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Nursing 265 > Renal/Urinary > Flashcards

Renal/Urinary Flashcards

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1
Q

The kidneys receive how much cardiac output?

A

20-25%

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2
Q

What substances are not supposed to be in urine?

A

Protein and glucose

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3
Q

Renal threshold for glucose urine..

A

180 mg/dL

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4
Q

Vasopressin is also known as…

A

ADH (antidiuretic hormone)

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5
Q

Osmolarity is

A

ratio of solute to water

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6
Q

Osmolality is

A

a measurement, the degree of dilution or concentration of the urine.

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7
Q

When the kidneys sense a decrease in blood pressure…

A

Renin is released, which causes kidneys to hold onto aldosterone, to retain fluids, to increase blood pressure

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8
Q

A primary cause of hypertension…

A

failure of the renin mechanism.

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9
Q

Renal clearance is..

A

the ability of the kidneys to clear solutes from the plasma (24 hour urine collection)

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10
Q

Creatinine clearance is..

A

the best approximation of renal function; a good measure of the GFR. (125)

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11
Q

Normal adult GFR:

A

125-200 mL/min

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12
Q

If kidney problems are detected (lab changes)

A

creatinine clearance decreases; serum creatinine increases; BUN increases.

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13
Q

Older patients have how much GFR compared to younger adults?

A

50%,

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14
Q

Erythropoietin stimulates

A

bone marrow to produce RBCs, which carry oxygen throughout body.

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15
Q

Normal BUN..

A

10-20

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16
Q

Normal creatinine..

A

0.5-1.5

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17
Q

If urea is not sufficiently excreted in the urine…

A

it accumulates in body tissues

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18
Q

Normal specific gravity..

A

1.010-1.030

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19
Q

Specific gravity increases when..

A

fluid intake decreases (concentrated urine)

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20
Q

Specific gravity decreases when..

A

fluid intake increases (diluted urine)

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21
Q

Serum creatinine does NOT increase until..

A

at least 50% of the kidney function is lost.

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22
Q

A serum creatinine level of 1.5 or above means…

A

risk for acute kidney injury from iodinated contrast dyes and some drugs

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23
Q

Nephrotoxic meds must be discontinued how long before contrast urologic testing?

A

24 hours

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24
Q

Before testing for at risk-patients, you should always check..

A

kidney function

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25
Q

Contrast-induced kidney failure..

A

onset of acute kidney failure 24-72 hours after iodine contrast given.

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26
Q

Post contrast, patients taking glucophage (Metformin) are at risk for…

A

lactic acidosis

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27
Q

Glucophage cannot be given for how long after a contrast procedure?

A

48 hours

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28
Q

Post biopsy education..

A

urine may contain blood for 24-48 hours; monitor for S/S of bleeding.

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29
Q

Chronic kidney disease means..

A

kidney damage or a decrease in the GFR that lasts more than 3 months.

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30
Q

Nephrosclerosis is..

A

the thickening in the nephron blood vessels (will cause kidneys to shrink and atrophy)

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31
Q

Treatment for nephrosclerosis..

A

Treat blood pressure (ACE inhibitors)

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32
Q

Acute Nephritic Syndrome..

A

kidney disease with glomerular inflammation (caused by immune response)

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33
Q

Acute Nephritic Syndrome main sympmtom..

A

oliguria (<400ml/24h)

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34
Q

Oliguria is..

A

urine output less than 400 ml in 24 hours

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35
Q

Glomerulonephritis typically occurs…

A

post infection (may take a couple of weeks)

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36
Q

Complications of glomerulonephritis…

A

pulmonary edema; heart failure; hypertensive encephalopathy …body is holding onto fluids

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37
Q

What is the risk of decreased GFR in older adults?

A

Fluid overload

38
Q

Rapidly Progressive Glomerulonephritis is a

A

medical emergency

39
Q

Nephrotic Syndrome main symptom

A

HIGH levels of protein in the urine (>3.5g/24h)

40
Q

What is Nephrotic Syndrome?

A

Problem in the nephrons; kidneys not filtering properly

41
Q

Treatment for Nephrotic Syndrome.

A

Treatment can prevent progression; treat what is causing the disorder…vascular dehydration is common…maintain good blood flow

42
Q

Polycystic Kidney Disease

A

inherited; noncancerous, fluid-filled sacs grow and take over the kidneys

43
Q

PKD treatment for…

A

Pain; Blood Pressure; prevent constipation

44
Q

Renal Cancer greatest risk factor..

