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NURS 301 - Exam 3 > Renal Alterations - UTI / Pyelonephritis / Glomerulonephritis > Flashcards

Renal Alterations - UTI / Pyelonephritis / Glomerulonephritis Flashcards

1
Q

______ is the most important data gathered in a urinary assessment

A

History

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2
Q

Flank pain is associated with nausea / vomiting and ______

A

Paralytic ileus

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3
Q

What is the primary manifestation associated with renal / urinary conditions?

A

Changes in voiding

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4
Q

Describe normal voiding patterns (3)

A
  • 5 - 6 times / day
  • 1200 - 1500 mL / day
  • Painless
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5
Q

______ is the best indicator of overall renal function

A

Creatine clearance

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6
Q

Why is creatinine clearance the best indicator of overall renal function?

A

It measures GFR

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7
Q

In urine diagnostic testing, the ______ is discarded

A

First void of the day

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8
Q

Which type of diagnostic test uses contrast dye to evaluate structure / excretory function?

A

IVP

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9
Q

A ______ is most often done in the OR

A

Cystoscopy

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10
Q

Describe a cystoscopy

A

Scope inserted into urethra / bladder - allows doctor to examine the inside of the bladder

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11
Q

What post-op complications are associated with a cystoscopy? (3)

A
  • Infection
  • Bleeding
  • Bladder perforation
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12
Q

Describe the post-procedure education associated with a renal biopsy

A

Possible hematuria for 24 hours

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13
Q

GFR begins to decrease after age ______

A

40

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14
Q

GFR decreases to approximately _______ by age 70

A

50%

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15
Q

Describe the gerontological considerations associated with the renal system (3)

A
  • Inability to completely empty bladder
  • Prostate enlargement
  • Sensitivity to infection
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16
Q

The elderly tend to ______ to decrease risk of incontinence

A

Limit fluid intake

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17
Q

It is common for ______ to make voiding more difficult for the elderly

A

Immobility

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18
Q

What is the most common cause of sepsis in the elderly?

A

UTIs

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19
Q

Where is the urinary tract normally sterile?

A

Above the urethra

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20
Q

What are UTIs?

A

Pathogenic microorganisms in the urinary tract

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21
Q

Uncomplicated upper / lower UTIs are ______

A

Community acquired

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22
Q

Complicated upper / lower UTIs are ______

A

Nosocomial - related to catheterization

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23
Q

What are the risk factors of UTIs? (4)

A
  • Inability to empty bladder
  • Obstructed urinary flow
  • Instrumentation
  • Aging
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24
Q

What conditions are considered risk factors for UTIs? (3)

A
  • Diabetes
  • Pregnancy
  • Neurologic disorders
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25
Q

What is the most common route of UTIs?

A

Transurethral from fecal contamination

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26
Q

What are the manifestations of uncomplicated lower UTIs (cystitis)? (4)

A
  • Burning while urinating
  • Urinary frequency / urgency
  • Nocturia
  • Hematuria
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27
Q

Elderly patients with UTIs often …

A

Lack typical symptoms

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28
Q

What are the manifestations of urinary infections in the elderly? (4)

A
  • Anorexia
  • Confusion
  • Lethargy
  • Low grade fever
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29
Q

What diagnostic study is used for UTIs?

A

Urinalysis

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30
Q

What laboratory findings indicate UTI diagnosis? (3)

A
  • Bacteriuria
  • Pyuria
  • E. coli
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31
Q

Female urinalysis samples are commonly ______

A

Contaminated

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32
Q

What is pyuria?

A

WBCs in urine

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33
Q

What diagnostic studies are associated with recurrent UTIs? (2)

A
  • IVP
  • Cystoscopy
34
Q

Why is antibiotic use to treat UTIs controversial in the elderly?

A

Can lead to resistance

35
Q

Antibiotics for treatment of UTIs are effective against ______

A

E. coli

36
Q

What antibiotics are used for complicated UTIs (pyelonephritis)? (3)

A
  • Cephalosporin
  • Ampicillin / aminoglycoside
  • Pyridium analgesic
37
Q

What antibiotic is used for complicated UTIs (pyelonephritis), specifically in pregnant patients?

A

Amoxicillin / ampicillin

38
Q

Describe the nursing interventions for UTIs (4)

A
  • Pain relief
  • Increase fluid intake
  • Avoid irritants (caffeine, citrus, alcohol)
  • Void every 2 - 3 hours
39
Q

In order to prevent complications from UTIs, it is important to avoid ______

A

Indwelling catheters

40
Q

Describe the primary education associated with UTI treatment

A

MUST take full course of antibiotics

41
Q

What is acute pyelonephritis?

A

Bacterial infection of the renal pelvis, tubules, and intersistial tissue of kidneys

42
Q

Acute pyelonephritis is commonly associated with what other conditions? (3)

A
  • Urinary tract obstructions
  • Bladder tumors
  • BPH
43
Q

What are the manifestations of acute pyelonephritis? (4)

A
  • Fever
  • Flank pain
  • Costovertebral pain
  • Painful urination
44
Q

What is the primary complication associated with acute pyelonephritis?

