Study Guide Exam #1 Flashcards
discuss what a nurse caring for a pt with ESRD should be monitoring
Uremic frost, hypertension, generalized edema (anasarca), bleeding disorders, halitosis
what are expected finding in the ERSD pt
pruritus, confusion, restless leg syndrome, , fatigue, electrolyte imbalance
why is the hemodialysis, ESRD pt at risk for anemia
Decrease of erythropoetin. because the body doesn’t produce enough RBC’s. Fewer red blood cells means less oxygen is sent to the cells. Without enough oxygen, your tissues and organs have less energy to perform their jobs.
what is the most common cause of glomerulonephritis (hardening of capillaries)
a streptococcal infection (strep throat)
what is the tx for glomerulonephritis
antibiotics, loop diuretics, vasodilators, corticosteroids, plasmapheresis, dialysis
what does a skin and throat culture have to do with glomerulonephritis
detects group A beta hemolytic streptococcus, positive ASO titer
what lab test would you expect to see elevated in the glomerulonephritis
BUN, creatinine, ESR, WBC
what findings what I expect to see in the acute glomerulonephritis patient
decreased urination, foamy urine from protein smokey, cola or coffee colored urine SOB Crackles periorbitaledema (eyes) Hypertension anorexia hemorrhage
what assessment finding/s would indicate a complication in your post-op TURP patient?
urethral trauma, urinary retention, bleeding, infection
what assessment finding would you expect to see that was normal in your post-op TURP pt
inability to pass urine, some pain, indwelling catheter in place , blood tinged urine, and tenderness
If the pt has the urge to urinate that has foley cath, what action are you taking first
I would make sure it’s placement was correct
discuss what you would be teaching on the prevention of UTI’s
Wipe front to back (cleanest to dirty) Void before and after sex Don't hold in pee Drink lots of fluids Shower daily Wet bathing suits No synthetic clothing
what are risk factors for UTI’s
urosepsis if UTI not treated (shock and death) being a female frequent use of feminine hygiene spray intercourse hormal imblanaces synthetic underwear hot tubs catheters
what is the diet plan for a pt that has nephrotic syndrome
low protein, low sodium, fat LOW
fruits, veggies, eggs, fish, wheat HIGH
besides hypoalbuminemia, and proteinuria , what else would you expect to see in your nephrotic syndrome patient
edema
irritability, malaise, fatigue, anorexia, nausea
hyperlipidemia
oliguria
what foods are high in potassium
bananas, avocado, spinach, yogourt, sweet potato, raisins, tomatoes, all veggies
what drug class and drug use is pyridium
analgesic. to treat UTI symptoms
what color does pyridium turn your urine
reddish-orange
renal medulla is located where
in the renal pyramids.
name and be able to identify the urinary system
kidneys, ureters, urethra, sphincter,
know what labs assess kidney function
BUN and creatine, GFR,
know the primary function of the kidney
Blood filtration Acid base balance Maintain balance of homeostasis in body Secretes renin and erythropoietin Forms and stores urine Eliminates electrolytes
what structure are the kidneys located behind
The peritoneum.
what foods are high in uric acid
Gravy, sardines, beer, organ meats such as liver, kidney, brains, game meats
what is another name for kidney stones
urolithiasis or calculi
why does spironolactone cause gynecomastia
blocks testosterone production.
what is the post op directions your pt must follow after a IVP
push fluids
what is the scope of practice for UAP’s
UAP’s have NO scope of practice, but can be trained in certain fields such as med passing.
what are s/s of kidney stones?
severe flank pain that can radiate to the groin, diaphoresis, nausea and vomiting, blood in urine.
what patient teaching will you be doing in the urolithiasis pt
The diet: decreased protein, sodium, calcium.
