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XIO > renal exam - study guide > Flashcards

renal exam - study guide Flashcards

1
Q

IVP (Intravenous pyelogram) - what does it do?

A

Visualizes urinary tract, shape, size position of kidneys, ureters, & bladder;

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2
Q

IVP detects

A

Detects cysts, tumors, lesions, obstructions.

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3
Q

IVP contraindicated in who?

A

Test contradicted for pt with decreased renal function because the contrast media can be nephrotoxic.

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4
Q

Side-effect of metformin is (increases what and stop before..)

A

increased lactic acid production. This may lead to lactic acidosis & death. Stop taking the metformin 48 hrs before & 48 hrs after the test or when renal function returns back to normal.

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5
Q

meds for IC - Calcium phosphorus - for (IC calcium before it’s too late)

A

Calcium phosphorus (Prelief)

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6
Q

BPH - If the DRE and PSA levels are abnormal, what is the next step? (visualize it)

A

then a transrectal ultrasound with possible biopsy is done to R/O prostate cancer.

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7
Q

5α-reductase inhibitors finasteride (Proscar) reduces size of (fin blocks androgens)

A

prostate gland by suppressing androgens.

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8
Q

α-adrenergic receptor blockers terazosin (Hytrin) & tamsulosin (Flomax) promote (tez and tam relax me)

A

smooth muscle relaxation in prostate facilitating urinary flow through urethra.

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9
Q

Saw palmetto action is the same as the

A

α-adrenergic receptor blockers.

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10
Q

Never use what with prostate?

A

Never use zinc because it stimulates the growth of the prostatic tissues.

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11
Q

TURP - what type of foley catheter?

A

A three-way foley cath is inserted after surgery. Continuous bladder irrigations are done to flush all the blood out of the bladder to prevent clots from developing.

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12
Q

priapism - complications (need hydro for my priapism)

A

penile tissue necrosis; Hydronephrosis (kidneys become stretched and swollen) from bladder distention; inability to achieve a normal erection after priapism subsides.

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13
Q

Transillumination is used to (illuminate the fluid)

A

identify solid tumors/cancer versus fluid in the scrotum

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14
Q

Epididymitis is (one or both sides?)

A

unilateral

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15
Q

Most common cause of infertility is (vari infertile)

A

varicocele.

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16
Q

Testicular torsion common in

A

young boys and is a surgical emergency to untangle the blood supply that is twisted around the vas deferens.

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17
Q

Vasectomy is performed where?

A

Vasectomy is performed in the MD office.

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18
Q

vasectomy - Should use contraception for

A

6 weeks or 10 ejaculations to evacuate sperm distal to surgical site.

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19
Q

drug therapy for prostate cancer

A

Drug therapy is called Hormonal therapy (androgen deprivation therapy – ADT).Goal: reduce the androgen level. Androgen promotes the tumor growth. Causing a castration effect will prevent the release of any androgen. Hence, the cancer will stop growing and begin to shrink in size

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20
Q

ADT is used as (ADP alone isn’t enough)

A

an adjunct therapy before surgery or radiation.

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21
Q

Complication of ADT is (adt security is bare bones)

A

osteoporosis

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22
Q

Glomerulonephritis (glum’s basement is damaged)

A

caused by Ab induced injury to the glomerular basement membrane.

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23
Q

glomerulonephritis - symptoms (glum has a swollen face)

A

Generalized body edema. May start with periorbital edema & progress to peripheral edema or ascites.

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24
Q

Polycystic kidney disease - both kidneys? is it genetic?

A

both kidneys and is genetic.

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25
Q

PKD - where are cysts?

A

Large thin walled cysts develop in cortex & medulla of kidneys. Cysts grow to the size of golf balls & filled with blood or pus. Large cysts compress surrounding tissues & destroy them. May lead to cysts in liver; Affect heart valves;

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26
Q

PKD - aneurysms and diverticulosis? how?

A

Aneurysms especially cerebral aneurysm (enlarged kidneys have tamponade effect on aorta); Diverticulosis (kidneys grow so large that it applies pressure against intestinal tract).

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27
Q

Elevated creatinine levels indicate

A

AKI.

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28
Q

pre-renal AKI - when is it reversible? how long?

A

There is no damage to the parenchyma so with hydration AKI is reversible if rehydrated in 48 hrs.

