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KN JD NPTE: OTHER SYSTEMS > OTH: Renal/Urological > Flashcards

OTH: Renal/Urological Flashcards

1
Q

Lower UTI

2 areas of inflammation/infection

A

Cystitis: inflammation/infection of bladder
Urethritis: inflammation/infection of urethra

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2
Q

Lower UTI usually secondary to ____ ____, may also involve ___ and ___

A

Ascending UTI

Kidneys, ureters

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3
Q

Lower UTI: associated with symptoms of urinary ___ and ___, sensation of ___ with urination. What is appearance/characteristic of urine? Where is pain noted?

A

Frequency, urgency
Burning
Cloudy, foul smelling
Pain in suprapubic, lower abdominal, or groin

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4
Q

Upper UTI is called ? Associated with?

A

pyelonephritis: inflammation/infection of 1 or both kidneys

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5
Q

Upper UTI: symptoms?

A

Systemic:
Fever, chills, malaise, headache, tenderness and pain over kidneys, tenderness over costovertebral angle, frequent and burning urination, N+V may occur

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6
Q

What is Murphy’s sign? Associated with what condition?

A

Pain/tenderness over costovertebral angle

Upper UTI

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7
Q

Upper UTI: where else may pain be located?

A

Over kidneys on palpation/percussion

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8
Q

Which is more serious: Upper or Lower UTI

A

Upper UTI

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9
Q

Increased risk of UTI in persons with ? (5)

What population has increased risk?

A
  1. Autoimmunity
  2. Urinary obstruction and reflux
  3. Neurogenic bladder and catheterization
  4. DM
  5. Kidney transplant
    — older adults and women
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10
Q

What is renal cystic disease? What can it lead to?

A

Renal cysts are fluid-filled cavities that form along the nephron
—> can lead to renal degeneration or obstruction

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11
Q

What are the types of renal cystic disease? (5)

A
  1. Polycystic
  2. Medullary
  3. Sponge
  4. Acquired
  5. Simple
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12
Q

Symptoms of renal cysts include? (3, possibly 4)

Which type are typically asymptomatic?

A
  1. Pain
  2. Hematuria (from ruptured cysts)
  3. HTN
    (4. Fever associated with infection)

—Simple typically asymptomatic

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13
Q

Obstructive disorders include: (6)

A
  1. Developmental defects
  2. Renal calculi
  3. Prostatic hyperplasia or cancer
  4. Scar tissue from inflammation
  5. Tumors
  6. Infection
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14
Q

What are renal calculi?

A

Kidney stones: formed from normal components of urine (calcium, magnesium, etc.)

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15
Q

Symptoms of kidney stones? Where does pain radiate?

A

Renal colic pain (pain from stone lodged in ureter worse by stretching the collecting system), radiating to lower abdominal quadrant, bladder area, perineal area.
N+V are common, skin may be cool and clammy

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16
Q

Tx for kidney stones?

A

Extracorporeal shock wave lithotripsy (ESWL)

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17
Q

Tx for kidney stones?

A
  1. Increase fluid intake
  2. Thiazides diuretics
  3. Restriction of foods high in oxalate
  4. acidification or alkalination of urine depending on type of stone.
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18
Q

Acute Kidney Failure: Sudden loss of kidney function with resulting elevation in serum __ and __

A

Urea

Creatinine

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19
Q

Chronic renal failure is progressive loss of kidney fxn leading to ?

A

End-stage kidney failure

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20
Q

What does chronic renal failure result from?

A
  1. Prolonged acute urinary tract obstruction and infection
  2. DM
  3. SLE
  4. Uncontrolled HTN
21
Q

What is uremia?

Symptoms are?

A

End-stage toxic condition resulting from renal insufficiency and retention of nitrogenous wastes in blood
Sx: anorexia, nausea, mental confusion

22
Q

Chronic renal failure: RED FLAGS

  1. Dizziness, headaches, ____ (psych), memory loss, inability to ____, ____ (muscle action), ____ (LOC)
  2. ___ (BP), DOE, HF
  3. Chronic pain: where?
  4. Edema: where?
  5. Muscle weakness: peripheral ___, cramping, restless __
  6. Skeletal: osteo___, osteo___, bone pain, fx
  7. Skin: ___ (color), ecchymosis, pruritis, ___ (clammy or dry?)
  8. ___, tendency to bleed easily
  9. Decreased endurance
  10. ANS dysfunction: (3) what?
A
  1. Anxiety, Concentrate, Convulsions ,Coma
  2. HTN
  3. Ischemic leg pain, painful cramps
  4. Pulmonary and peripheral
  5. Neuropathy, legs
  6. Osteomalacia, osteoporosis
  7. Pallor, dry
  8. Anemia
  9. —
  10. Decreased HR/BP, orthostatic hypotension
23
Q

Process of diffusing blood across semipermeable membrane for purposes of removal of toxic substances; maintains fluid, electrolyte, and acid-base balance in presence of renal failure; peritoneal or renal (?)

