renal A+P, diagnostic testing, and assessment

Question 1

describe blood flow the kidney gets

Answer 1

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

Question 2

what are the kidneys protected by

Answer 2

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

Question 3

what are the three parts the kidney is divided into

Answer 3

• cortex
• medulla
• pelvis

Question 4

describe bloodflow coming to and leaving the kidneys

Answer 4

• afferent arteriole supplies the glomerulus with blood
• efferent arteriole drains blood from glomerulus

Question 5

what is a nephron

Answer 5

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

Question 6

describe the glomerulus

Answer 6

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

Question 7

what is GFR

Answer 7

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

Question 8

what are some functions of the kidneys

Answer 8

• 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

Question 9

what does the RAAS do

Answer 9

regulates blood flow to kidneys, BP, and GFR

Question 10

what are some functions of aldosterone

Answer 10

• hold onto Na+
• H2O follows Na+
• releases K+
• increases BP

Question 11

where does furosemide work in the kidney?

Answer 11

tubules

Question 12

what can affect GFR? choose all that apply

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

Answer 12

all of em

Question 13

what does aldosterone do to the body?

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

Answer 13

retain Na, release K

Question 14

whats included in the urinary system

Answer 14

• ureters
• bladder
• urethra

Question 15

whats the capacity of the bladder

Answer 15

400-500ml

Question 16

whats an acceptable bladder post residual

Answer 16

less than 100ml

Question 17

when does decline in renal function begin

Answer 17

35-40 years

Question 18

describe the progressive loss of renal function

Answer 18

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

Question 19

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

Answer 19

• adverse drug effects
• hypernatremia
• fluid volume imbalance
• UTIs

Question 20

what health history is included in renal assessment

Answer 20

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

Question 21

whats included in physical assessment of renal assessment

Answer 21

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

Question 22

what diagnostic tests are used for the renal assessment

Answer 22

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

Question 23

whats used to test function of kidneys

Answer 23

BUN and Cr

Question 24

describe BUN

Answer 24

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

Question 25

describe creatinine

Answer 25

- normal is 0.7-1.4 - waste product from everyday living

Question 26

what does GFR test

Answer 26

filtration

Question 27

whats included in urinalysis results

Answer 27

- color - clarity - odor - pH - specific gravity - protein - glucose - ketones - RBC - WBC - bacteria - leukocyte esterase

Question 28

what can tell the concentration of urine

Answer 28

- color - clarity - odor - pH - specific gravity

Question 29

increase speicifc gravity can mean...

Answer 29

super concentrated urine

Question 30

what does protein in the urine mean

Answer 30

tells if theres damage to glomerulus

Question 31

what does glucose in the urine mean

Answer 31

blood sugar is super high

Question 32

what do ketones in the urine mean

Answer 32

then the body starts to break itself down bc its not getting proper nutrition can be seen in DKA

Question 33

what does RBC in the urine indicate

Answer 33

UTI or kidney damage

Question 34

what does WBC in the urine indicate

Answer 34

infection

Question 35

what does leukocyte esterase indicate

Answer 35

show inflammation in kidneys/urinary tract

Question 36

what does renal angiography do

Answer 36

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

Question 37

what are some pre test interventions for renal angiography

Answer 37

- need good kidney function -> check labs - be hydrated to dilute dye

Question 38

what are some post procedure interventions for renal angiography

Answer 38

check for bleeding

Question 39

what are some complications of renal angiography

Answer 39

hematoma, damage from dye, blood clots

Question 40

whats some patient education shit to include for renal angiography

Answer 40

- hydrate - explain what will happen with test - explain what to expect after - explain when to call the doc

Question 41

what is a renal biopsy

Answer 41

- can diagnose cancer or failure - big ass needle, numb spot

Question 42

what are some pre test nursing interventions for renal biopsy

Answer 42

look at clotting times, no blood thinners

Question 43

what are some post procedure interventions for renal biopsy

Answer 43

- vitals, watch for low BP and high hr

Question 44

what are some complications with renal biopsy

Answer 44

- bleeding - urination issues - can have a little blood in the urine and thats okay

Question 45

whats some stuff to include in patient education for renal biopsy

Answer 45

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

Question 46

describe cystoscopy

Answer 46

- scope up the urethra - can take samples - see urethra, bladder - uncomfy procedure

Question 47

what are some pre test interventions for cystoscopy

Answer 47

do UA beforehand

Question 48

what are some post procedure interventions for cystoscopy

Answer 48

burning and painful urination after

Question 49

what are some complications of cystoscopy

Answer 49

blood tinged urine, urinary retention

Question 50

what does intravenous pyelography show

Answer 50

shows shape and size of kidney

Question 51

what are some pre test interventions for intravenous pyelography

Answer 51

need working IV and be hydrated

Question 52

what are some post procedure interventions for intravenous pyelography

Answer 52

hydrate to flush the dye out

Question 53

whats some patient education for intravenous pyelography

Answer 53

- ecourage fluid - call if not urinating

Question 54

describe KUB

Answer 54

kinda like intravenous pyelography but with no dye better for patients with bad kidney function can see kidney stones

Question 55

what does an ultrasound show

Answer 55

shape of kidney, massess, tumors, and size