Renal & Urologic Problems Flashcards
List the ranges
BUN
Creatinine (M & F)
Urine Output
BUN: 10-20
Creatinine
M: 0.6-1.2
F: 0.5-1.1
UOP: 30 ml/hr
The following are lower UTI ____ symptoms
-dysuria
-hesitancy
-intermittency
-postvoid dribbling
-urinary retention/incomplete emptying
Emptying
The following are lower UTI ____ symptoms
-incontinence
-nocturia
-noctural enuresis
-urgency
-urinary frequency
Storage
Upper UTI symptoms include:
Lower UTI symptoms +
Fever/chills
flank pain
What foods may cause bladder irritation
Avoid caffiene, alcohol, citrus, chocolate, spiced food/beverages
Explain Acute Pyelonephritis
UTI that has reached the kidneys
Severe= urosepsis risk
Explain chronic pyelonephritis
Kidneys continually infected leads to inflammation and fibrosis
can lead to CKD
Explain urethritis
Inflammation of urethra caused by infection
Symptoms resemble UTI
Explain interstitial cystitis
Chronic, painful disease of bladder
-urgency, frequency, bladder pain
Not caused by bacteria- ABX not effective
Eliminate bladder-irritating foods
Explain Genitourinary TB
Onset can occur 1-33 years after primary lung TB infection
Microscopic hematuria/pyuria, urgency, frequency, dysuria, nocturia, back pain
How is genitourinary TB diagnosed?
Treatment?
Mycobacterium TB in the urine
CT scan w/ contrast
Skin TB test
Treatment: same abx regimen as pulmonary TB
Explain Acute Post-Strep Gomerulonephritis
Glomeruli inflammation- bilateral
-1-6 weeks after strep infection
-Periorbital edema, HTN, red/brown urine, proteinuria
-Early diagnosis of strep infections, full abx course, good personal hygiene
Explain Nephrotic syndrome
Glomerulus becomes excessively permeable to plasma protein, causing proteinuria- low albumin and edema occur
Peripheral edema, massive proteinuria, hyperlipidemia, hypoalbuminemia, foamy urine
Ascites, anasarca
Manage diabetes, control symptoms, ambulation
Explain hydration/nutrition for kidney stones
Adequate but not excess hydration before stone passes
Increase to 3-4 L after stone passes
Reduce sodium and intake of causative substance
Explain lithotripsy
Procedure used to break up kidney stones with lasers, shock wave, sound waves
What is an expected finding after lithotripsy?
Hematuria up to a few weeks. Stent may be placed to prevent obstruction
Drink lots of fluids
What is the major priority for urinary calculi/kidney stones?
Pain relief
Explain Polycystic Kidney Disease
Genetic-autosomal dominant
Bilateral
Can lead to renal failure
No cure
Explain causes of the following types of urinary incontinence:
Functional
Overflow
Reflex
Stress
Urge
Functional: arthritis, dementia
Overflow: neurogenic bladder, outlet obstruction
Reflex: CNS problems, MS, brain tumors, spinal cord injury
Stress: laughing, sneezing, lifting
Urge: many causes, CNS, cancer, obstructions
Normal postvoidal residual is under ___mL
Elderly: ____ mL
Above ____ is abnormal
50 mL
50-100mL
Above 200- abnormal
Acute urinary retention is…
A medical emergency
Explain suprapubic catheters
Requires surgical placement. Placed directly into bladder from outer abdomen.
Done for obstructions, retention, diversion
Prone to poor drainage due to tube obstruction
Explain nephrostomy tubes
Inserted through small flank incision directly into renal pelvis
If irrigation is ordered, no more than 5 mL sterile saline
Infection = common complication
When is urinary diversion surgery done?
When urine needs to be redirected from the bladder
-urine cancer, neurogenic bladder, congenital anomalies, strictures, trauma to the bladder
