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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
Q

three main types of urinary diversion surgeries

A

Cutaneous ureterostomy
Ileal conduit
Nephrostomy

26
Q

post op nursing care for urinary diversion surgeries

A

Stoma care & appliances
Skin care
Psychosocial

27
Q

causes for urinary diversion surgery

A

bladder cancer, neurogenic bladder, congenital anomalies, strictures, chronic infections with deteriorating renal function, renal trauma, bladder removal

28
Q

CKD

A

progresses over time, is irreversible, azotemia, uremia, uremic syndrome

29
Q

causes of CKD

A

DM, HTN, vascular disorders, chronic glomerulonephritis, pyelonephritis, nephrotic syndrome, meds or toxic agents, obstruction of urinary tract, hereditary lesions

30
Q

GFR differences depending on stages

A

Stage 1 : >90mL/min
Stage 2 : 60-89mL/min
Stage 3 : 30-59mL/min
Stage 4 : 15-29mL/min
Stage 5 : <15mL/min

31
Q

kidney failure results when

A

the kidneys cannot remove wastes or perform regulatory functions

32
Q

acute renal failure

A

a reversible syndrome that results in decreased glomerular filtration rate and oliguria

33
Q

chronic renal failure

A

progressive, irreversible deterioration of renal function that results in azotemia

34
Q

complications of renal failure

A

hyperkalemia
hypervolemia
pericarditis
pericardial effusion
pericardial temponade
HTN
anemia
bone disease
metastatic calcifications

35
Q

diagnostics images related to the kidneys

A

ultrasound
KUB
CT
MRI
aortorenal angiography
cystoscopy
retrograde pyelography
kidney biopsy

36
Q

labs related to the kidneys

A

BUN, CBC, electrolytes Crt, Urinalysis, 24 hour urine, fluid volume overload

37
Q

temporary vs long term access for hemodialysis

A

temporary : Hemodialysis catheter, dual or triple lumen, or AV shunt
long term : Arteriovenous (AV) fistula or graft

38
Q

postdialysis assessment

A

Hypotension
Headache
Nausea, vomiting
Malaise, dizziness
Muscle cramps or bleeding

39
Q

vascular access complications

A

thrombosis
stenosis
infection
aneurysm formation
tissue ischemia
heart failure

40
Q

hemodialysis complications

A

Hep B and C
HIV
infections
dialysis disequilibrium syndrome

41
Q

types of peritoneal dialysis

A

automated or continuous ambulatory

42
Q

peritoneal dialysis

A

Involves siliconized rubber catheter placed into abdominal cavity for infusion of dialysate

43
Q

what to assess prior to starting peritoneal dialysis

A

baseline vitals, weight, labs

44
Q

continually monitor ___ during and after peritoneal dialysis

A

resp distress, pain, discomfort, prescribed dwell time, initiate outflow, outflow amount, pattern of fluid

45
Q

complications of peritoneal dialysis

A

peritonitis
pain
exit site/tunnel infection
poor dialysate flow
dialysate leakage

MED SURG (30 decks)

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