Renal/Urinary System Flashcards
What are the important labs associated with urinary and renal function? (5)
- Blood Urea Nitrogen
- Creatinine
- Blood Osmolality
- Specific Gravity
- Urine Osmolality
Blood Urea Nitrogen (2)
- Measures the amount of waste product
- Measures dehydration
- 10-20mg/dL
Creatinine (2)
- End product of protein and muscle metabolism
- Measures renal function
- 0.6-1.2 mg/dL (males)
- 0.5-1.1 mg/dL (females)
Blood Osmolality (2)
- measurement of particle in the blood
- indicates hydration status
WBC over what indicates a bladder infection and/or UTI?
over 100,000
What is the BUN to serum creatinine ratio?
6:25
Specific Gravity (3)
- shows how well the kidneys concentrate urine
- increased specific gravity, increases concentration of urine=dehydration
- decreased specific gravity, decreases concentration of urine= fluid overload
- 1.010-1.025
Urinalysis
-used for drug testing and detecting ketones and infection
When is the best time to take a urine sample?
In the morning
Creatinine Clearance
-best indication of overall kidney function (24 hour collection of urine, then a blood test after the urine collection is complete)
Urine Osmolality
- collection of the particles in the urine
* 200-800
What is the normal urine output for a healthy adult?
1-2 liters
What position must the patient be in when performing a KUB and what is the test looking for?
- Patient must be supine
- Looking for kidney stones
Cytoscopic Examination (2)
- direct visualization: stones, abnormalities, and blockages
- Dr’s can use this method to remove kidney stone
What nursing interventions should be done prior to a patient getting a kidney biopsy? (4)
- Informed consent
- Vital signs
- CBC
- Coagulation studies
What nursing intervention should be done after a patient getting a kidney biopsy? (4)
- IV site
- Vitals: BP, HR, respirations
- Incision site: signs of infection & bruising
- Urine output
* *drastic increase in pain can alert to bleeding
Urinary Incontinence
- involuntary loss of urine
- pressure in the urethra is greater than the pressure in the bladder
What are the 4 types of incontinence?
- Stress
- Urge
- Functional
- Total
Stress Incontinence
-occurs with laughing or coughing
Urge Incontinence
-waiting until the last minute to void (common in children)
Functional Incontinence (2)
- everything physical works as normal
- cognitive issue
Total Incontinence
-nothing is working like it is supposed to
What are risk factors for incontinence? (5)
- Multiple pregnancies
- Renal disease
- Cognitive (Parkinson’s)
- Spinal cord injurt
- Diuretics
What are nursing interventions appropriate for a patient with urinary incontinence?
- Have pt void q2h
- Remove barriers
- Pelvic floor exercises (kegel’s)
- Avoid use of indwelling catheters
Urinary Retention
-inability of the bladder to empt completely
What are causes of urinary retention? (5)
- BPH
- opiods (suppress the CNS- relaxes the GI tract)
- neurological
- MS
- spinal cord injury
Urolithiasis
-kidney stones in the urinary tract
Nephrolithiasis
-kidney stones in the kidneys
What sex are kidney stones more common in?
Males
What are symptoms of a kidney stone?
- N&V
- radiating pain
- painful urination
- increased HR
What are nursing interventions for treatment of kidney stones? (4)
- pain management (Toradol in combo w/ morphine or dilaudid)
- obstruction: fluids (0.9% NS), increase fluid intake to 3-4L/day
- prevent infection
- monitor and strain urine
Lithotripsy (4)
- shock wave that breaks the stone into small fragments
- pt is under conscious sedation
- continuous monitoring by electrocardiography
- topical anesthetic is applied to skin site of stone
Pyelonephritis
-bacterial infection in the kidney and renal pelvis (upper urinary tract)
What are risk factors of pyelonephritis? (5)
- women over 65
- spinal cord injury
- pregnancy
- chronic illness
- incomplete bladder emptying
What are the lab and diagnostic procedures with pyelonephritis? (4)
- urinalysis
- WBC count (w/ differential)
- KUB xray
- IV pyelogram (dye is inserted to visualize/identify abnormalities/blockages)
What are nursing interventions necessary for patient with pyelonephritis?
- monitor: nutritional status, I/O’s, F/E balance, pain and vitals
- fluid intake
- medications for pain
- caloric intake needs to be increased
What are surgical intervention for pyelonephritis?
- pyelolithotomy (stone in the kidney is removed)
- nephrectomy (kidney removed)
- ureteroplasty (revising ureters)
