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Exam 4 Renal NSG 219 > Renal > Flashcards

Renal Flashcards

1
Q

Where are the kidneys located?

A

Retroperineally
T12 and T3

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2
Q

What is the loop of Henle?

A

Reabsorps sodium B water from glomerulus
Produces concentrated urine (dark yellow)

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3
Q

When is renin released?

A

Blood loss
Hypotension
↓ sodium
↑ potassium
↓eCF

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4
Q

What controls voiding?

A

Impulses from brain
T11 and L2
S2 to S4

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5
Q

Aging affects kidneys by

A

Decreases ability to concentrate urine

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6
Q

What do anticoagulants cause?

A

Hematuria

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7
Q

What can Rn check on PA of renal?

A

Distention of bladder

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8
Q

What is a urine analysis?

A

1st morning void
Examine w/in 1st hr

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9
Q

What is a creathine clearance test?

A

24hour urine that determines GFR

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10
Q

What is a urine cytology?

A

Screens for bladder cancer

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11
Q

What is a urodynamic study?

A

‘urinary tract function

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12
Q

What does increased bun indicate?

A

Dehydration
Proteinuria

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13
Q

What is osmolarity of urine?

A

50-1200

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14
Q

What is the ph of urine?

A

4.8 - 8.0

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15
Q

What does UTI does not cause?

A

Increased gravity, BUN and creatinine

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16
Q

What does a u/a look for in CAUTI’S?

A

Nitrates
WBC
Leukocyte esterase

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17
Q

Leukocyte esterase indicates

A

Pyuria

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18
Q

ecoli is resistant to

A

Bactim
Ciprofloxacin

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19
Q

What is the cause of acute pyelonephritis?

A

E. coli
Proteus
Klebsiella
Enterobacter

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20
Q

What are the preexisting factors of acute pyelonephritis?

A

Vesicourteal reflex
Obstruction
Pregnancy
Cystitis

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21
Q

What are obstructions?

A

BPH
Renal calculi
Strictures

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22
Q

What does an u/s identify

A

Hydronephoresis
Renal abscess
Obstructing stones

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23
Q

What does a CT scan?

A

Pyelonephritis
Scarring
Abscess

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24
Q

Why is A CBC taken w/ pyelonephritis?

A

To look for leukocytosis w/ a left shift

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25
Q

What causes an inflamed kidney W) fibrosis and atrophy?

A

Chronic pyelonephritis

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26
Q

What do you test for w/ recurring UTI’S?

A

Chronic pyelonephritis

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27
Q

What is associated w/ urethritis?

A

STD

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28
Q

What meds treat trichomonias?

A

Flagyl and monistat

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29
Q

What med will not treat trichomoniasis?

A

Bacterium

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30
Q

What meds treat monillial infections?

A

Nystatin
Clotrimozale
Fluconazole

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31
Q

What meds treat chlamydia?

A

Doxyclicline
Azithromycin

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32
Q

What causes ic?

A

. Delayed emptying
Sex
Stress
Premenstrual

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33
Q

What causes scarring?

A

Acidic urine

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34
Q

What are hunner lesions?

A

Inflamed bladder wall

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35
Q

What foods increase urine ph?

A

Fruits
Veggies
Non-cheese dairy

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36
Q

What foods decrease ph?

A

Fish
Meat
Cheese

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37
Q

What does OTC prelieffor ic do?

A

Alkalizer urine

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38
Q

What reduces burning and frequency?

A

Tricyclic antidepressants
Amitripityline
Nortriptyline

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39
Q

What does elimeron do for ic?

A

Reduces irritation
Takes weeks-months

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40
Q

What is instilled into the bladder for ic?

A

‘DMSO
Heparin
Lidocaine
Sodium bicarb/ hydraulic acid

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41
Q

What is the surgical intervention for ic?

A

Sacral neuro-modulation / fulguration for hunner lesions
Diversion for illegal conduit

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42
Q

What are the interventions for ic?

A

Log record
Vitamin
Lose clothing

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43
Q

What does glomerlonephritis cause?

A

3rd leading cause of esrd

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44
Q

What is glomerlonephritis caused by?

A

Strep
Goodpasture syndrome

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45
Q

What does a u/a show W/ glomerlonephritis?

