MIDTERMS: QUIZ 2 RESPONSES TO ALTERED ELIMINATION Flashcards
Inquire about other family members with
renal and/or urinary tract malformations.
Ask about family history of kidney disease
with onset in
third to fifth decade
Identify family history of male
infertility and
cystic fibrosis
Be alert for family members with history of
early-onset renal
(Wilms’ tumor) or other
cancers.
is a “snapshot” assessment of
patient urine at one point in time
➢ The urinalysis is a valuable
screening tool for urinary tract
infections, kidney diseases, and
other conditions.
Urinalysis
This is to know how much urine the
body is producing in a day or how
much of a particular substance is
eliminated in a day
24-urine collection
INSTRUCTIONS FOR COLLECTION OF A 24-HOUR URINE
TEST FORM
This is the end of the collection. Record the
end time on the container label as “Date and Time
Completed.”
This non-invasive diagnostic exam uses
sound waves to create images of the
kidney(s)
can assess the
size, location and shape of the kidneys,
ureters and bladder.
Renal ultrasound
Renal ultrasound
Preparations
Drink a minimum of 24 ounces of clear
fluid at least one hour before the appointment. Do not
empty the bladder prior to the procedure.
❖ No Fasting or sedation
refers to a series of X-rays taken of the
kidneys, their collecting or drainage system
(the ureters), and the bladder.
➢ is commonly done to identify diseases of the
urinary tract, such as kidney stones, tumors,
or infection.
Serum studies intravenous pyelography
Serum studies intravenous pyelography
Prep
❖ Inform your physician if there are any allergies,
especially to iodinated contrast materials.
❖ Those with diabetes who are taking metformin
(Glucophage) will have to discontinue this medication
prior to and for 2 days after the IVP
NURSING DIAGNOSES
★ Fluid volume excess related to decreased glomerular
filtration rate and sodium retention
★ Risk for infection related to alterations in the immune
system and host defenses
is the syndrome in which glomerular filtration
declines abruptly from hours to days and is
usually reversible.
Acute Renal Failure
Acute Renal Failure
The main causes are:
➢ Not enough blood flow to the kidneys
➢ Direct damage to the kidneys
➢ Urine backed up in the kidneys
is a condition involving a decrease in the
kidneys’ ability to filter waste and fluid from
the blood.
➢ It is chronic, meaning that the condition
develops over a long period of time and is
not reversible.
Chronic Renal failure
Chronic Renal failure
Those things can happen when:
● Diabetes (types 1 and 2)
● High blood pressure
● Immune system diseases (lupus nephritis)
● Drugs and toxins
➢ also referred to as fluid replacement
➢ this fluids are administered to improve
cardiac and tissue oxygenation, which in part
depends on flow
Fluid resuscitation
Two classes of Intravenous solutions:
Crystalloids
Colloids
- which are solutions of electrolytes in water
that cross freely from the vascular space into
the interstitium - are the most commonly administered
intravenous fluid.
Crystalloids examples
EX: PNSS, PLR
Colloids EXAMPLE
EX: human plasma (albumin) and
semisynthetic colloids (starches,
gelatins, and dextrans).
the inside lining of patient own belly acts as
a natural filter. Wastes are taken out by
means of a cleansing fluid called
dialysate,
the inside lining of patient own belly acts as
a natural filter. Wastes are taken out by
means of a cleansing fluid called dialysate,
which is washed in and out of patient belly in
cycles.
➢ This process usually is done three, four or
five times in a 24-hour period while patient
are awake during normal activities. Ea
Peritoneal dialysis
This process usually is done in? what hours
Peritoneal dialysis
three, four or
five times in a 24-hour period
Two kinds of peritoneal dialysis:
Continuous Ambulatory Peritoneal Dialysis
(CAPD)
Automated Peritoneal Dialysis (APD)
➢is “continuous,” machine-free and done
while patient go about their normal activities
such as work or school.
➢ This is done by hooking up a plastic bag of
cleansing fluid to the tube in their belly.
Continuous Ambulatory Peritoneal Dialysis
(CAPD)
The CAPD patients need to do
4 exchanges
per day
➢ A machine (cycler) delivers and then drains the
cleansing fluid automatically. The treatment usually is
done at night while patient’s sleep.
Automated Peritoneal Dialysis (APD)
Automated Peritoneal Dialysis (APD)
Machine has 3 main function:
➔ Heat PD fluid to body temperature
➔ Controls time of exchange and
amount of fluid used
➔ Monitor treatment safety alarm
is a treatment to filter wastes and water from
patient’s blood, as the patient kidneys did
when they were healthy.
Hemodialysis
Three types of entrance points are: Hemodialysis
Arteriovenous (AV) fistula
AV Graft
Vascular Acces Catheter
this type connects an
artery and a vein. Healing time after surgery: 6-8
weeks to mature.
Arteriovenous (AV) fistula
This type is a looped tube. Healing time
after surgery: 2-3 weeks
AV graft
this may be inserted into
the large vein in your neck. Healing time after surgery:
Ready for immediate use after placement—not
recommended unless medically necessary
Vascular access catheter
To ensure patency, palpate for a thrill or auscultate for a
bruit over the fistula or graft. Notify the HCP if a
a thrill or
bruit is absent
➢ is a special type of dialysis that we do for
unstable patients in the ICU whose bodies
cannot tolerate regular dialysis.
➢ is a slower type of dialysis that puts less
stress on the heart.
Continuous Renal Replacement Therapy (CRRT)
CRRT is done
e 24 hours a day to slowly and
continuously clean out waste products and
fluid from the patient.
It requires special anticoagulation to keep
the dialysis circuit from clotting.
Continuous Renal Replacement Therapy (CRRT)
refers to the practice of limiting the intake of
electrolytes.
➢___________ are minerals that carry an
electric charge and are found in your blood,
urine, and sweat.
Electrolytes Restriction
Electrolytes
Normal Sodium
135 and 145 milliequivalents per liter
(mEq/L)
Normal levels of potassium range from
m 3.5 mmol/L to 5.1
mmol/L in adults
Normal adult value for magnesium is
1.5-2.5 mEq/L
Total blood calcium
: 8.5 to 10.5 milligrams per deciliter (mg/dL)
means that patient can only have a certain
amount of liquid each day.
➢____________ 800-1000 ml/day
Fluid restriction
Common medical conditions and associated symptoms
requiring fluid restriction are listed below:
● Heart problems
● Kidney problems
● Endocrine System and Adrenal gland disorders
● Conditions that cause the release of stress hormones
● Treatment with medications called corticosteroids
● Low levels of Sodium in your body (Hyponatremia)
They help fuel the brain, kidneys, heart
muscles, and central nervous system
High CHO Diet
, also known as starches and sugars.
Carbohydrates
r is stored in the liver and muscles as glycogen
Sugar
Take sports drinks, gels, or bars, fruit, or hard or
chewy candies during the event at the rate of
of 30 to 60
grams qh or 2h
are one type of dietary supplement. They are
sold as tablets, capsules, powders, teas,
extracts, and fresh or dried plants
Halamang Gamot
The FDA considers herbal supplements foods, not
drugs
CLIENT EDUCATION
Signs & Symptoms of infection
● Fluid intake ( if no restrictions 2-5 L/day )
● Perineal hygiene
● Meds. & side effects on urination, color, and volume
REPORTING AND DOCUMENTATION OF CARE
Encourage the patient to drink
2-3L of fluid a day
(Dougherty and Lister, 2015). –if not restricted
Ask the patient to observe for any signs of _______ and report these immediately.
voiding
difficulties
