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Nursing 265 > Renal/Urinary > Flashcards

Renal/Urinary Flashcards

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
Contrast-induced kidney failure..
onset of acute kidney failure 24-72 hours after iodine contrast given.
26
Post contrast, patients taking glucophage (Metformin) are at risk for...
lactic acidosis
27
Glucophage cannot be given for how long after a contrast procedure?
48 hours
28
Post biopsy education..
urine may contain blood for 24-48 hours; monitor for S/S of bleeding.
29
Chronic kidney disease means..
kidney damage or a decrease in the GFR that lasts more than 3 months.
30
Nephrosclerosis is..
the thickening in the nephron blood vessels (will cause kidneys to shrink and atrophy)
31
Treatment for nephrosclerosis..
Treat blood pressure (ACE inhibitors)
32
Acute Nephritic Syndrome..
kidney disease with glomerular inflammation (caused by immune response)
33
Acute Nephritic Syndrome main sympmtom..
oliguria (<400ml/24h)
34
Oliguria is..
urine output less than 400 ml in 24 hours
35
Glomerulonephritis typically occurs...
post infection (may take a couple of weeks)
36
Complications of glomerulonephritis...
pulmonary edema; heart failure; hypertensive encephalopathy ...body is holding onto fluids
37
What is the risk of decreased GFR in older adults?
Fluid overload
38
Rapidly Progressive Glomerulonephritis is a
medical emergency
39
Nephrotic Syndrome main symptom
HIGH levels of protein in the urine (>3.5g/24h)
40
What is Nephrotic Syndrome?
Problem in the nephrons; kidneys not filtering properly
41
Treatment for Nephrotic Syndrome.
Treatment can prevent progression; treat what is causing the disorder...vascular dehydration is common...maintain good blood flow
42
Polycystic Kidney Disease
inherited; noncancerous, fluid-filled sacs grow and take over the kidneys
43
PKD treatment for...
Pain; Blood Pressure; prevent constipation
44
Renal Cancer greatest risk factor..
Occupational exposure (petroleum products; heavy metals; asbestos)
45
Prerenal cause of AKI/ARF
hypertension, decreased cardiac output
46
Intrinsic causes of AKI/ARF
smoking; medications
47
Postrenal causes of AKI/ARF
Kidney stones; Stricture; enlarged prostate
48
4 phases of ARF/AKI
Initial; Oliguric; Diuresis; Recovery
49
Treatment for AKI/ARF
HDTV
50
H (HDTV)
Hyperkalemia...treat with kayexalate
51
D (HDTV)
Dopamine...dilates renal arteries, increased blood flow
52
T (HDTV)
Increased Total Volume (bolus with IV fluid)
53
V (HDTV)
Volume depletion (give diuretics)
54
Uremia...
when the kidneys fail to function fully and urea, creatinine, and other wastes build up in the blood
55
3 types of hemodialysis devices..
Synthetic AV Graft; AV fistula; Central Venous Cath
56
AV fistula...
lower risk of rejection; takes a while to mature
57
Synthetic AV Graft...
can use sooner; easier to reject and clot
58
Biggest concern with hemodialysis...
hypotension
59
Peritoneal dialysis greatest complication
peritonitis due to caregiver error (unclean)
60
A "thrill" in fistula
palpable vibration at the anastomosis
61
Bruit...
buzzing sound
62
Post kidney transplant complications
hypotension; excessive diuresis
63
Foods to avoid with Interstitial Cystitis
Coffee, tea, chocolate, carbonated drinks, alcohol, acidic fruits/juices, spices, nitrates, vitamin c
64
Most common cause for urethritis in males..
STDs
65
Urolithiasis treatments (in order)
IV fluids; pain medication; lithotripsy; scope; retrieval
66
Obstruction with urolithiasis is..
a medical emergency (oliguria, anuria)
67
Hydronephrosis can cause
permanent damage within 48 hours if left untreated
68
Bladder cancer treatment
BCG
69
BCG teaching
live virus; excreted in urine; use private bathroom
70
Neobladder patients have
no sensation of bladder fullness
71
Common complication with neobladder..
infection
72
hydrochlorothiazide ( Hydrodiuril) is a
thiazide diuretic, treats hypertension and edema (lowers potassium)
73
furosemide (Lasix) is a
loop diuretic (lowers potassium)
74
acetazolamide (diamox) wastes
potassium
75
spironolactone (Aldactone) is a
aldosterone antagonist (potassium sparing agent; decreases Na and water)
76
Caffeine free drugs
Motrin; Tylenol Cold Congestion; Aleve; Advil
77
Good sources of potassium
Raisins; baked potato; lima beans; Spinach; tomato sauce
78
High levels of sodium..
Frozen dinners; cereals; vegables (canned and juices); packaged deli meats; soups; marinades/flavorings; spaghetti sauce; spices; tomato sauce
79
ACE Inhibitors...
``` "pril"s...Benazepril (Lotensin) Captopril Enalapril (Vasotec) Fosinopril Lisinopril (Prinivil, Zestril) Moexipril ```
80
Nephrotoxic Medications
antibiotics (vancomycin, neomycin, gentamycin, tobramycin) and NSAIDS
81
Function of kidneys
Clean blood of waste products; control blood pressure; erythropoetin
82
Any kidney disease has low GFR due to
kidney damage
83
UTI/Cystitis/Pyelonephritis are usually caused by
E.coli
84
Bacteria in the urine is
not normal
85
Incontinence teaching
Kegel exercises, avoid bladder irritants, bladder training
86
Urolithiasis can cause
hydronephrosis
87
bladder cancer warning sign
hematuria (painless)
88
ileal conduit has
stoma and bag
89
urinary reservoir has
no stoma, pouch in body, self cath
90
sigmoidostomy has
no collection pouch, urine excreted with stool

Nursing 265 (4 decks)

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