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Med Surg 1 > Renal system > Flashcards

Renal system Flashcards

1
Q

What is Hydronephrosis

A

swelling of a kidney due to a buildup of urine

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2
Q

Hydronephrosis Causes

A

Obstruction in Urinary Tract

Can be secondary to prostate enlargement

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3
Q

Signs and symptoms of Hydronephrosis

A
  • Frequency
  • Urgency
  • Dysuria
  • Flank and Back pain
  • Renal failure
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4
Q

Interventions for Hydronephrosis

A
  • Treat cause
  • Urinary catheter
  • Stents (runs from kidney pelvis to bladder)
  • Nephrostomy Tube
    • intake and output
    • no clamping
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5
Q

What is Polycystic kidney disease

A
  • multiple cysts in the kidney

- inherited disease

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6
Q

Signs and symptoms of Polycystic kidney disease

A
  • Dull Heaviness in Flank/Back
  • Hematuria
  • Hypertension
  • UTI (prone)
  • Kidney would become enlarged (palpation possible)
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7
Q

Interventions for Polycystic kidney disease

A
  • Progressive

- No treatment

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8
Q

What is Glomerulonephritis

A
  • acute inflammation of the kidney, typically caused by an immune response
  • causes glomerulus to become more porous
  • tends to be a post-strep infection
  • can be caused by drugs or toxins
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9
Q

Signs and symptoms of Glomerulonephritis

A
  • Oliguria
  • Hypertension
  • Electrolyte Imbalances
  • Edema
  • Electrical imbalances
  • Flank Pain
  • Proteins, WBCs, RBC’s in urine
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10
Q

Dx for Glomerulonephritis

A
  • urinalysis
  • ultrasound
  • x-ray
  • biopsy
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11
Q

Interventions for Glomerulonephritis

A
  • Interventions
    • managing hypertension
    • quick treatment for strep
  • Renal Failure Treatment
  • renal dialysis
  • fluid, sodium, protein restrictions
  • Monitor Vital signs
  • Symptom support
  • rest
  • education
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12
Q

Acute Renal Failure

A

-Sudden loss of kidney function

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13
Q

Acute renal failure causes

A

types

  • prerenal failure
  • intrarenal failure
  • nephrotoxins
  • postrenal failure
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14
Q

Cause of prerenal failure

A
  • Decreased blood supply to kidneys
    • blood loss
    • heart failure
    • blockage
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15
Q

Cause of intrarenal failure

A
  • damage to nephrons
    • nephrotoxins
      • diagnostic contrast media (dyes)
      • medications (IV Aminoglycosides, Tobramycin, Amikacin, Cisplatin), Chemicals
    • damaging immune response
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16
Q

Causes for postrenal failure

A

-Obstruction (below kidney) causing backflow

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17
Q

Dx of acute renal failure

A
  • History
  • Prevention
    • check serum BUN and creatinine prior to dyes or meds
    • Hydrate before/after contrast media
    • Monitor peak/trough levels of nephrotoxic drugs per policy
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18
Q

Oliguric phase of acute renal failure

A
  • low output
  • Monitor labs
  • Restrict fluid, Na & poss. Protein
  • 24hrs-week
  • Fluid, electrolytes imbalance
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19
Q

Diuretic phase of acute renal failure

A
  • high output
  • Fluid electrolytes balance out of wack
  • dehydration – on high IV fluids
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20
Q

Recovery phase of acute renal failure

A

-takes up to 1 year

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21
Q

interventions for acute renal failure

A
  • treat cause
  • supportive treatment (fluid electrolytes, HbG, Hct,etc)
  • dialysis
  • continuous renal replacement
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22
Q

Chronic Renal Failure

A
  • Gradual decrease in kidney fx

- irreversible

23
Q

Causes of chronic renal failure

A
  • Diabetes
  • Hypertension
  • Chronic exposure to toxins
  • Hyperlipidemia
  • Diabetic Nephropathy
  • Nephrosclerosis
  • Glomerulonephritis
  • Autoimmune Diseases
24
Q

