Renal System Flashcards
Normally, kidneys excrete approximately
1ml of urine per kg of body weight per hour.
Adults normal urine output
1500-2000ml
In some cases, persons in ARF may not experience the oliguric phase but may progress
Directly to the diuretic phase, during which the urine output may be as much as 10L per day
Body weight is a good indicator of
Fluid retention and renal status.
Obtain accurate weights of all clients with renal failure
obtain weight on the same scale at the same time every day
Signs of excess fluid
- Dyspnea
- Tachycardia
- Jugular vein distention
- Peripheral edema
- Pulmonary edema
- weight gain
Signs of fluid deficit syndrome
- Decreased urine output
- Reduction in body weight
- Decreased skin turgor
- Dry mucous membranes
- Hypotension
- Tachycardia
- Weight loss
Signs of hyperkalemia
- Dizziness
- weakness
- cardiac irregularities
- muscle cramps
- diarrhea
- nausea
High Potassium foods
Bananas Orange Juice Cantaloupe Strawberries Avocados Spinach Fish
Clients with renal failure
retain Na. Because of water retention serum levels may appear normal.
During oliguric phase minimize protein breakdown and prevent rise in BUN by limiting
protein intake
Accumulation of waste products from protein metabolism I the primary cause of
uremia
The GFR is most often used as an indicator of the level of
protein consumption
The major difference between dialysate for hemodialysis and peritoneal dialysis is the amount of
glucose
Peritoneal dialysis dialysate is much higher in glucose. Fro this reason if the dialysate is left in the peritoneal cavity too long hyperglycemia may occur
In CRF protein intake is
restricted
Signs of digoxin toxicity
- nausea
- vomiting
- anorexia
- visual disturbances
- restlessness
- headache
- cardiac dysrhythmias
- pulse >60
Flank pain usu means the stone is in the
kidney or upper ureter
If pain radiates to the abdomen or scrotum, the stone is likely to be in the
Ureter or bladder
excruciating spastic type pain is called
Colic
Percutaneous nephrostomy
A needle or catheter is inserted through the skin into the calyx of the kidney. The stone may be dissolved by percutaneous irrigation with a liquid that dissolves the stone or by ultrasonic sound waves that can directed through the needle or catheter to break up the stone. Stone is then eliminated through the urinary tract.
Bladder spasms frequently occur after TUPR. Inform the client that the presence of the oversized balloon on the catheter with cause a continuous feeling of needing to void. The client should not
try to void around the catheter because this can precipitate a bladder spasm. Medications can reduce or prevent spasms should be given.
The solution used to irrigate for a TUPR must be
isotonic to prevent fluid and electrolyte imbalance.
Differentiate between acute renal failure and chronic renal failure
Acute: Reversible, abrupt
Chronic: Irreversible, slow, dialysis
During the oliguric phase of renal failure, protein should be severely restricted, why?
Toxic metabolites that accumulate in the blood (urea, creatinine) are derived mainly from protein catabolism.
Identify two nursing interventions for the client on hemodialysis
- Don’t take blood pressure or perform venipuncture on the arm with AV shunt, fistula, or graft
- Assess access site for a thrill and bruit
What is the highest priority nursing diagnosis for clients with any type of renal failure?
Risk for imbalance fluid volume
A client is renal failure asks why is being given antacids. How should the nurse reply?
Calcium and aluminum antacids bind phosphate and help to keep phosphates from being absorbed into the blood stream. Thereby preventing a rise in phosphate levels. Must be taken with meals.
List four essential elements of a teaching plan for a clients with frequent UTI’s?
- Fluid intake of 3L /day
- Good handwashing
- Void q 2-3 hrs during waking hours
- Take all prescribed medications
- Wear cotton undergarnments
What are the most important nursing interventions for clients with possible renal calculi?
Straining all urine
- accurate I and O documentation
- administer analgesics as needed
What discharge instructions should be given to a client who has had a renal calculi?
- Maintain high fluid intake 3-4L/day
- Persue follow up care
- Follow prescribed died based on calculi content
- Avoid supine position
Following a TURP resection of the prostate gland, hematuria should subside by what PO day?
Day 4
After the urinary catheter is removed in the TUPR client, What are three priority nursing actions?
- Cont. strict I and O’s
- Cont observation for hematuria
- Burning and frequency may last for a week
After kidney surgery, What are the primary assessments the nurse should make?
Resp status
Circulatory status
Pain assessments
urinary assessments