A

Occupational exposure (petroleum products; heavy metals; asbestos)

45
Q

Prerenal cause of AKI/ARF

A

hypertension, decreased cardiac output

46
Q

Intrinsic causes of AKI/ARF

A

smoking; medications

47
Q

Postrenal causes of AKI/ARF

A

Kidney stones; Stricture; enlarged prostate

48
Q

4 phases of ARF/AKI

A

Initial; Oliguric; Diuresis; Recovery

49
Q

Treatment for AKI/ARF

A

HDTV

50
Q

H (HDTV)

A

Hyperkalemia…treat with kayexalate

51
Q

D (HDTV)

A

Dopamine…dilates renal arteries, increased blood flow

52
Q

T (HDTV)

A

Increased Total Volume (bolus with IV fluid)

53
Q

V (HDTV)

A

Volume depletion (give diuretics)

54
Q

Uremia…

A

when the kidneys fail to function fully and urea, creatinine, and other wastes build up in the blood

55
Q

3 types of hemodialysis devices..

A

Synthetic AV Graft; AV fistula; Central Venous Cath

56
Q

AV fistula…

A

lower risk of rejection; takes a while to mature

57
Q

Synthetic AV Graft…

A

can use sooner; easier to reject and clot

58
Q

Biggest concern with hemodialysis…

A

hypotension

59
Q

Peritoneal dialysis greatest complication

A

peritonitis due to caregiver error (unclean)

60
Q

A “thrill” in fistula

A

palpable vibration at the anastomosis

61
Q

Bruit…

A

buzzing sound

62
Q

Post kidney transplant complications

A

hypotension; excessive diuresis

63
Q

Foods to avoid with Interstitial Cystitis

A

Coffee, tea, chocolate, carbonated drinks, alcohol, acidic fruits/juices, spices, nitrates, vitamin c

64
Q

Most common cause for urethritis in males..

A

STDs

65
Q

Urolithiasis treatments (in order)

A

IV fluids; pain medication; lithotripsy; scope; retrieval

66
Q

Obstruction with urolithiasis is..

A

a medical emergency (oliguria, anuria)

67
Q

Hydronephrosis can cause

A

permanent damage within 48 hours if left untreated

68
Q

Bladder cancer treatment

A

BCG

69
Q

BCG teaching

A

live virus; excreted in urine; use private bathroom

70
Q

Neobladder patients have

A

no sensation of bladder fullness

71
Q

Common complication with neobladder..

A

infection

72
Q

hydrochlorothiazide ( Hydrodiuril) is a

A

thiazide diuretic, treats hypertension and edema (lowers potassium)

73
Q

furosemide (Lasix) is a

A

loop diuretic (lowers potassium)

74
Q

acetazolamide (diamox) wastes

A

potassium

75
Q

spironolactone (Aldactone) is a

A

aldosterone antagonist (potassium sparing agent; decreases Na and water)

76
Q

Caffeine free drugs

A

Motrin; Tylenol Cold Congestion; Aleve; Advil

77
Q

Good sources of potassium

A

Raisins; baked potato; lima beans; Spinach; tomato sauce

78
Q

High levels of sodium..

A

Frozen dinners; cereals; vegables (canned and juices); packaged deli meats; soups; marinades/flavorings; spaghetti sauce; spices; tomato sauce

79
Q

ACE Inhibitors…

A 
"pril"s...Benazepril (Lotensin)
Captopril
Enalapril (Vasotec)
Fosinopril
Lisinopril (Prinivil, Zestril)
Moexipril
80
Q

Nephrotoxic Medications

A

antibiotics (vancomycin, neomycin, gentamycin, tobramycin) and NSAIDS

81
Q

Function of kidneys

A

Clean blood of waste products; control blood pressure; erythropoetin

82
Q

Any kidney disease has low GFR due to

A

kidney damage

83
Q

UTI/Cystitis/Pyelonephritis are usually caused by

A

E.coli

84
Q

Bacteria in the urine is

A

not normal

85
Q

Incontinence teaching

A

Kegel exercises, avoid bladder irritants, bladder training

86
Q

Urolithiasis can cause

A

hydronephrosis

87
Q

bladder cancer warning sign

A

hematuria (painless)

88
Q

ileal conduit has

A

stoma and bag

89
Q

urinary reservoir has

A

no stoma, pouch in body, self cath

90
Q

sigmoidostomy has

A

no collection pouch, urine excreted with stool

Nursing 265 (4 decks)

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