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29
Q

pre-renal AKI - If no hydration is performed

A

then the nephrons will eventually
die off and become to stage 2 intrarenal

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30
Q

Intrarenal AKI results from direct damage to the kidneys caused by

A

prolonged ischemia, nephrotoxins, hemoglobins released from hemolyzed RBCs, or myoglobins released from necrotic muscle cells

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31
Q

causes of acute tubular necrosis (ATN) (ant is caused by SIN)

A

Ischemia, nephrotoxins, or sepsis

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32
Q

Postrenal is reversible if the obstruction is relieved within

A

48 hrs.

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33
Q

Prolonged obstruction leads to (the atrophy and fibrosis are prolonged)

A

tubular atrophy & irreversible kidney fibrosis resulting in CKD.

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34
Q

AKI - oliguric phase - signs of

A

dehydration, JVD, LE edema, lung congestion

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35
Q

oliguric phase - risk factors - IV fluids

A

CHF due to over hydrations with IVF for treatment during oliguric phase

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36
Q

Bruises occur when

A

renal not producing erythropoietin. Pt becomes anemic.

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37
Q

Oliguric Phase - onset (olga’s onset was 17 days)

A

<400 ml urine output per day
Onset: within 1-7 days of AKI

38
Q

oliguric phase - If caused by ischemia, then oliguria occurs within (olga and ishmail married in 24 hrs)

A

then oliguria occurs within 24 hrs

39
Q

oliguric phase - If caused by nephrotoxic drugs, then the onset may be (toxins in my system for a week)

A

then the onset may be delayed for as long as 1 week.

40
Q

oliguric phase - duration (olga could only endure until 10:14)

A

Duration is usually 10 to 14 days but can last months in some cases. Just remember the longer the oliguria lasts the poorer the prognosis for recovery of kidney
function

41
Q

In the oliguric & anuric phases, IVF cause

A

neck vein distention, bounding pulse, HTN, edema & result in HF, pulm edema, pericardial & pleural effusion.

42
Q

oliguric - metabolic acidosis

A

NaHCO3 normally binds with the excess H but in the oliguric phase NaHCO3 production is reduced due to a defective reabsorption & regeneration of bicarbonate ions.

43
Q

Pts with severe metabolic acidosis develop (blow off the acid)

A

Kussmal breathing (rapid deep respirations) trying to exhale the excess CO2

44
Q

If AKI is caused by a massive tissue trauma

A

then those damaged tissue cells releases K
into the ECF. This increases the already high K level

45
Q

In Metabolic acidosis the extra H - it takes action

A

enters the cell & pushes K out there by increasing the K level.

46
Q

Hematologic disorders (RBCs, bone marrow) occur in those with (heman is sick)

A

multi-organ failures or hematologic disorders

47
Q

Leukocytosis is often present in (luke is friends w/ aki)

A

AKI

48
Q

The most common cause of death in AKI is

A

infection.

49
Q

The most common site of infection are from the (think catherter and breathing)

A

urinary & respiratory systems.

50
Q

BUN may be caused from - think infections and bleeding

A

dehydration, corticosteroids, catabolism from infections,
fever, severe injury, or GI bleed.

51
Q

The best serum indicator of AKI is

A

elevated creatinine levels

52
Q

excess BUN accumulates in

A

the brain and nervous system. Causes fatigue, difficulty concentrating, seizures, stupor, coma

53
Q

chronic kidney disease - cardiovascular - but why?

A

HTN (renal medulla gone so prostaglandins cannot be synthesized to vasodilate)

54
Q

chronic kidney disease - symptoms (chronic breath smells like feta)

A

Uremic fetor (breath smells like urine)

55
Q

chronic kidney disease - GI (this is about anorexia)

A

GI bleed occurs when stomach continues to produce gastric acids and there is no food in the stomach

56
Q

chronic kidney disease - GI - Constipation occurs with the (selma has constipation)

A

intake of sevelamer/phoslo, limited po fluids, & reduced physical activity

57
Q

Chronic kidney disease - women

A

decreased level of estrogen, progesterone, luteinizing hormone that results in amenorrhea. Menstruation recurs with dialysis.

58
Q

chronic kidney disease - men

A

inconsistent levels of testosterone, low sperm count

59
Q

chronic kidney disease - neurologic

A

Increased nitrogenous waste products, electrolyte imbalance, metabolic acidosis,
atrophy & demyelination of nerve fibers

60
Q

atrophy & demyelination of nerve fibers (mom demylenates)

A

slows the nerve conduction to BLE (bilateral lower extremities) so peripheral neuropathy occurs

61
Q

Dialysis reduces the CNS manifestations except it cannot reverse

A

the motor neuropathies

62
Q

Increased BUN & HTN leads to (tu has a high BUN)

A

seizures, coma

63
Q

pruritis caused by - (calcium makes me itch)

A

dry skin, Ca Phosphate deposits in the skin,

64
Q

Uremic frost comes from extremely high BUN levels

A

(>200). Urea seeps thru skin & forms
white itchy flakes.

