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MED SURG > TOPIC 9 - renal / chronic kidney disease and dialysis > Flashcards

TOPIC 9 - renal / chronic kidney disease and dialysis Flashcards

1
Q

most frequent cause of UTI

A

bacteria

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2
Q

manifestations of UTI

A

Fever, chills, dysuria, suprapubic pain, hesitancy, intermittent stream, postvoid dribbling, painful urination, urgency, incontinence, nocturia
Urine: cloudy, hematuria, foul odor

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3
Q

interventions for UTI

A

Encourage fluids, medication compliance, emptying bladder frequently, when to empty bladder

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4
Q

education for UTI

A

Empty bladder regularly & completely
Empty bowels regularly
Cleanse perineum front to back
Drink adequate fluids daily
Avoid caffeine, alcohol, citrus juices, chocolate, spicy foods
Take full course of prescribed antibiotics, even if symptoms subside

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5
Q

complications of UTI

A

The infections can migrate up to the kidneys, causing infection & injury to the kidney

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6
Q

interstitial cystitis

A

Pain varies in severity, UTIs, frequency, urgency, role of stress, frequent urination (60X/day)

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7
Q

what to assess in interstitial cystitis

A

PQRST of pain
Voiding dysfunction
Bladder or voiding log to identify diet & lifestyle factors for at least 3 days
Diet: quality nutrition, role of vitamins (avoid excess doses)
Clothing that avoids perineal & pelvic pressure
Psychosocial: frustration, guilt, anger, coping

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8
Q

systemic meds for interstitial cystitis

A

Tricyclic antidepressants – amitriptyline, nortriptyline, pentosan
Short course of opioids to treat acute pain

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9
Q

local meds for interstitial cystitis

A

Dimethyl sulfoxide (DMSO)
Heparin, hyaluronic acid, lidocaine

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10
Q

examples of bladder irritants to avoid with IC

A

Caffeine
Alcohol
Citrus products
Ages cheeses
Nuts
Foods containing vinegar
Curries
Hot peppers

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11
Q

chronic glomerular nephritis onset

A

Insidious onset, frequently clients are unaware of their declining kidney function
Potential to develop ESKD between 2-30 years

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12
Q

assessment of chronic glomerular nephritis

A

Hematuria, WBCs & casts in urine
Proteinuria
s/s of uremia
Elevated BUN & Creatinine
History of: drug use, Lupus, Scleroderma

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13
Q

labs and diagnostics for chronic glomerular nephritis

A

Kidney Biopsy
Ultrasound
CT
CBC, CMP

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14
Q

abnormal lab test results show

A

urine with fixed specific gravity, casts, proteinuria, electrolyte imbalances and hypoalbuminemia

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15
Q

different types of urinary incontinence

A

Stress
Urge
Overflow
Reflex
Trauma or surgery
Functional

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16
Q

causes (DRIP mneumonic)

A

D stands for – delirium, dehydration, depression
R stands for – restricted mobility, rectal impaction
I stands for – infection, inflammation, impaction
P stands for – polyuria, polypharmacy

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17
Q

anticholinergic med for urinary incontinence

A

tolterodine

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18
Q

diagnostic for chronic pyelonephritis

A

kidney biopsy

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19
Q

what can chronic pyelonephritis progress in to

A

progresses into end stage renal disease

Decreased kidney function depends on previous infections and subsequent scarring

20
Q

change in kidney shape in chronic pyelonephritis

A

Kidneys are small, atrophic , shrunken, loss of function from scarring (fibrosis).

21
Q

risk factors for bladder cancer

A

smoking, dyes, chemo, actos, recurrent renal calculi

22
Q

assessment of bladder cancer

A

hematuria, IBS, frequency, urgency, dysuria

23
Q

diagnostic testing for bladder cancer

A

U/A, cystoscopy with biopsy, CT, MRI

24
Q

interventions for bladder cancer

A

surgery, urinary diversion, radiation, chemo, immunotherapy

25
three main types of urinary diversion surgeries
Cutaneous ureterostomy Ileal conduit Nephrostomy
26
post op nursing care for urinary diversion surgeries
Stoma care & appliances Skin care Psychosocial
27
causes for urinary diversion surgery
bladder cancer, neurogenic bladder, congenital anomalies, strictures, chronic infections with deteriorating renal function, renal trauma, bladder removal
28
CKD
progresses over time, is irreversible, azotemia, uremia, uremic syndrome
29
causes of CKD
DM, HTN, vascular disorders, chronic glomerulonephritis, pyelonephritis, nephrotic syndrome, meds or toxic agents, obstruction of urinary tract, hereditary lesions
30
GFR differences depending on stages
Stage 1 : >90mL/min Stage 2 : 60-89mL/min Stage 3 : 30-59mL/min Stage 4 : 15-29mL/min Stage 5 : <15mL/min
31
kidney failure results when
the kidneys cannot remove wastes or perform regulatory functions
32
acute renal failure
a reversible syndrome that results in decreased glomerular filtration rate and oliguria
33
chronic renal failure
progressive, irreversible deterioration of renal function that results in azotemia
34
complications of renal failure
hyperkalemia hypervolemia pericarditis pericardial effusion pericardial temponade HTN anemia bone disease metastatic calcifications
35
diagnostics images related to the kidneys
ultrasound KUB CT MRI aortorenal angiography cystoscopy retrograde pyelography kidney biopsy
36
labs related to the kidneys
BUN, CBC, electrolytes Crt, Urinalysis, 24 hour urine, fluid volume overload
37
temporary vs long term access for hemodialysis
temporary : Hemodialysis catheter, dual or triple lumen, or AV shunt long term : Arteriovenous (AV) fistula or graft
38
postdialysis assessment
Hypotension Headache Nausea, vomiting Malaise, dizziness Muscle cramps or bleeding
39
vascular access complications
thrombosis stenosis infection aneurysm formation tissue ischemia heart failure
40
hemodialysis complications
Hep B and C HIV infections dialysis disequilibrium syndrome
41
types of peritoneal dialysis
automated or continuous ambulatory
42
peritoneal dialysis
Involves siliconized rubber catheter placed into abdominal cavity for infusion of dialysate
43
what to assess prior to starting peritoneal dialysis
baseline vitals, weight, labs
44
continually monitor ___ during and after peritoneal dialysis
resp distress, pain, discomfort, prescribed dwell time, initiate outflow, outflow amount, pattern of fluid
45
complications of peritoneal dialysis
peritonitis pain exit site/tunnel infection poor dialysate flow dialysate leakage

MED SURG (30 decks)

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