Mod 2 Flashcards
What is overflow incontinece?
Involuntary urine loss associated with overdistention of the bladder
In older adults over 60 year how much residual urine may remain after voiding and why?
50- 100 mls because of decreased contractility of the detrusor muscles
What is urinary suppression?
When the kidney aren’t functioning properly and making urine
How do you determine post void residual PVR?
Straight catheter
Bladder scan
Tenesmus
Painful to void seen in UTIs
Anuria is an urine output less the what?
50 mls
Acute and chronic renal failure
At what age should enuresis stop?
5 years old
What are the FVD manifestations and intervention?
Manifestation: acute weight loss 5%, decreased skin turgor, dry mucous membranes, oliguria or anuria, increased hematocrit, BUN, hypothermia
Intervention: fluid challenge, fluid replacement
What are the FVE manifestations and intervention?
Manifestation: acute weight gain, edema, crackles, sob, decreased BUN, decreased hematocrit, distended neck veins
Intervention: fluid and sodium restrictions, diuretic, dialysis
What are the Sodium deficit manifestations and intervention?
Manifestation: Nausea, malaise,lethargy, headache, abdominal cramps,seizures
Intervention: diet, normal saline, hypertonic saline
What are the Sodium excess manifestations and intervention?
Manifestation: dry sticky mucous membranes, thirst, rough dry tongue, fever, restlessness
Intervention: fluid, diuretic agent, dietary restrictions
What are the Potassium deficit manifestations and intervention?
Anorexia, abdominal distention, paralytic ileum, muscle weakness, ECG changes, dysthymias
Intervention: diet, oral or parenteral potassium replacement therapy
What are the Potassium excess manifestations and intervention?
Manifestation: diarrhea, colic, nausea, irritability, muscle weakness, ECG changes
Intervention: dietary restrictions, diuretics, IV glucose, insulin and sodium bicarbonate, cation exchange resin, calcium gluconate, dialysis
What are the Calcium deficit manifestations and intervention?
Manifestation: abdominal and muscle cramps, stridor, carpopedal spasms, hyperactive reflexes, tetany, positive chvostek’s or trousseau sign, tingling or the fingers and around the mouth
Intervention: diet, oral or parenteral calcium salt replacement
What are the Calcium excess manifestations and intervention?
Manifestation: deep bone pain, flank pain, muscle weakness, depressed deep tendon reflexes, constipation, nausea and vomiting, confusion, impaired, impaired memory, polyuria, polydipsia,ECG change
Intervention: fluid replacement, etidronate, pamidronate, mithramycin, calcitonin, glucorticoids, phosphate salt
What is urinary retention?
It is the inability to empty the bladder completely during attempts to void
What is iatrogenic urinary incontinece?
Involuntary urine loss due to medical factors such as medication like BP meds
What are intervention for urinary incontinece?
Fluid management
Times voiding
Bladder training
Pelvic muscles exercises
What is a superpubic catheter?
It is a catheter inserted through the abdominal wall above the pubis and secured with sutures or tape
Is intermittent self catheterization a sterile procedure if some at home?
No the client dose this at home they will need to wash hand and the urinary meatus with warm water/ anti bacterial soap
When educating the patient on intermittent self catheterization what should the nurses emphasize?
The importance of frequent catheterization and emptying the bladder at the prescribed time ( every 4-6 hours)
What does retro peritoneal mean?
Behind the peritoneal
What is the only nonsterile part of the urinary system?
Urinary meatus
What two substance are not normally found in the urine?
Glucose and amino acids (proteins)
At what level will glucose appear in the urine?
Blood glucose of 180
If protein appears in the urine what can you assume?
That there is damage to the glomeruli because protein molecules are to large to be filtered at the glomeruli
What might be the cause of urine is blue, blue green?
Dyes, methylene use during procedures
What could be the cause of urine that is orange to Amber?
Phenazopyridine used to relieve pain during urination UTI
What major role do the kidneys play?
B/p regulation, acid base regulation, elec excretions
What is the normal BUN?
11-23 mg/ 100 ml
What does the body use amino acids for?
Rebuilding/ fuel
negative does the body use nitrogenous for?
Nothing it’s waste
Urea nitrogen is the end product of what?
Protein metabolism
When you are looking for a kidney function test is BUN a good choice?
No because increased BUN can be caused by something other than kidney disfunction
Low profusion pressure (shock)
volume depletion
Increased catabolic process
BUN levels must be examined with serum creatinine levels
What is normal creatinine levels?
0.6 to 1.2 mg/ml
Most sensitive measure of renal function
What is unaffected by diet and fluid intake?
Creatinine
What is the normal BUN to creatinine ratio?
20:1
Dullness to percussion of the bladder after voiding indicates what?
Incomplete bladder emptying
What will need to be done to preform a IVP intravenous pyelogram?
-Obtain a patient history
- history of allergies- if patient has a positive history a test dose is given intruder ally if there is no reaction in 15 min the IV does is given
- iodine or shellfish
- restless, apprehensive, wheezing
ANAPHYLACTOID REACTION
-inform patient they may feel warmth, flushing in the face And unusual flavor
What are the emergency drugs need to treat anaphylactic reaction?
Epinephrine, corticosteroids and vasopreseors, antihistamines, bronchodilator as well as o2 equipment
What dose a KUB kidney, ureter, bladder do?
It is an X-Ray of the abdomen to determine size, shape and position of the kidneys to reveal any abnormalities
How does the IVP work?
Allows visualization of the renal perenchyma, calices and pelvis as well as the ureter, bladder and urethra following a contract medium it is used to diagnose lesion of the kidneys and ureters and a rough estimate of renal fiction
How is the retrograde pyelography used?
This allows radiographic examination of the renal collecting system after injection of contrast medium through a urethral catheter
