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FNP Licensure Review > Renal > Flashcards

Renal Flashcards

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Family Nurse Practitioner (FNP) flashcards
1
Q
  • Better measure for renal function (blood test).
  • Tests kidney function. Renal function decreases, creatinine
    increases.
  • Male 0.7-1.3, female 0.6-1.1. >5.0 in adults = kidney impairment.
  • High levels may indicate dehydration, protein intake, creatine
    supplements.
A

Serum Creatinine

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2
Q

When Renal function decreases ______

A

creatinine increases and creatinine clearance also decreases

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3
Q

Provides information on how well the kidneys are working.
* Tests proteinuria, albuminuria, microalbuminuria. Renal function decreases, Creatinine clearance also decreases. Reflects renal function
for the past 24 hrs.

A

Creatinine Clearance (24 hr. urine)

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4
Q

Used to evaluate for kidney disease and stage. Measures the kidney’s
ability to filter toxins and waste from the blood.
* Ranges: >90 mL/min. Renal failure stage 5 if <15 mL/min.

A

Estimated Glomerular Filtration Rate (eGFR)

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5
Q

Reveals information on how well the kidneys are working, measures kidney’s ability to excrete urea.
* High levels: acute renal failure, high protein diet, hemolysis, CHF, drugs.
Normal ranges 6-24 mg/dL.

A

Blood Urea Nitrogen

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6
Q

High BUN with normal eGFR =

A

renal function probably normal

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7
Q

High BUN with low GFR =

A

higher mortality

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8
Q

Used to evaluate dehydration, hypovolemia, acute renal failure and level of renal failure. used in chemo to evaluate stress on the kidneys

A

BUN-to-Creatinine Ratio

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9
Q
  • Color: yellow, light/pale, amber, red.
  • Clarity/turbidity- clear or cloudy
  • pH: 4.5-8
  • Specific gravity: 1.005-1.025
  • Glucose: ≥130 mg/d
  • Ketones
  • Nitrates
  • Leukocyte esterase
A

UA

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10
Q

WBC casts with proteinuria is observed in _______.

A

pyelonephritis

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11
Q

+ Nitrites in UTI indicates

A

Ecoli Infection

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12
Q

What if leukocytes seen in male urine

A

tx for infection

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13
Q

Protein in the urine…

A

kidney damage, pyelonephritis.

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14
Q

Presence of bacteria (urine culture growth of 100,000 CFU/mL or more) in the urine without
symptoms of UTI.
* Due to increasing antimicrobial resistance, DO NOT treat.
* Always treat pregnant woman with antibiotics.

A

Asymptomatic Bacteriuria

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15
Q

(leukocytosis, fever, chills, malaise) is treated as a UTI.

A
  • Symptomatic bacteriuria
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16
Q

Majority caused by E.coli
* Symptoms: dysuria, frequency, frequent urge to void, nocturia, suprapubic
discomfort.
* UA dipstick: large number of leukocytes, + nitrates, may show RBC.
* UTI in males: r/o other causes (STI, anatomical abn…)
* Risk factors
* female, pregnancy, history of recent UTI, history of recurrent infections, DM,
immunocompromised, failure to void post intercourse, spermicide use,
dehydration, poor hygiene, catheterization

A

Urinary Tract Infection

17
Q

What if pt symptomatic after 48-72 hrs. from initiating tx

A

switch tx and order UA and C&S.

18
Q

Meds to tx uncomplicated UTI

A

Trimethoprim-Sulfamethoxazole (Bactrim, Septra) BID x 3.

  • Sulfa allergic: Nitrofurantoin BID x 5
  • Fosfomycin 3g x 1 dose
  • Augmentin 875/125 mg BID x 5-7 days
  • Phenazopyridine (Pyridium) BID x 2 days PRN, will turn urine orange/yellow.
19
Q

Meds to tx complicated UTI

A

Ciprofloxacin (Cipro) 500mg BID or levofloxacin 750mg once a day for 7-10 days

  • Trimethoprim-sulfamethoxazole BID or cefixime (Suprax) 400mg BID for 7-10 days.
  • Sulfa allergy: Cephalexin (Keflex), Ceclor, Cipro
20
Q
  • Acute bacterial infection of the kidneys.
  • Symptoms: high fever, chills, N&V, one-sided flank pain
    (costovertebral angle tenderness on one kidney), dysuria, urinary
    frequency & urgency.
  • Shift to the left
  • Close follow up 12-24 hrs.
  • Refer: pregnancy (fluoroquinolones contraindicated), children, elderly, anatomical abn, DM…
A

Acute Pyelonephritis

21
Q

Shift to the left

A

the presence of immature neutrophils = serious
infection

22
Q

Tx for acute pyelonephritis

A

Mild uncomplicated (young healthy adult): Cipro/Levaquin 7 days, Ceftriaxone 1g IM inj, Augmentin 14 days…

  • Moderate to severe or immunocompromised might require hospitalization.
23
Q

AKA: Kidney stones.
* Majority made up of calcium oxalate.
* Size of stone corresponds to level of pain. Location of stone determines location of pain.
* Risk Factors: family hx, low fluid intake, gout, bariatric surgery.
* Symptoms: acute pain on one side, come in waves, pain builds in intensity (pain passes when stone moves or passes), may have N&V with severe pain, hematuria?
* Tests: strain urine, renal US, UA, if stone is too large refer, may need to go to ED.
* Education: hydration. Avoid foods high in oxalate (meats, beets, chocolate, spinach…)

A

Nephrolithiasis (Urolithiasis)

24
Q

The majority of kidney stones made up of

A

Calcium Oxalate

25
Q

AKA: Acute Renal failure.
* May last hrs. or days. Can be reversible.
* A buildup of waste products can cause a sudden episode of kidney failure or damage.
* Symptoms: oliguria, edema, weight gain (from fluid retention), lethargy, nausea, loss of appetite, itching, confusion.
* Causes: infection, liver failure, medications, heart failure, burns, dehydration…
* Findings: rapid decrease in kidney function, elevated serum creatinine, decline GFR.
Source

A

AKI

26
Q
  • Blood in the urine.
  • Revealed by positive urine dipstick , or gross (visible).
  • If dipstick is positive, order a microscopic UA.
  • Infection suspected? Order C&S.
  • Malignancy suspected? Order urine cytology study.
  • R/o: menses, hemorrhoids, food dyes (beets).
A

Hematuria

27
Q

Biggest risk factor for bladder cancer

A

Smoking

28
Q
  • Think cancerous mass: hematuria, pelvic/ lower back/ lower abdominal pain, may or may not have irritative voiding symptoms (dysuria, frequency, nocturia).
  • Risk factors: older age, smokers, workplace exposures (industrial chemicals).
  • Patients will most likely seek for help after noticing hematuria or blood stains on underwear.
  • Treatment: surgery, biological therapy, chemotherapy.
A

Bladder Cancer

29
Q

A 24-week pregnant patient has asymptomatic UTI. How would you treat it?

A

Treat w/ nitrofurantoin 100 mg 4 x daily

FNP Licensure Review (10 decks)

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