A

Proteinuria
Leukocytes
↑ gravity, bun, and creatine

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46
Q

What happen to gfs W/ glomerlonephritis?

A

GFR decreases

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47
Q

A pt W/ apsgn should rest until

A

Proteinuria and hematuria subsides
That will indicate no more inflammation

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48
Q

When does apsgn develop?

A

1-2 weeks after strep Group A infection

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49
Q

What does au/a show W/ apsgn?

A

Erythrocyte caste

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50
Q

What are the interventions for apsgn?

A

Rest
fluid and sodium restriction
↓ protein
Diuretics

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51
Q

What do arbs do?

A

Prevent blood vessel restriction
Give for a haeadache

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52
Q

What disorder is ace and arbs used for?

A

Apsgn

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53
Q

What are the ace drugs?

A

Lisinopril
Catapril

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54
Q

What are the arb drugs?

A

’ Lasartan
Valsartan

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55
Q

What do arbs not cause?

A

‘do not cause a cough

56
Q

What test is used to show scarring?

A

Biopsy

57
Q

What causes chronic glomerlonephritis?

A

Glomerlonephritis
Nephrotic syndrome

58
Q

What are the interventions for chronic glomerlonephritis?

A

Restrict: protein, sodium, phosphorous,
Treat HTN and UTI

59
Q

What is scarring of the glomeruli caused by?

A

Hypertension

60
Q

What is not found in urine wl nephrotic syndrome?

A

Blood
WBC
Leukocytes

61
Q

What is need when urine gets backed up in the kidney?

A

Nephrostomy

62
Q

What does a pt. Have w/ nephrotic syndrome and decreased albumin?

A

Ascites and massive edema

63
Q

What does nephrotic syndrome lead to?

A

Hyper coagulation
Thromboembolism

64
Q

Pressure on the bladder leads to?

A

Ureter dialation
Vesicourteal reflux
Hydronephoresis

65
Q

What happens to ph with calculi?

A

It increases

66
Q

What will a u/a show with calculi?

A

Blood in urine

67
Q

What does urine ph test for?

A

Struvite stones

68
Q

What is a lithotripsy?

A

Removes stone from urinary tract

69
Q

What does a lithotripsy use?

A

Laser,
ESWl
Ultrasonic sound wave
Electro hydraulic

70
Q

How does a pt reduce the risk for calculi?

A

Keep urine dilute and free flowing

71
Q

What are struvite stone?

A

Alkalitic

72
Q

What are Uris acid and cystine stones?

A

Acidic

73
Q

What can cause AKI?

A

Heart failure
Nephrotoxic drugs
Decreased blood
Inflammation

74
Q

What are the causes of prerenal AKI?

A

Decreased BP and blood flow
Hypovolemia

75
Q

What disorders cause prerenal AKI?

A

Dehydration
Heart failure
Decreased CO2

76
Q

What are the causes of intrarenal AKI?

A

Direct damage
Inflammation
Toxins
Drugs
Infection

77
Q

What disorders cause intrarenal AKI?

A

Acute tubular necrosis
Ischemia

78
Q

What are the diagnostics for intrarenal AKI?

A

Renal biopsy
U/a will show abundant cells, cast, and proteins

79
Q

What do you not use for intrarenal cause of AKI?

A

Contrast media test

80
Q

What cause postrenal AKI?

A

Enlarged prostate
Stones
Tumor
Hydronephoresis

81
Q

What happens in the oliguric phase of AKI?

A

Less than 400ml/day
Metabolic acidosis
Hyperkalemia
Hyponatremia
Fatigue and malaise

82
Q

What does a u/a show during the oliguria phase of AKI?

A

Cast
RBC and WBC
Increased BUN and Creatnine

83
Q

What happens in the diuretic phase of AKI?

A

Increase output
Hypovolemia
Dehydration
Hypotension

84
Q

What helps identify the specific cause of AKI?

A

Osmolarity
Gravity
Sodium

85
Q

What are the hyperkalemia meds for AKI?

A

Calcium gluconate
Regular insulin and dextrose
Sodium bicarbonate
Kayexalate
Veltassa
Hemodialysis

86
Q

What does calcium gluconate do?

A

Protects heart from dysrhythmias

87
Q

What does sodium bicarbonate do?

A

Increases ph

88
Q

What does Vettasa do?