Avoid high phosphate foods.
drink fluids, ambulation, strain urine if stone will not pass
what is a primary medical management goal in the pt who has kidney stones
Pain
what are the symptoms of interstitial cystitis
interstitial means the lining that gets inflamed. suprapubic pain. a chronic painful bladder condition. pain during pee, sexual intercourse. Urge to pee often.
what foods and drinks are you advising your pt with interstitial cystitis to avoid
alcohol, Avoid aged, canned, cured, processed, and smoked meats and fish. Avoid spicy foods. Avoid acidic foods and drinks. Avoid anything with artificial sweeteners such as aspartame.
what drug class and use is Ditropan
urinary antispasmodics. reduces muscle spasms of the bladder and urinary tract.
what specific symptom can be contributed to a UTI in the elderly patient that should not be taken lightly?
confusion. risk for bacteremia, sepsis, and shock.
what risk factors make the ERSD pt an unlikely candidate for a kidney transplant
chronic infections. a drinker, a smoker. Anyone with a bad diet.
what lab tests are elevated in the renal pt with disease
BUN and creatinine.
what s/s would you expect to see in the CRF pt
Lethargy, seizures, coma, tremors, ataxia.
hypertension, peripheral edema.
uremic halitosis, tachypnea
anorexia, nausea, vomiting, diarrhea
polyuria, oliguria, anuria, proteinuria, poor turger.
what foods/drinks contain phosphorus that your CRF should avoid
animal products, dairy, gravy, white and whole grain bread, nuts.
what technique should you use to assess the patency of an AV graft use for hemodialysis
palpate - “thrill”. auscultate - “bruit”. check distal pulses, and circulation.
what is the s/s of dialysis disequilibrium
nausea, vomiting, change in level of consciousness, seizures, and agitation.
what is a serious complication of having peritoneal dialysis
peritonitis, infection at the access site, protein loss, hyperglycemia and lipidemia, poor inflow and outflow, cloudy urine.
what assessment finding would you indicate if your pt has peritonitis
infection. obtain CandS and gram stain if suspected
what is your post op interventions/assessments in the renal biopsy pt
monitor dressing site, VS, urine output, H and H levels for 24 hours. Flank pain. Watch signs for internal bleeding. Bed rest in supine position with a back roll. Monitor for hematuria, and medicate for pain.
why is potassium decreased after having hemodialysis
Instead of having two kidneys continuously filtering out excess water, potassium, sodium and poisonous waste products, you have an artificial kidney, which filters these substances only for several hours and only three times per week. DIALYSIS
what is the nephrons job in the kidney
It is the filtering unit of the kidneys. Functioning unit.
what is the glomeruluses job within the kidney
the components that carry out the primary filtering action of the kidney. filters the blood
what are the normal components in urine
nitrogenious waste. nitrogen, urea, concentration urea 9.3 g/L, chloride 1.87 g/L, sodium 1.17 g/L, potassium 0.750 g/L, creatinine 0.670 g/L and other dissolved ions, inorganic and organic compounds (proteins, hormones, metabolites).
what is the purpose of the kidneys producing renin
which sense changes in renal perfusion pressure, via stretch receptors in the vascular walls
Renin increases BP
what is the most common cause of pyelonephritis
E. Coli
what is the s/s of pyelonephritis
urinary tract infection, cloudy urine, foul smelling urine, frequent urge to urinate, frequent urination, or blood in urine, chills, fever, fatigue, loss of appetite, or malaise, nausea, vomiting, fast HR
how would you describe what pyelonephritis was in simple terms to your patient
It is a type of UTI that affects both kidneys.
discuss how the urine leaves the body after production formation from kidneys
Before leaving your body, urine travels through the urinary tract. … kidneys: two bean-shaped organs that filter waste from the blood and produce urine. ureters: two thin tubes that take pee from the kidney to the bladder. bladder: a sac that holds pee until it’s time to go to the bathroom.
describe why you would find glucose in a patients urine
For someone who is a diabetic
what is the goal for both hemodialysis and peritoneal dialysis
dialysis can sustain life for clients who have bot acute and chronic kidney disease
what is your post op priority care in the renal anagiography pt
monitor for bleeding from catheter insertion site, monitor for hematoma, VS, bedrest 4-6 hours with legs extended, push fluids post procedure and assess pedal pulses
why would a CRF patient need amphrogel and antacid
Binds to phosphate.
what is the drug class and use of Proscar and what types of pt take the med?
an alpha inhibiter and it is used treat BPH
what is septra
antibiotics used for UTI. bacterial infections