65
Q

dialysis - hypotension - fluid is reduced before or after?

A

Hypotension: dialysis rapidly reduces vascular volume which results in reducing the preload
& cardiac output

66
Q

dialysis - to prevent hypotension

A

less fluid is removed & NS IVF may be given

67
Q

dialysis - hep b

A

Hepatitis B is avoided by vaccination. Hep C can occur due to poor infection control during
dialysis.

68
Q

Peritoneal dialysis - how much? and for how long? (Tone just needs 10 min)

A

As per physician order. Usually fill - 2 L Dialysis solution (room temp) instilled into peritoneal space (10 mins) Larger abdomen takes up to 3 L.

69
Q

peritoneal dialysis - Equilibration takes how long? (tone needs 30 min to get right)

A

Leave solution so it can dwell (diffusion/osmosis between blood & peritoneal cavity) 20-30 mins or as per order depending on desired outcome.

70
Q

peritoneal dialysis - drain how long? (I was drained already at 15)

A

Drain - 15-30 mins. May have to massage abdomen or change positions.

71
Q

peritoneal dialysis - after - assess what? (3 things) (tone is SEC)

A

Assess the effluent, site , catheter and report any signs of infection, or complications.

72
Q

kidney transplant - steroids - given with what?

A

Corticosteroid use leads to aseptic necrosis of the joints (hips, knees, etc.). Tacrolimus & other immunosuppressants helps lower the required steroid dose.

73
Q

Kidney transplant post-op care in addition to standard post-op care: - what is the #1 priority???

A
  • Monitor incision, renal function, bleeding, URINE OUTPUT IS PRIORITY ASSESSMENT
  • Pain management
  • Immunotherapy
  • Signs of rejection
74
Q

meds for IC - Antidepressants & Elmiron (Elmo w/ glyco)

A

Antidepressants; Pentosan (Elmiron) for IC enhances the protective
effects of glycosaminoglycan layer of the bladder

75
Q

meds for IC - (IC a dime)

A

Dimethylsulfoxide (DMSO); Reduce stress;
Relaxation techniques; Avoid tight clothing around suprapubic area.

76
Q

glomerulonephritis - Can be caused by (glum, inside and out)

A

Can be caused by endogenous (autoimmune antigen) or exogenous (infection such as strep antigen).

77
Q

glomerulonephritis - HTN and oliguria? (glum is too extra)

A

HTN (too much ECF); oliguria (decreased GFR)

78
Q

epididymis is caused by (p diddy has infection and trauma)

A

infection, trauma, urinary reflux down the vas deferens

79
Q

what drugs are given to prevent osteoporosis with ADT? (Bison against osteoporosis)

A

Bisphonate drugs are given to prevent osteoporosis.

80
Q

uncomplicated UTI

A

just involves bladder. complicated = catheter, pregnancy, recurrent infection, immune compromised

81
Q

uncomplicated UTI - how long for antibiotics?

A

3 days

82
Q

Complicated UTI - how long for antibiotics?

A

7-14 days

83
Q

about what % of UTIs are asymptomatic?

A

50%

84
Q

uretheral trauma - s/s classic triad

A

blood visible at the meatus, inability to void, distended bladder

85
Q

struvite stones

A

ask if pt has had UTIs

86
Q

bladder cancer - post op - how often to assess output? (assess Jean every hour)

A

every hour

87
Q

Saw palmetto

A

promotes smooth muscle relaxation. action is the same as the α-adrenergic receptor blockers.

88
Q

AKI is reversible for the

A

the prerenal and postrenal stages.

89
Q

Intrarenal AKI results from direct damage to the kidneys caused by

A

prolonged ischemia, nephrotoxins, hemoglobins released from hemolyzed RBCs, or myoglobins released from necrotic muscle cells.

90
Q

chronic kidney disease - GI (metal is chronic)

A

stomatitis with exudate & ulcerations & metallic taste in mouth

91
Q

chronic kidney disease - Restless legs syndrome

A

Restless legs syndrome begins with burning sensation then later muscular
weakness & atrophy leading to foot drop, Muscle twitching, asterixis, nocturnal
leg cramps

XIO (393 decks)

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