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Med Surg > Renal > Flashcards

Renal Flashcards

1
Q

s/s of cystitis (UTI)

A

urgency, frequency, burning with urination, fever and confusion in older adults

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2
Q

does cranberry juice help cystitis

A

does NOT treat, changes pH urine in future

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3
Q

what is the treatment of cystitis

A

bacterialcidal (antibiotics), increased fluid intake, prevention

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4
Q

how do you diagnose cystitis

A
  • dipstick will show blood, leukocytes, and bacteria in urine
    • culture and sensitivity tells us what the culture is and what antibiotic can kill it
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5
Q

what meds are given empirically for cystitis

A

Cipro and Bactrim (if these do not work, do C & S)

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6
Q

what is the most common offender of UTI

A

E coli

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7
Q

teaching (preventative) for cystitis

A

no thongs, tight clothing, front to back wiping, no fragrance soaps/wipes, and urinate after sex

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8
Q

what are the two important things to remember with cystitis

A

education and prevention

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9
Q

s/s of pyelonephritis

A

flank pain, dysuria, fatigue, malaise, chills

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10
Q

describe what pyelonephritis is

A

bacteria travels up ureters

may require hospitalization

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11
Q

treatment for pyelonephritis

A

IV antibiotics if severe

monitor for sepsis

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12
Q

benign prostatic hy. (BPH) s/s

A

nocturia, frequency, urgency, decreased stream/force, incomplete emptying/dribbling, hematuria (elderly)

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13
Q

assessment of BPH

A

digital rectal exam, urinalysis, **PSA level

*PSA just shows prostate enlargement (does not indicate if BPH or cancer)

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14
Q

what occurs with BPH

A

enlarged prostate prevents urine from being able to flow out, constant flow builds up in bladder

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15
Q

_______ mL in bladder gives sensation to urinate

A

500

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16
Q

prostate differences in BPH and cancer

A

BPH: prostate enlarges in uniformular manner
cancer: prostate enlarges more rough and nodular

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17
Q

what are the meds and goals of treatment of BPH

A
  • shrink size of prostate (Proscar, finasteride) takes 6 mos

- Alpha adrenergic blockers (Hytrin, Cardura, Flomax)

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18
Q

what is the treatment (not meds) of BPH

A
  • surgery (TURP)
  • avoid meds that cause urinary retention
  • don’t take in large amounts of fluid
  • CBI
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19
Q

describe CBI and nursing interventions for it

A

continuous bladder irrigation

  • continuous drainage (pink color)
  • blood is okay, but there should NOT be clots
  • usually discontinued after 24 hrs
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20
Q

what does TURP stand for

A

transurethral resection of the prostate

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21
Q

what is the main thing to remember for renal calculi

A

assessment, prevention, pain, hydration

22
Q

broadly describe renal calculi

A

(kidney stones)-more common in men

  • calcium stones are most common
  • urine is backed up in ureter behind stones
  • ureter begins to expand
23
Q

when is pain most prevalent with renal calculi

A

when stone goes down ureter

24
Q

what are the types of renal calculi

A
  • hypercalcemia
  • hyperoxaluria
  • hyperuricemia
  • struvite (magnesium ammonium)
  • cystinuria (genetic defect of amino acid)
25
Q

renal colic = _______

A

PAIN

26
Q

what is common of renal calculi

A

oliguria (decreased urine output)

anuria (no urine output)

27
Q

what should be implemented after you have renal calculi

A

increase fluids intake (2-3 L/ day)

28
Q

what is the drug therapy for renal calculi

A

ketorolac, opioid analgesic

29
Q

describe Lithotripsy

A
  • used if it takes too long to pass stone (>3 days)
  • sound waves to break up stone
  • put pt on EKG
  • *strain urine after to monitor for stone fragments
  • bruising on back after is normal
30
Q

how do you know if lithotripsy worked

A
  • if you see stone fragments come out

- pain does NOT indicate stone passage

31
Q

describe glomerulonephritis

A
  • glomerulous loses selective filtering ability
  • usually occurs d/t STREP infection
  • body builds antibiotic complexes that build up on glomerulous and pokes holes in it (makes it a low pressure system)
32
Q

if protein in urine….

A

means filtering has been compromised in the kidneys

33
Q

glomerulonephritis s/s

A

increased BP, decreased urine output, concentrated urine, increased specific gravity, CVA tenderness, facial edema

34
Q

treatment of glomerulonephritis

A

antibiotic**PRIORITY
monitor intake and output
fluid replacement
daily weights

35
Q

nursing interventions for glomerulonephritis

A
  • decrease sodium and increase carbs
  • treat aggressively to prevent DIALYSIS
  • educate about s/s of renal failure
36
Q

describe what insensible fluid loss is

A
  • how to determine intake for glomerulonephritis pt

- loss after 24 hrs plus 500 mL = TOTAL amount of fluids that can be given

37
Q

broadly describe nephrotic syndrome

A
  • more acute, more severe than glomerulonephritis (100 times worse)
  • MASSIVE fluid retention
  • strep is not the lone cause
38
Q

patho of nephrotic syndrome

A
  • lose severe amount of protein (albumin)
  • lose ability to hold fluid in vascular space which causes fluid to travel to tissue (EDEMA)
  • goes to 3rd space where blood is not supposed to be
39
Q

what is anasarca

A

total body edema

40
Q

describe liver in association with nephrotic syndrome

A

liver attempts to replace albumin which decreases triglycerides which causes high cholesterol (hyperlipidemia)

41
Q

what renal can strep. cause

A

endocarditis or glomerulonephritis

42
Q

can you give albumin to nephrotic syndrome pt

A

yes but it will increase fluid so give with DIURETIC (ie/ Lasix)

43
Q

treatment of nephrotic syndrome

A
  • ACE inhibitor (will stop cycle because cannot hold extra fluid)
  • prednisone (shrinks holes in glomerulous)
  • lipid lowering agent
  • Albumin and Lasix
44
Q

broadly describe renal failure

A
  • 3 types: prerenal, intrarenal, postrenal
  • failure of both kidneys
  • you CAN function with one kidney
45
Q

describe prerenal failure

A
  • anything that affects blood getting to kidney
  • only takes about 20 min of decreased blood supply for renal failure to occur
  • causes: hypotension, diabetes, decreased cardiac output, hypovolemic shock
46
Q

describe intrarenal failure

A

something wrong inside kidneys

scans with dyes inside kidneys can cause this

47
Q

describe psotrenal failure

A
  • urine cannot get out of kidneys

- prostate issues, kidney stones

48
Q

what increases in blood with renal failure

A

increased BUN levels

49
Q

describe fixed specific gravity

A
  • pt is given fluid challenge
  • expect urine to be dilute after fluid
  • does NOT dilute, stays concentrated and thus fixed specific gravity
50
Q

what is decreased in the blood with renal failure

A
  • erythropoetin, kidneys do NOT make enough RBC

- causes ANEMIA

Med Surg (23 decks)

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