Renal Diagnotic Procedures Flashcards
What structures does renal x-ray’s make visual?
Renal calculi
Strictures
Calcium deposits
Obstruction
Nursing actions for renal X-ray?
Ask patient if they are pregnant
Remove clothes, jewelry, metal objects
What does renal ct scan reveal? And what can it contain?
Kidney size, obstruction, cysts, or masses
It can contain iodine (IV contrast media)
Nursing actions for renal ct scan?
Ask client if pregnant
Remove jewelry, clothes, metal objects
(Include preop and postop from excretory urography, excluding bowl preparation)
What are the complications of renal ct scan
Acute kidney injury
Bigger risk for:
Older adults, dehydrated clients, clients with previous renal insufficiency and clients taking nephrotoxic drugs
Renal MRI
Useful for staging cancer
Nursing actions for renal MRI
Clients have to remain still
Clients with metal implants are not eligible due to magnet can move the metal implant
Renal ultrasound
Assess the kidneys, images ureters, bladder, masses,cyst, calculi, obstruction of the lower urinary tract
-alternative to excretory urography
Nursing actions of renal ultrasound
Provide skin care by removing gel after procedure
Cystography, cystourethrography, voiding cystourethrogram (VCUG)
Detects urethral or bladder unjustly after instillation of contrast media through urinate catheter, providing image of bladder and ureters.
Detects via an x-ray during urination whether urine refluxes into the ureters
Nursing actions for VCUG
Monitor for infection-72 hours
Encourage increased fluid intake
—dilutes urine
—minimize burning in urination
Monitor urine output
—report less than 30mL
Complications of VCUG
UTI due to catheter placement
Cloudy, foul smelling urine
Urine positive for leukocyte esterase and nitrites, sediment and RBC’s
Kidney biopsy
Removal sample of tissue by excitation or needle aspiration
Nurse actions for kidney biopsy
Clients receive sedation and ongoing monitoring
Pre procedure for kidney biopsy
Review coagulation studies
Ensure client has been NPO 4 to 6 hours
Post procedure for kidney biopsy
Monitor vital signs
Assess dressings and urinary output
Review Hgb and Hct
Administer analgesia
Complications of kidney biopsy
Hemorrhage
Infection
Cloudy, foul smelling urine
Cystoscope, cystourethroscopy
Used to discover abnormalities of bladder wall and/or occlusions or ureters or urethra
Nursing actions for Cystoscope, cystourethroscopy
Clients receive anesthesia
Check for finding if bleeding and infection (72hrs)
Pre procedure for Cystoscope, cystourethroscopy
NPO after midnight
Admin laxative or enemas
Intra procedure for Cystoscope, cystourethroscopy
Monitor vitals
Place client in lithotomy position
Post procedure of Cystoscope, cystourethroscopy
Monitor vital & urine output
Document color of urine
—can be pink tinged
Irrigate urinary catheter with 0.9 NS if blood clots are present or the urine output is decreased
Encourage oral fluids
Complications of Cystoscope, cystourethroscopy
UTI
Cloudy, foul smelling urine
Retrograde, pyelogram, csytogram, urethrogram
Identifies obstruction or structural disorders of the ureters and renal pelvis of the kidneys
Identifies fistula, diverticula, and tumors in the bladder by instilling contrast media
Renal scan
Assess renal blood flow & estimates glomerular filtration rate after IV injection of radioactive material
Post procedure for renal scan
Assess blood pressure
Alert clients about orthodontic hypotension
Increase fluid intake
Excretory urography
Detects obstruction, parenchyma masses, assesses the size of the kidneys.
IV contrast media enhances images
Pre procedure for Excretory urography
Encourage increased fluids
Bowel cleansing with laxative an enema
NPO after midnight
Determine allergies
Check creatinine and BUN levels
Withhold metformin for 24hrs
Postprecedure Excretory urography
Administer parenteral fluid or oral fluids
Diuretics
Check creatinine and BUN levels before resuming metformin