A

Atrophy of tubules / glomeruli

45
Q

What diagnostic studies are used for acute pyelonephritis? (3)

A
  • Ultrasound / CT
  • Radionucleotide imaging
  • Urine culture and sensitivity
46
Q

Which diagnostic test is used to locate obstructions?

A

Ultrasound / CT

47
Q

Which diagnostic test is used to identify sites of infection that are not visualized on a CT?

A

Radionucleotide imaging

48
Q

Which diagnostic test is used to determine the causative organism?

A

Urine culture and sensitivity

49
Q

What laboratory findings indicate acute pyelonephritis diagnosis? (3)

A
  • Leukocytosis
  • Bacteriuria
  • Pyuria
50
Q

Uncomplicated acute pyelonephritis uses ______ treatment

A

Outpatient

51
Q

Describe the medical management of uncomplicated acute pyelonephritis

A

2-week antibiotic course

52
Q

Treatment of uncomplicated acute pyelonephritis may require long-term antibiotics for up to ______

A

6 weeks

53
Q

______ is a common cause of end-stage renal disease

A

Chronic pyelonephritis

54
Q

What is chronic pyelonephritis?

A

Scarring of the kidneys

55
Q

What is the cause of chronic pyelonephritis?

A

Recurrent acute pyelonephritis

56
Q

Chronic pyelonephritis is usually ______ unless acute exacerbations occur

A

Asymptomatic

57
Q

What are the manifestations of chronic pyelonephritis? (3)

A
  • Polyuria
  • Polydipsia
  • Poor appetite
58
Q

What diagnostic studies are used for chronic pyelonephritis? (3)

A
  • Creatinine clearance
  • BUN / creatinine
  • Urine culture and sensitivity
59
Q

What are the complications associated with chronic pyelonephritis? (3)

A
  • End-stage renal disease
  • Kidney stones
  • Hypertension
60
Q

Describe the medical management of chronic pyelonephritis

A

Antimicrobials - based on culture results

61
Q

In what case is careful antimicrobial selection necessary for the treatment of chronic pyelonephritis?

A

Impaired renal function

62
Q

Describe the nursing interventions used for chronic pyelonephritis (2)

A
  • Increase fluid intake
  • Check temperature every 4 hours
63
Q

What is glomerulonephritis?

A

Inflammation of glomerular capillaries

64
Q

What are the general manifestations of glomerulonephritis? (6)

A
  • Hypertension
  • Edema
  • Oliguria
  • Hematuria
  • Proteinuria
  • Azotemia
65
Q

What type of glomerulonephritis primarily occurs in children > 2 years of age?

A

Post-streptococcal glomerulonephritis

66
Q

When does post-streptococcal glomerulonephritis develop?

A

5-21 days after strep infection of the tonsils, pharynx or skin

67
Q

Describe the pathophysiology of post-streptococcal glomerulonephritis

A

Strep antibodies deposited in glomeruli - causes tissue injury

68
Q

Describe the filtration resulting from post-streptococcal glomerulonephritis (2)

A
  • Decreased filtration of waste products from blood
  • Increased permeability to large protein molecules
69
Q

______ can develop from post-streptococcal glomerulonephritis

A

Chronic glomerulonephritis

70
Q

Describe the pathophysiology of acute glomerulonephritis

A

Antibodies react against immunoglobulins deposited in the glomerular basement membrane

71
Q

Acute glomerulonephritis is commonly secondary to what other conditions? (3)

A
  • Hepatitis
  • Measles
  • Viral infections
72
Q

Manifestations of acute glomerulonephritis are due to …

A

Increased permeability of glomeruli

73
Q

Describe the laboratory findings associated with post-streptococcal glomerulonephritis (2)

A
  • Elevated antistreptolysin-O
  • Elevated anti-Dnase B
74
Q

Describe the laboratory findings associated with acute glomerulonephritis (2)

A
  • Elevated BUN
  • Elevated creatinine
75
Q

Describe the medical management of acute glomerulonephritis (5)

A
  • Rest
  • Diuretics
  • Antibiotics
  • Protein restriction
  • Sodium restriction
76
Q

What is the primary nursing intervention used for acute glomerulonephritis?

A

Monitor BP

77
Q

What is chronic glomerulonephritis?

A

Atrophy of kidneys to 1/5 of normal size - fibrotic tissue remaining

78
Q

Chronic glomerulonephritis causes severe glomerular damage resulting in ______

A

End-stage renal disease

79
Q

What are the manifestations of chronic glomerulonephritis? (5)

A
  • Crackles
  • Renal failure
  • Peripheral neuropathy
  • Malnourished appearance
  • Yellow / gray skin
80
Q

What diagnostic study is used for chronic glomerulonephritis?

A

Urinalysis

81
Q

What laboratory findings indicate chronic glomerulonephritis diagnosis? (3)

A
  • Hyperkalemia
  • Hypermagnesemia
  • Hypoalbuminemia
82
Q

Describe the medical management of chronic glomerulonephritis (2)

A
  • High protein diet
  • Early initiation of dialysis

NURS 301 - Exam 3 (5 decks)

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