s may also occur these include:

A

Altered senses, lethargy, anorexia, new incontinece, hyperventialation, and lowgrade fevers.

23
Q

Uncomplicated UTIS Lower or upper are

A

Generally cured with one antibiotic, a commuinity accquired infection, common in young women, and not usually recurent

24
Q

Complicated UTIS are:

A

Often Nosocomial due to catherters and are regularly recurent

occur in pts with abnormalities of renal sys

pregnacy

immunosupressed pts

diabetes

obstructions (ie Prostate)

MAY NEED Culture and Sensativity and MULTIPLE antibiotics

25
Q

Tests done to determine UTI’s

A

U/A, urine culture(C+S)

Presence of Nitrates and leukocytes in urine,

CT Scans, ultrasound, iv Pyelogram for uppers

cystoscopy for lower

26
Q

Drugs Commonly used for Uncomplicated UTIS

A

Sulfamethoxazole-trimethoprim(Bactrim) Usually first offered.

Amoxicillin

ampicillin

Cipro

Levoflaxacin

27
Q

Analgesic used with UTI

A

Phenazopyridine(pyridium) relieves pain and burning turns urine orange

28
Q

Medications for Upper UTI (yelonephritis)

A

IV or PO cipro

IV cefriaxon(rocephin)

IV amnioglycociedes(may be nephrotoxic)

Mycin’s(Tobra, genta, neo)

These have a longer course of tx

29
Q

Prevention is key, name some ways to prevent UTI in catherterized pts

A

strict aseptic techinique when inserting

using smallest cath possible

securing cath to avoid movement

frequent inspection of urine

Meticulous daily cleaning

30
Q

Prevetion of UTI’s In non cathed pts includes

A

avoid products that irritate urethra

cleanse before intercourse

change soild diapers promptly

Increased fluid consumption

Do not routienley resist urge to urinate

take showers instead of baths

urinated after intercourse

Wipe from front to back

31
Q

Functions of the Kidney include

A

Regulation of Water, electrolyte function, acid base balance, blood pressure, and RBCs as well as Vit D synthesis

Blood pressure is regulated with renin-angio-aldos-sys

RBC’s regulated by Erthropoetin secretion

Caclium is not metabolized if Vit D is down

32
Q

What medication would you give if the Kidneys were not properly regulating the RBC’s in the body. What precautions may be needed

A

Epogin or procrit which stimulates Erythropoesis( Rbc production)

With Epogin Seziure precautions may be needed

33
Q

There are three types of diuretics, what are then and where do they function

A

Manitols(Very strong) first part of nephrons K depleting

Loop Diuretics(furosomide) In the loops K depleting

aldosterones after loops K sparing

34
Q

What are the hormones that affect renal function

A

Renin- Raises BP so blood in Glomerous

Erthopoietin

Anti Diuretic Hormone (ADH)

Aldosterone- Promotes NA reabsorbtion and K excretion

Natriuretic hormones released from the Cardiac atria and Brain

35
Q

Due to hormone actions some meds are used to protect the kidneys these may be

A

Ace inhibitors to decrease blood pressure.

36
Q

Pre-renal problems are treated-

and is what type of problem-

Inter-renal problems are treated-

and is what type of problem-

A

Before the Kidneys( ie blood systems)

Usually a volume or horomone problem

Inter renal is within the kidneys

Generally a structure or nephron problem, can be made worse by nephrotoxins or metabolites

37
Q

What is the normal GFR

A

125 ml/min

38
Q

There are five stages for Kidney disease they are characterized by GFR what are they and there ranges

39
Q

After 40 how much does GFR decline

A

about 1 ml/min per year

40
Q

What is the number 1 cause of CKD

A

Diabetes

41
Q

Elderly considerations for the kidneys

A

Decrease in GFT, Multiple medications can become toxic metabolites, Dimished sense of thirst increasing risk of dehydration, Urinary issues that can lead to infectious damage

42
Q

Renal Function TESTS ***MUST KNOW***

A

Urine osmolarity changes can be seen in early stages which results in decrease concentration of urine

Creatinine clearance- amount of creatinine cleared in one min reflects GFR

Serum Creatinine levels should be between 0.6-1.2 this is a prime measure of renal effectiveness

BUN is also a funtion test but is not as accurate, should be between 7-18

43
Q

Why is BUN obtained

A

Liver function is key to proper renal function. The liver produces nitrates, BUN measure the amount in the blood, if it is elevated, the kidneys are not processing it out which is an indication of a problem

44
Q

Urine Specific Gravity is the concentration of urine. This correlates with Osmolarity how does this relate to volume

A

More fluid lower concentration, less fluid more concetrated..by fluid I mean preload fluid

45
Q

Creatinine Clearance

A

is calcuated by GFR over 24 hours where at the midway point a serum Creatinine level is taken then a calcuation is completed.

(Volume of urine x urine creatinine)

Serum Creatinine

46
Q

Factors that can give elevated BUN levels not related to Kidney issues include

A

Dehydration, Low blood volume, Low BP

when these occure BUN raises more rapidly then Creatinine

Creatinine and BUN should be similar in ration and proportion otherwise it is most likely a volume not kidney issue

47
Q

Kidneys can be images to diagnose issues these tests include..

What drug may need to be held

A

KUB

Ultrasound(most common)

CT/MRI

Nuclear Scans

IV Urography, pt must be NPO and get Bowel Prep(this is nephrotoxic)

HOLD METFORMIN IF DIES ARE NEEDED FOR 48 hours pre testing

48
Q

Kidneys can be treated with scope procedures they include

A

Cystoscopy

Ureteral brush biopsy

kidney biopsy

49
Q
A

Health Promotion (14 decks)

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