nephrosclerosis

Question 1

nephrosclerosis

Answer 1

• sclerosis of the small arteries and arterioles of the kidney
• etiology: vascular changes due to malignant hypertension and arteriosclerosiss
• treatment: antihypertensive medications

Question 2

polycystic renal disease

Answer 2

*rare hereditary, recessive disorder
*40 yrs old
*men and women
*both kidneys
CLINCIAL MANIFESTATIONS
*flank pain
*palpable bilateral kidneys
*hematuria
*UTI
*Hypertension
TREATMENT
-nephrectormy/dialysis

Question 3

surgical procedures for urinary problems

Answer 3

Nephrostomy
Nephrectomy
cystectomy
     ileal conduit
     continent division

Question 4

causes of cystectomy w/urinary diversion

Answer 4

• cancer of the bladder
• neurogenic bladder (does not contract)
• congenital anomaolies
• trauma
• chronic infection

Question 5

cystectomy w/urinary diversion types

Answer 5

*heal conduit
   stoma;
*continent division -Koch's pounch
   -section of bowel serves as reservoir
   -self-cath every 4-6 hrs
*Disadvantages
   -uti
   -pylonephritis
   -renal calculi
   -skin problems

Question 6

postoperative management for urinary divisions

Answer 6

*assess color of stoma every shift
*good skin care around the stoma (some mucus
discharge normal
*increase fluids to prevent infections
*avoid odor producing foods: onions, fish, eggs,
cheese and asparagus
*ambulate early to prevent thrombophlebitis
*monitor for paralytic ileus

Question 7

types of urethral caths

Answer 7

*uretheral cath-most common
*suprapubic caths (straight into bladder to drain-
allows urethra to heal after surgery) mostly w/men
*nephrostomy tubes
-temp placement to preserve renal function
-inserted into the pelvis of the kidney

Question 8

straight cath

Answer 8

*for urinary retention
*patient has to empty bladder & then straight cath
(whatever left over is residual retention)

Question 9

3 way cath

Answer 9

*bladder irrigation

Question 10

code cath

Answer 10

used in men with enlarges prostrate (nurses do not pass this cath) you can damage prostrate

Question 11

nursing care of the client with nephrostomy tubes

Answer 11

*urine outpus is measured separately for each tube
every 1-2 hrs
*don’t lay on tube, kink or clamp tube
*do not irrigate tubes without md order
*goes straight into kidneys
* can damage nephrons will get better
*irregate slowly with no more than 5-10 ccs sterile
saline using strict aseptic technique (hurts)
*daily weights
*monitor bun and creatine

Question 12

urinary impotence

Answer 12

*involuntary loss of urine
*causes include:
infection
confusion/depression
meds
restricted mobility
cns disorders - neurogenic bladder
congenital disorders

Question 13

urinary retention

Answer 13

*inability to urinate

causes include:
meds: antihistamines, sedatives, anticholenergics   
           &anesthesia
urethral obstruction
bph
tumors
psychological factors

Question 14

forms of incontinence

Answer 14

*stress (coughing or sneezing)bladder full nothing
wrong
*urge (overactive detrusor muscle (treat w/meds)
*overflow (neuro and obstructive causes) neurogenic
bladder does not contract-it overflows w/urine &
drips out (bladder training)
*reflex: (loss of neuromotor or sensory control)
spasms - treat w/meds
*functional (cognitive impairment) dementia patients
bladder training

Question 15

pharm management of incontinence

Answer 15

*estrogen replacement
*anticholenergics to treat hyperreflex bladders;
probantine, ditropan, bentyl
*cholinergics to treat flaccid bladers:
urecholine, preostigmin
*alpha adrenergic blockers decrease uretheal
resistance: minipress
*ccb to decrease contractions
nifedipine

Question 16

nursing interventions for urinary incontinence

Answer 16

• teach keagel exercises
• crede maneuver
• bladder training program
• apple juice, grape and cranberry juice to prevent uti
• avoid citrus juices

Question 17

nursing diagnosis

Answer 17

• acute pain
• impaired urinary elimination
• risk for infection
• body image disturbed
• ineffective therapeutic regimen management