A

Dialysis

hemodialysis

24
Q

Symptoms of nausea, vomiting, drowsiness, headache, seizures- result of rapid changes after beginning procedure

A

Dialysis disequilibrium

25
Q

Signs of cerebral dysfunction (speech difficulties, mental confusion, myoclonus, seizures, death) — what does this result from and what is condition?

A

From prolonged years of dialysis

Dialysis dementia

26
Q

Contraindication of dialysis

A

taking BP at the shunt

27
Q

Locate peritoneal catheters if used— what do you have to be aware of?

A

Avoid trauma to area

28
Q

What should you examine with dialysis?

A

For multisystem dysfunction: vital signs, strength, sensation, ROM, function, endurance

29
Q

What is stress incontinence?

A

Sudden release of urine due to increase in intra-abdominal pressure

30
Q

With stress incontinence, weakness/laxity of ___ and __. Examples? (3 listed)

A

Pelvic floor musculature, sphincter weakness

  1. Postpartum incontinence
  2. Menopause
  3. Damage to pudendal nerve
31
Q

Urge incontinence?

A

Bladder begins contracting and urine is leaked after sensation of bladder fullness is perceived; inability to delay voiding to reach toilet

32
Q

What is urge incontinence a result of?

A

Detrusor muscle instability or hyperreflexia, sensory instability (hypersensitive bladder)

33
Q

What is overflow incontinence?

A

Bladder continuously leaks secondary to urinary retention (overdistended bladder or incomplete emptying of bladder)

34
Q

Cause of overflow incontinence? (3) and what are examples of each cause?

A 
Anatomical obstruction (prostate enlargement)
Acontractile bladder (SCI, DM)
Neurogenic bladder (MS, suprasacral spinal lesions)
35
Q

Functional incontinence?

A

Leakage associated with inability or unwillingness to toilet

36
Q

What is functional incontinence caused by?

A
  1. Impaired cognition (dementia); depression
  2. Impaired physical functioning (stroke)
  3. Environmental barriers
37
Q

What is mixed incontinence?

A

Usually combination of stress and urge

38
Q

Catheter may be indicated for what type of incontinence? What are complications?

A

Overflow

Possible skin integrity concerns, UTIs common

39
Q

Surgery for incontinence?

A

Bladder neck suspension, removal of prostate obstruction, suprapubic cystostomy

40
Q

Bladder training is? May involve what methods?

A

Prompted voiding to restore a pattern of voiding

  1. Toileting schedule (regular intervals)
  2. Intermittent catheterization
41
Q

Examination for incontinence includes?

A
  1. Identify symptoms: onset, duration, urgency, frequency, timing
  2. Strength of pelvic floor muscles using perineometer
  3. Fxn mobility, environmental factors
42
Q

PT interventions for what type of incontinence?

A

Stress, urge

43
Q

Pelvic floor muscle exercises target what muscle? (For stress incontinence)

A

Pubococcygeus muscle

44
Q

How do you teach Kegels?

Type 1 vs 2

A

Type 1: holding contractions, progressing to 10-second holds, rest 10 seconds between
Type 2: quick contractions to shut off flow of urine, 10-80 reps/day

45
Q

Incontinence tx: FES used for muscle re-ed if pt is unable to ___ ___ ___

A

Initiate active contractions

46
Q

Incontinence tx: Biofeedback: uses __ __ to reinforce active contractions, ___ bladder

A

Pressure recordings

Relax

47
Q

Progressive strengthening: use of weighted ___ ___ (lol) for HEP or pelvic floor exercises

A

Vag cones

48
Q

Provide behavioral training— record keeping/voiding diary, education about anatomy, reasons for weakness/incontinence… avoid ___, and ___ exercises. Functional mobility training, ensure independence, environmental modifications, maintain adequate __ __ and teach __ __ /hygiene strategies.

A

Valsalva, heavy resistance

Skin care, skin care

KN JD NPTE: OTHER SYSTEMS (12 decks)

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