S/S of chronic renal failure

A
  • Large Proportion of Nephrons Damaged
  • Progressive
  • Renal Insufficiency: 75% of Nephrons Lost
  • End-stage: 90% of Nephrons Lost
  • Uremia: Urea in the Blood
  • Affects All Body Systems
25
Interventions for chronic renal failure
``` Treat causation -Hypertension -Diabetes -Cholesterol Fluid Restriction Treat anemia (w/erythropoietin) Treat Ca+/hyperparathyroidism Treat metabolic acidosis Diet Medications Dialysis ```
26
Diet interventions for chronic renal failure
- High Calorie - Low Protein (Unless Dialysis) - b/c of the byproducts that kidneys must filter - [controversial b/c lack of ability to repair tissue] - Low Sodium, Potassium, Phosphorus - Increased Calcium - Vitamins
27
Medication interventions for chronic renal failure
- Diuretics - Antihypertensives - Phosphate Binders - Calcium/Vitamin D Supplements - Kayexalate prn
28
Dialysis intervention for chronic renal failure - occurs with specific symptoms
- Symptoms of Fluid Overload - High Potassium - Neurological Signs - Uremia
29
Vascular access care for acute renal failure
- listen for thrill, bruit over access site - don’t take BP on arm with access - instruct pt to be careful with arm with access - keep watch for infection - take radial pulse, size, T etc of each arm to monitor for circulatory compromise - postop - NV checks, pain, elevate extremity
30
Dialysis done by pt
- Peritoneal Membrane Is Semipermeable Membrane, Across which Excess Wastes/ Fluids Move from Blood - Peritoneal Catheter - Exchange Process: Fill, Dwell Time, Drain - Takes about 8 hrs - must have frequent labs to determine solution concentrations
31
Kidney transplant interventions
- Living-Related Donor or Cadaver Donor - Antirejection Drugs - Donate kidney typically lasts ~10 yrs
32
Nursing care for excess fluid volume
- Monitor Weight - Intake and Output - Fluid Restriction - Monitor for Fluid Retention
33
Nursing care for electrolyte imbalance
- Monitor Levels - Dietary Restrictions - Monitor Dysrhythmias
34
Nursing care for waste products
- Oral Care - Skin Care - Lotion - Protect from Injury
35
Nursing care for impaired hematological fx
-Protect from Injury/Infection
36
Cancer of the Kidney
- Rare - Exact cause unknown - Risk Factors - Smoking – lifetime risk - Obesity - Hypertension - Exposure to asbestos, lead, cadmium and phosphates
37
S/S of cancer of the Kidney
- Palpable abdominal mass found during routine exam. - Hematuria - dull pain in flank area - mass
38
Dx for cancer of the kidney
- IVP (intravenous pyelogram- x-ray examination of the kidneys) - Cystoscopy and Pyelogram - Ultrasound - CT Scan - MRI - Renal Biopsy
39
Cancer of the Bladder
``` Most Common Urinary Tract Cancer Men > Women Ages 50-60 Years Etiology Smoking Industrial Pollution – aniline dyes, asbestos, and aromatic amines ```
40
S/S of cancer of the bladder
``` Early -Painless -Hematuria Late -Pelvic pain -lower back pain -dysuria, frequency, urgency -inability to void ```
41
Dx for bladder cancer
- Urinalysis - Urine for Cytology, Culture - Cystoscopy and Transurethral Biopsy - IVP (Intravenous pyelogram)
42
Urological obstructions
Obstruction of Urine Flow Is Always Significant Backup of Urine Destroys Kidney -urethral strictures (lumen narrowing due to scar tissue) -renal calculi -hard, generally stones -kidney stones (nephrolithiasis) - formed primarily in kidney
43
Types of kidney stones
- Calcium – found in 90% of stones - Uric acid - Oxalate - Struvite - Cystine - Xanthine
44
Causes of kidney Calculi (stones)
- Heredity - Chronic Dehydration - Infection - Immobility - Men >Women
45
S/S of Renal Calculi (stones)
- Flank Pain - Renal Colic - Dysuria - Costovertebral Tenderness - Hematuria - Frequency - Urgency - Enuresis - GI Upset
46
Dx of Renal Calculi
- Kidney-Ureter-Bladder X-ray - IVP - intravenous pyelogram - renal ultrasound - urinalysis (RBC, WBC)
47
Complications of Renal calculi
- UTIs - Hydronephrosis - Pain, spasm, or colic from peristalsis movement of ureter contracting on the stone - tissue trauma
48
Tx for renal calculi
-Using pain medicine: Nonprescription medicine, such as NSAIDs, Narcotics -Drinking enough fluids: drinking water and other fluids may help passing a calculi. -Lithotripsy -Surgery -(Uric Acid) Allopurinol
49
Urinary Incontinence/ Urinary retention Types
Stress Incontinence -Involuntary Urine Loss from Increasing Abdominal Pressure Urge Incontinence -Involuntary Urine Loss with Abrupt/Strong Desire to Void Overflow Incontinence -Incontinence for distension of bladder -Commonly assoc. with obstruction of outlet or BPH (benign prostate hypertrophy) Functional Incontinence -Incontinence from Impairment of Physical/Mental Function Total Incontinence -Continuous, Unpredictable Loss of Urine
50
Urinary Retention
Acute -Anesthesia, Medications, Local Trauma to Urinary Structures Chronic -Enlarged Prostate, Medications, Strictures, Tumors
51
Urinary retention Dx
-Monitor Urine Output, Bladder distention -Bladder Scan -Residual Volume of more than100 ml Urine -Indicates Need for Treatment Nursing diagnosis – Risk for impaired tissue/tissue damage Indwelling Catheters Urinary Catheters Result in Infection
52
Types of Urinary Catheters
``` Intermittent Catheterization -Best -Reduces Risk of Infection -Patients May Self-cath Suprapubic Catheter -Indwelling Catheter Inserted Through Incision in Lower Abdomen into Bladder ```
53
Nursing Dx for Urinary Incontinence
Risk for - Stress incontinence - Urgency incontinence - Total incontinence - Functional incontinence - Overflow incontinence - Skin impairment - Self-care deficit r/t toileting - Situational low self esteem - Social anxiety - Disturbed body image
54
Justifiable reasons for catheterization
- Close monitoring of output - Urinary Tract Obstruction - Neurogenic Bladder - Treatment Related Immobility

Med Surg 1 (8 decks)

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