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NCLEX: Med Surg > Renal System > Flashcards

Renal System Flashcards

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1
Q

Functions of the kidneys

A

Maintenance of proper fluid volume, regulation of electrolytes and acid-base balance, elimination of waste products such as urea, uric acid, ammonia, creatinine, regulation of BP through renin, enable RBC production through release of erythropoietin, convert vitamin D to active form essential for calcium absorption

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2
Q

Urinalysis should NOT include

A

Glucose, ketones, blood, protein, bilirubin, nitrates, leukocyte esterase

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3
Q

Normal creatinine

A

0.6-1.2

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4
Q

Normal BUN

A

10-20

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5
Q

Small amount of urine loss that occurs with abdominal pressure from laughing, coughing, sneezing caused by a weakened pelvic floor

A

Stress incontinence

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6
Q

Stress incontinence risk factors

A

Menopause, obesity, constipation, pelvic surgery

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7
Q

Stress incontinence treatment

A

Kegel exercises, weight reduction, estrogen, vaginal cone therapy

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8
Q

With _________ incontinence, the patient is unable to reach the bathroom in time due to an overactive destructor muscle (smooth muscle in bladder)

A

Urge

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9
Q

Urge incontinence treatment

A

Anticholinergics (oxybutynin), bladder training, toileting schedule, avoid caffeine and alcohol

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10
Q

Bladder analgesic that can decrease pain and urgency associated with UTI

A

Phenazopyridine

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11
Q

S/S of acute pyelonephritis

A

Costovertebral tenderness, flank or back pain, fever, chills, N/V, tachycardia, tachypnea, hypertension

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12
Q

Labs associated with pyelonephritis

A

Elevated WBC, creatinine, BUN, CRP, ESR

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13
Q

Autosomal dominant genetic disorder that causes the formation of fluid filled cysts in the kidneys

A

Polycystic kidney disease (PKD)

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14
Q

PKD S/S

A

Abdominal distention, flank or back pain, hypertension, hematuria

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15
Q

Glomerulonephritis risk factor

A

Strep infection

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16
Q

S/S of glomerulonephritis

A

Oliguria, s/s of fluid volume excess, brown cola-colored urine

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17
Q

Labs associated with glomerulonephritis

A

Elevated creatinine, BUN, WBC, ESR, CRP, (+) ASO titer, proteinuria, hematuria

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18
Q

Glomerulonephritis treatment

A

Antibiotics to treat strep infection, diuretics, Anti-hypertensive agents, corticosteroids, Plasmapharesis, dialysis, kidney transplant

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19
Q

Glomerulonephritis nursing care

A

Monitor I&Os, daily weight, decreased fluid, sodium, and protein intake until kidneys heal

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20
Q

Kidney disorder characterized by massive loss of protein in urine

A

Nephrotic syndrome

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21
Q

Symptoms of nephrotic syndrome

A

Edema — periorbital, ascites, peripheral; frothy urine

22
Q

Labs associated with nephrotic syndrome

A

Hypoalbuminemia, hyperlipidemia, massive proteinuria (2+)

23
Q

Nephrotic syndrome treatment

A

Corticalsteroids, diuretics, 25% albumin, statins

24
Q

Nephrotic syndrome nursing care

A

Monitor I&Os, I&Os, daily weight, abdominal girth daily, implement fluid and sodium restrictions, moderate protein intake, prevent skin breakdown, monitor for infection d/t corticosteroids

25
Q

S/S of urolithiasis

A

Severe pain on the flanks, the back, lower abdomen, dysuria, fever, diaphoresis, N/V, tachycardia, tachypnea, oliguria, hematuria

26
Q

Urolithiasis post-lithotripsy nursing care

A

Screen urine for stone fragments that may be passed, monitor I&Os

27
Q

Urolithiasis patient education

A

Increase fluid intake (3 L/day), limit foods according to type of calculi

28
Q

Sudden loss of kidney function that is typically reversible

A

Acute kidney injury (AKI)

29
Q

The gradual, irreversible loss of kidney function

A

Chronic kidney disease (CKD)

30
Q

General underlying causes of acute kidney injury

A

Prerenal AKI: decrease blood flow to the kidneys due to sepsis, shock, hypovolemia
Intrarenal AKI: direct damage to the kidneys by trauma, hypoxic injury, or chemical injury due to toxins or medication‘s such as gentamicin
Post renal AKI: mechanical obstruction to urine leaving the kidneys caused by stone, tumor, or BPH

31
Q

Phases of AKI

A

Onset, oliguria, diuresis, recovery

32
Q

Labs associated with AKI

A

Hyperkalemia, hyponatremia, hypocalcemia, hypermagnesemia, metabolic acidosis, anemia

33
Q

AKI nursing care

A

Implement seizure precautions,monitor I&Os and daily weight, educated patient to reduce/restrict potassium, sodium, phosphorus, and magnesium intake

34
Q

CKD risk factors

A

Older age, dehydration, AKI, hypertension, diabetes, medication’s, autoimmune disorders

35
Q

S/S of CKD

A

Fluid volume overload, pruritis, N/V, uremic frost

36
Q

Labs associated with CKD

A

Elevated potassium, phosphorus, magnesium, creatinine, BUN
Decreased Sodium and calcium, Hgb, Hct, GFR

37
Q

Stage five (end stage) renal disease GFR

A

<15

38
Q

CKD nursing care

A

Monitor I&Os, daily weight, restrict fluid, sodium, potassium, phosphorus, and magnesium

39
Q

CKD patient education

A

Avoid nephrotoxic drugs (NSAIDs, contrast dye, magnesium-containing antacids)

40
Q

Nursing care/consideration of hemodialysis patient with AV fistula

A

Do NOT take BP or venipuncture on that arm, if advice, patient not to carry heavy objects or sleep on that arm

41
Q

Nursing care for AV fistula

A

Auscultate bruit, palpate thrill

42
Q

Nursing actions prior to dialysis

A

Obtain patient, vital signs, weight, and labs, hold certain medications until after dialysis

43
Q

Nursing actions during dialysis

A

Monitor for hypotension and adverse effects like cramping, N/V, bleeding associated with heparin

44
Q

Nursing actions post-dialysis

A

Measure patient weight and vitals (decrease in weight and BP is expected), compare weight to pre-procedure weight

45
Q

Solution used for peritoneal dialysis

A

Hypertonic

46
Q

Peritoneal dialysis nursing considerations

A

Sterile technique, keep outflow lower than patients abdomen, monitor color of outflow (should be clear or light yellow; if bloody or cloudy — could mean infection)

47
Q

Complications of hemodialysis

A

Disequilibrium syndrome (neurologic deterioration associated with cerebral edema and increased ICP), hypotension (administer IV fluids and colloids, slow infusion rate and lower HOB)

48
Q

Complications of peritoneal dialysis

A

Peritonitis (fever, cloudy outflow, N/V, abdominal pain and tenderness)

49
Q

Kidney transplant post-op nursing care

A

Closely monitor UOP, monitor bladder irrigation for clots, monitor for infection, monitor for signs of organ rejection (fever, pain, weight gain, HTN, increased creatinine, BUN, WBC)

50
Q

Kidney transplant patient education

A

No contact sports, monitor for infection and rejection, monitor BP daily, immunosuppression such as cyclosporine for life

NCLEX: Med Surg (10 decks)

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