Renal and Urologic System (Kelsey's Handout) Flashcards

1
Q

Etiology and RF of UTI’s

A
  • most adult women
  • sexual activity
  • pregnancy
  • previous UTI
  • incontinence
  • indwelling catheters
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2
Q

Why are women more at risk for UTI’s?

A
  • shorter urethra

- close proximity to fecal flora

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3
Q

Structural abnormalities that can increase risk of an UTI?

A
  • kidney stones
  • cystocele-bladder bulge into vagina
  • enlarged prostate
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4
Q

Functional abnormalities that can increase risk of an UTI?

A
  • reflux of urine from bladder to kidney
  • MS
  • SCI
  • low bladder tone and urine retention contributing to UTI (PD, MS, LMNL, disc disease, surgery)
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5
Q

S/S of UTI

A
  • buring, pain, discomfort with urination
  • urgency
  • freq.
  • nocturia
  • enuresis
  • fever, chills, malaise (general discomfort)
  • diaphragm, shoulder, lumbar pain
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6
Q

S/S of UTI in older adult:

A
  • malaise
  • anorexia
  • mental status change
  • confusion
  • flank pain, chills, fever often indicate upper UTI
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7
Q

What can mimic UTI S/S?

A

overactive pelvic floor muscles and interstitial cystitis

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8
Q

PT implications for UTI

A
  • may not be able to fully participate in exercise
  • early intervention (fever >102, vomiting, nausea, confusion refers to MD)
  • prevent spread of infection
  • watch for insidious onset of back or shoulder pain, confusion, history of UTI refers to MD
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9
Q

Classical Triad for Renal Cell Carcinoma?

A
  1. Flank pain
  2. hematuria
  3. palpable abdominal mass
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10
Q

Implications for PT with Renal Cell Carcinoma:

A

watch for sternal pain (tumor)

  • may benefit form STM
  • manage side affects
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11
Q

where does kidney stone obstruction usually occur?

A

where ureter crosses iliac vessels or at the ureterversical junction

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12
Q

Four basic stones are:

A
  1. calcium**
  2. struvit
  3. uric acid
  4. cystine
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13
Q

Classic presentation of a kidney stone

A

is acute “colicky” flank pain radiating to the groin or perineal areas.
-pain is severe and unable to find comfortable position

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14
Q

Kidney stone S/S are consistent with a UTI and in 90% of the time what is present?

A

Hematuria

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15
Q

Medications for kidney stones if fluid intake is not enough:

A
  1. Thiazide diuretics (increases Ca excretion)
  2. alkali (increases urine citrate excretion)
  3. allopurinol (prevents uric acid crystals)
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16
Q

If you are a PT working with someone with Kidney stones what would indicate that you should refer them to an MD?

A

fever, chills, and sweats

17
Q

Clinical manifestations of Bladder cancer:

A
  • painless hematuria is the most common sign

- 85 % gross hematuria, onset is sudden, intermittent frequency

18
Q

is hematuria related to tumor size or stage of bladder cancer?

A

no

19
Q

during bladder cancer what can cause bladder enlargements and painful spasms?

A

clots blocking urethra

20
Q

is bladder cancer more common in men or women?

A

men

21
Q

Clinical manifestations of Neurogenic Bladder disorders?

A
  • partial or complete urinary retention
  • incontinence,
  • urgency,
  • suprapubic pain
  • frequent urination
22
Q

Clean intermittent catheterization protocol:

A

performed in 4-hour interval, reduced vesicoureteral reflux and kidney damage

23
Q

♣ Implication for short-term indwelling urinary catheter:

A

• Accurate monitoring of urine output
• Relief of urinary obstruction
• Prevention of obstruction from large clots when hematuria is present
• For surgical procedures involving general or spinal anesthesia
Incontinence when ulcers are present

24
Q

alteration of kidney function or structure for a duration of 3 months or longer

A

Chronic Kidney Disease

25
Q

most common causes of chronic kidney disease

A
  1. diabetes
  2. hypertension
  3. glomerulonephritis
26
Q

Stage 1 of CKD:

A
  • GFR normal or increased
  • no impaired renal fx or sx present
  • unaffected nephrons hypertrophy to compensate for damaged ones
  • BUN returns normal
  • creatine returns normal
  • can be REVERSED
27
Q

Stage 2:

A
  • damaged capillaries allow small amounts of albumin to be excreted in urine
  • stage can be years w/proper management of hypertension and blood glucose
28
Q

Stage 3:

A
  • more noticeable albumin levels in urine and decreased in blood
  • noticeable edema
  • creatinine and BUN levels increase
  • waste accumulation in blood
29
Q

Stage 4:

A

kidney unable to fx and complications appear

  • proteinuria is hallmark
  • kidneys can no longer excrete toxins
  • progress to stage 5 quickly
30
Q

Stage 5:

A
  • end stage renal disease

- dialysis

31
Q

contraindications for transplant of kidney:

A
  • active or non-compliant metastatic cancer
  • active ischemic cardiac and cerebrovascular disease
  • dementia
  • debility
32
Q

Renal transplant complications:

A
  • hypertension
  • lipid disorders
  • hepatitis
  • cancer
  • tendinopathies
  • osteopenia
  • corticosteroids impari bone formation
33
Q

Dialysis complications

A
  • increased thirst
  • wt. gain
  • abdominal distension
  • depression
  • infertility
  • amenorrhea
  • uterine bleeding
  • increased susceptibility to infection
34
Q

Where can pain occur in the early days of dialysis?

A

chest and back

-watch for thromosis

35
Q

Exercise and CKD:

A
  • lifting and carrying can be difficult
  • strength training, balance and mobility are key components for HEP
  • performed during, before, or after dialysis
  • provides better mvmt of fluids during dialysis
36
Q

What are the two most commonly monitored values during renal failure?

A

-serum creatinine and BUN

37
Q

Dyspnea at rest or with exertion, increased fatigue or chest pain with exercise may indicate?

A

low hematocrit levels