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adults > renal A+P, diagnostic testing, and assessment > Flashcards

renal A+P, diagnostic testing, and assessment Flashcards

1
Q

describe blood flow the kidney gets

A
  • total blood supply circulates through the kidneys 12x/hr
  • receives a ton a blood/minute (25% of CO)
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2
Q

what are the kidneys protected by

A

fat, renal capsule, muscle, SQ tissue, and skin

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3
Q

what are the three parts the kidney is divided into

A
  • cortex
  • medulla
  • pelvis
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4
Q

describe bloodflow coming to and leaving the kidneys

A
  • afferent arteriole supplies the glomerulus with blood
  • efferent arteriole drains blood from glomerulus
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5
Q

what is a nephron

A
  • the functional unit of the kindey
  • each kidney is composed of 1 million nephrons
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6
Q

describe the glomerulus

A
  • specialized capillary loops at the beginning of the nephron
  • site of filtration, first process in urine formation
  • rate of blood flow determined by BP
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7
Q

what is GFR

A
  • volume of plasma filtered from the glomerular capillaries into bowmans capsule each minute, expressed in ml/min
  • normal 125ml/min
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8
Q

what are some functions of the kidneys

A
  • urine formations
  • excretion of wastes
  • fluid and electrolyte regulation
  • acid base balance
  • regulation of blood pressure
  • stimulation of RBC production
  • synthesis of vit D to active form
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9
Q

what does the RAAS do

A

regulates blood flow to kidneys, BP, and GFR

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10
Q

what are some functions of aldosterone

A
  • hold onto Na+
  • H2O follows Na+
  • releases K+
  • increases BP
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11
Q

where does furosemide work in the kidney?

A

tubules

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12
Q

what can affect GFR? choose all that apply

1) chronic HTN
2) diabetes type 1
3) advanced age
4) hpotension

A

all of em

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13
Q

what does aldosterone do to the body?

1) vasodilation
2) release Na, retain K
3) fight or flight
4) retain Na, release K

A

retain Na, release K

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14
Q

whats included in the urinary system

A
  • ureters
  • bladder
  • urethra
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15
Q

whats the capacity of the bladder

A

400-500ml

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16
Q

whats an acceptable bladder post residual

A

less than 100ml

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17
Q

when does decline in renal function begin

A

35-40 years

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18
Q

describe the progressive loss of renal function

A
  • glomerular sclerosis
  • decreased blood flow
  • decreased GFR
  • altered tubular function
  • acid-base imbalance
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19
Q

whats a person at risk for with age related changes in the renal system

A
  • adverse drug effects
  • hypernatremia
  • fluid volume imbalance
  • UTIs
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20
Q

what health history is included in renal assessment

A
  • chief complaint
  • pain
  • changes in voiding
  • GI symptoms
  • unexplained anemia
  • past health, family, and social history
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21
Q

whats included in physical assessment of renal assessment

A
  • subjective like asking about what the piss looks like
  • objective data like I+O, weight, lab values, meds
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22
Q

what diagnostic tests are used for the renal assessment

A
  • UA/C&S
  • BUN
  • creatinine
  • GFR
  • 24 hour creatinine clearance
  • hemoglobin and hematocrit
  • electrolytes
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23
Q

whats used to test function of kidneys

A

BUN and Cr

24
Q

describe BUN

A
  • normal is 10-20
  • measures nitrogen in blood
  • can be falsey elevated with increased protein intake
25
Q

describe creatinine

A
  • normal is 0.7-1.4
  • waste product from everyday living
26
Q

what does GFR test

A

filtration

27
Q

whats included in urinalysis results

A
  • color
  • clarity
  • odor
  • pH
  • specific gravity
  • protein
  • glucose
  • ketones
  • RBC
  • WBC
  • bacteria
  • leukocyte esterase
28
Q

what can tell the concentration of urine

A
  • color
  • clarity
  • odor
  • pH
  • specific gravity
29
Q

increase speicifc gravity can mean…

A

super concentrated urine

30
Q

what does protein in the urine mean

A

tells if theres damage to glomerulus

31
Q

what does glucose in the urine mean

A

blood sugar is super high

32
Q

what do ketones in the urine mean

A

then the body starts to break itself down bc its not getting proper nutrition

can be seen in DKA

33
Q

what does RBC in the urine indicate

A

UTI or kidney damage

34
Q

what does WBC in the urine indicate

A

infection

35
Q

what does leukocyte esterase indicate

A

show inflammation in kidneys/urinary tract

36
Q

what does renal angiography do

A

looks at bloodflow of the kidneys, can tell if there is a clot

37
Q

what are some pre test interventions for renal angiography

A
  • need good kidney function -> check labs
  • be hydrated to dilute dye
38
Q

what are some post procedure interventions for renal angiography

A

check for bleeding

39
Q

what are some complications of renal angiography

A

hematoma, damage from dye, blood clots

40
Q

whats some patient education shit to include for renal angiography

A
  • hydrate
  • explain what will happen with test
  • explain what to expect after
  • explain when to call the doc
41
Q

what is a renal biopsy

A
  • can diagnose cancer or failure
  • big ass needle, numb spot
42
Q

what are some pre test nursing interventions for renal biopsy

A

look at clotting times, no blood thinners

43
Q

what are some post procedure interventions for renal biopsy

A
  • vitals, watch for low BP and high hr
44
Q

what are some complications with renal biopsy

A
  • bleeding
  • urination issues
  • can have a little blood in the urine and thats okay
45
Q

whats some stuff to include in patient education for renal biopsy

A
  • know when to call doc, if theres still bleeding after three days
  • explain what the test is and what to expect after
46
Q

describe cystoscopy

A
  • scope up the urethra
  • can take samples
  • see urethra, bladder
  • uncomfy procedure
47
Q

what are some pre test interventions for cystoscopy

A

do UA beforehand

48
Q

what are some post procedure interventions for cystoscopy

A

burning and painful urination after

49
Q

what are some complications of cystoscopy

A

blood tinged urine, urinary retention

50
Q

what does intravenous pyelography show

A

shows shape and size of kidney

51
Q

what are some pre test interventions for intravenous pyelography

A

need working IV and be hydrated

52
Q

what are some post procedure interventions for intravenous pyelography

A

hydrate to flush the dye out

53
Q

whats some patient education for intravenous pyelography

A
  • ecourage fluid
  • call if not urinating
54
Q

describe KUB

A

kinda like intravenous pyelography but with no dye

better for patients with bad kidney function

can see kidney stones

55
Q

what does an ultrasound show

A

shape of kidney, massess, tumors, and size

adults (51 decks)

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