Med

Question 1

Radiologic study to evaluate structure, function of KUB

Using radiographs and radiopaque dye

Force fluids after to excrete dye

Answer 1

Intravenous pyelography

Question 2

Visualization of complete ureter, renal pelvis needed.

Performed during cystoscopy

Carries risk of sepsis, severe UTI

Answer 2

Retrograde pyelography

Question 3

Evaluates the bladder structure abnormalities, filling.

Answer 3

Cystogram

Question 4

Rapid series of x rays while voiding

Contradicted in UTI

Answer 4

Voiding cystourethrography

Question 5

Evaluate bladder, renal function, assess cause of reduced urinary flow, urinary retention or incontinence.

Uroflowmetry, cystometrography

Answer 5

Urodynamic studies

Question 6

BUN normal range

Answer 6

7-20

Question 7

GFR normal range

Answer 7

90 or greater

Question 8

Inflammation in glomeruli believed to be from antigen antibody stimulation in the glomerular membrane which changes the membrane permeability. More common in males

More common in children and young adults.

Proceeded by strep or viral inf

Answer 8

Acute glomerulonephriris/ Bright’s disease

Question 9

Hematuria and proteinuria is a S/S of

Answer 9

Acute glomerularnephritis/Brights disease

Question 10

How do you dx acute glomerularnephritis/brights disease

Answer 10

Proteinuria

Elevated ASO titer

Percutaneous renal biopsy

Question 11

Tx for acute glomerularnephritis/Bright’s disease

Answer 11

Tx SS

Bed rest until BUN decreases and hematuria decreases

Low sodium diet and dec fluids if needed

Diuretics/ antihypertensives/ steroids

i&O and weights

Question 12

Nursing care for acute glomerularnephritis/ Bright’s disease

Answer 12

Inc urine output and dec wt means patient is improving.

VS monitor BP

Sodium and protein diet restriction

BR

Pt not cured till urine free of protein and RBC for 6 mo

Question 13

Causes of ____ ____ causes are autoimmune connective tissue disorders (lupus) resulting in scar tissue that replaces nephrons and may progress in renal failure

Slow progressive disease in which there is inflammation of the glomeruli that causes irreversible damage to nephrons

Answer 13

Chronic glomerulonephritis

Question 14

S/S of ___ ___ may not have SS for years

Anasarca- which is caused by a fluid shift and protein (albumin) is lost in urine.

Ss of renal failure

DX- dec RBC
Azotemia- nitrogenous waste in blood
Protein and casts in urine
Early stages percutaneous kidney bx

TX: symptomatic
Dec edema, and bp
Prevent CHF, correct fluid and electrolyte prob, eliminate UTI
May eventually require dialysis or kidney transplant

Answer 14

Chronic glomerulonephritis

Question 15

___ ___ ___ inherited as autosomal dominant trait, infantile (rare) and adult forms, formation of multiple bilateral kidney cysts. They cause kidneys to greatly enlarge as cysts accumulate fluids

*hypertension, pain, colic. Hematuria, renal stones

Dx findings:
Abd US, CT, MRI, IVP, labs

Tx- no cure, tx HTN, *avoid all nephrotoxic meds-nsaids/cephalosporins
Surgical removal of kidney, dialysis, transplant
Monitor BP, I&O and labs

Answer 15

Polycystic renal disease

Question 16

Stones in urinary tract

Answer 16

Urolithiasis

Question 17

Stone in kidneys

Answer 17

Nephrolithiasis

Question 18

Stones in ureters

Answer 18

Ureterlithiasis

Question 19

Chronic ureteral stone formation; compressive congenital anomalies of conditions

S/S flank pain or discomfort, tenderness

DX: voiding cystourethrogram, ultrasonography

Tx: dilation ureteroplasty(remove narrow section of ureter and put good parts together)

Typical post op care, I&O, assess for shock pain SS of UTI

Answer 19

Ureteral stricture

Question 20

___ ___ are typically malignant

*painless hematuria, flank pain, palpable mass.

Tumor cells often metastasize to *lungs, bone, lymph, liver, and brain by way of renal vein and vena cavae

Dx finding/ PE, radiography, IVP, cystoscopy w retrograde pyleogram, ultrasonography, MRI, CT, renal angiography

Med management: nephrectomy; radiation therapy; chemotherapy, palliative tx for metastases
*wilms rumor in children do not palpate

Answer 20

Kidney tumors

Nurse care: discourage laying on operative side, monitor I&O, pain, bleeding. Encourage fluids, irrigate tubes/catheter or ordered

Question 21

___ ___ is the inability of nephrons in kidneys to maintain fluid/electrolyte & acid base balance: excrete waste products and to perform their regulation of body

Acute: ARF, sudden, rapid decrease in renal function

Chronic: CRF, progressive, irreversible, takes years to develop

Answer 21

Renal failure

Question 22

__ ___ ___ develops due to prerenal, intrarenal, and post renal disorders.

Answer 22

Acute renal failure

Question 23

___ ___ ___ usuAlly is caused by intrarenal conditions or systemic diseases

ESRD- less than 10% of kidney function and pt require dialysis. GFR less than 15

Damage to nephrons is slow and often do not notice declining renal function.

Uremia, hyponatremia, electrolyte imbalances-metabolic acidosis, uremic frost-skin acts as excretory organ and precipitation-irritation of skin and smells bad.

Answer 23

Chronic renal failure

SS
H/A blurred vision, 
Tiredness
Inability to concentrate 
Inc BP 
Dec urine output 
Facial puffiness 
Dry itchy skin
Odor of urine

Question 24

Dx of chronic renal failure

Answer 24

Inc BUN, creatine, K, MG, Ph
Dec GFR
Dec CA, RBC, h&h, GFR
blood ph is acidotic
Renal Bx

Tx: prevention
ARF promptly tx cause
Hemodialysis/peritoneal dialysis
Kidney transplant

Medical TX
IV fluids, vasodilator, diuretic, dopamine, temp hemodialysis while tubules regenerate, protein K, NA, ph restriction.
-protein restriction helps decrease urea build up in body. NA polystyrene sulfonate (po/rectal)
IV glucose and insulin to move K back into the cells
Epogen inj- inc o2 compacity of RBC