A

Treats CKD symptoms

89
Q

What disorders indicate RRT?

A

Pericarditis
Pericardial effusion
Cardiac tamponede

90
Q

What levels indicate need for RRT?

A

BUN>120
Metabolic acidosis
Increased potassium
Overload

91
Q

What is the nutrition intervention for AKI?

A

Restrict sodium
Increase Carbs and fat

92
Q

What are nephrotoxic meds?

A

Aminoglycosides

93
Q

What is the GFR of CKD?

A

less than 60 for more than 3 months

94
Q

Stage 1 GFR

A

Greater or equal to 90

95
Q

Stage 2 GFR

A

60-89

96
Q

Stage 3 GFR

A

30-59

97
Q

Stage 4 GFR

A

15-29

98
Q

When does uremia begin?

A

GFR below 10

99
Q

What interventions are done with a pt with diabetes and CKD?

A

Reduce insulin

100
Q

When do fatal dysrythmias begin?

A

Potassium above 7

101
Q

What does fluid overload lead to?

A

Dilutional Hyponatremia

102
Q

What increases with CKD?

A

Phosphorous
PTH
Glucose
Insulin
Triglycerides

103
Q

What cause Polyuria?

A

Inability to concentrate urine

104
Q

What does increased ammonia lead to?

A

Causes encephalopathy and pruritis

105
Q

When GFR decreases…

A

BUN and creatnine increase

106
Q

What happens to the heart with CKD?

A

Arythmias

107
Q

What are the elctrolyte levels with CKD?

A

Increased potassium and phosphorus
Decreased sodium and calcium

108
Q

What potassium foods should we encourage with CKD?

A

Eggplant
White rice
Celery
Carrot
Peach

109
Q

What happens when magnesium levels are high?

A

Decreased reflexes and mental status
Dysrythmias
Hypotension
Respiratory failure

110
Q

What does urea cause?

A

Gastro problems

111
Q

When does restless leg syndrome begin?

A

Stage 5

112
Q

What is a late neuro change with CKD?

A

Peripheral neuropathy
Dialysis encephalopathy

113
Q

What causes pruitis with CKD?

A

Calcium and phosphorus in skin

114
Q

When does uremic frost become an issue?

A

BUN>200

115
Q

When is a albumin to creatnine ratio completed?

A

In first morning void

116
Q

What do you give to decrease proteinuria?

A

ACE and ARBS

117
Q

What is the levels for a creatnine clearance test?

A

Women: 87-107
Men: 107-139

118
Q

What are the interventions for hypertension with CKD?

A

DASH diet’
Restrict sodium and fluid

119
Q

When is phosphate restricted with CKD?

A

Not until RRT

120
Q

What are the phosphate binders and when do you give them?

A

Phoslo
Caltrate
Renewal
Give with each meal

121
Q

What is calciferol?

A

Vitamin D replacement that reduces PTH

122
Q

What are the anemia meds?

A

Alfa

123
Q

What do you give for dyslipedemia?

A

Statins (Lipitor)

124
Q

What is the nutritional treatment for CKD?

A

Restrict:
Protein
Water
Sodium
Potassium
Phosphorus

125
Q

What do you give for RBC formation?

A

Folic acid

126
Q

When is immediate dialysis needed?

A

Encephalopathy
Neuropathies
Hyperkalemia
Pericarditis
HTN

127
Q

Diffusion

A

High to low

128
Q

Osmosis

A

Low to high
Pulls fluid from blood

129
Q

What does ultrafiltration do?

A

Removes fluid

130
Q

What does a PD cath have?

A

2 polyester cuffs (Dacron)

131
Q

What are some complications of PD?

A

Peritonitis
Hernia
Lower back problems
Bleeding
Pulmonary complications
Decreased proteins

132
Q

What do you do pre op PD?

A

Empty bladder and bowel
Get a weight

133
Q

What is an AVF?

A

Anastomosing cephalon vein
Listen for thrill and bruit

134
Q

What is an AVG?

A

Brachial artery to antecubital vein

135
Q

What are the HD complications?

A

Hypotension
Muscle cramps
Low blood
Hepatitis

136
Q

What color fluid should CRRT be?

A

Clear yellow

Exam 4 Renal NSG 219 (2 decks)

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