Urinary and Renal problems

Question 1

What is difference between complicated and uncomplicated UTIs?

Answer 1

Uncomplicated means have normal urinary tract and only involves bladder
Complicated means something else is going on (diabetes, pregnancy, catheter, renal calculi, etc.)

Question 2

What is first choice (4 of them) of abxs for UTI?

Answer 2

Bactrim (trimethoprim/sulfamethoxazole)
Macrobid (nitrofurantoin)
Keflex (cephalexin)
Fosfomycin

Question 3

What are some other abxs that are given for UTIs?

Answer 3

Ampicillin
Amoxicillin
Cephalosporins
Fluoroquinolones

Question 4

What is a common anti fungal given for UTIs?

Answer 4

Diflucan (fluconazole)

Question 5

What is the name of common urinary analgesic?

Answer 5

Pyridium (phenAZOpyridine)
Azo

Question 6

What bacteria is commonly the cause of CAUTIs and UTIs?

Answer 6

E. coli

Question 7

What is the big clinical manifestation DIFFERENCE between upper and lower UTIs?

Answer 7

Flank pain, fever, chills with upper
—Remember upper will have more systemic s/sx—
—Lower will have more s/sx related to bladder storage and emptying–

Question 8

What diagnostic tests will be ordered for suspected UTI?

Answer 8

UA
Urine for C/S
CBC with Diff
Blood culture (if bacteremia suspected)
Ultrasound
CT

Question 9

What are common risk factors/causes of glomerulonephritis?

Answer 9

Diabetes
HTN
Glomerulosclerosis
Post-strep
Illegal drug use
Lupus (SLE)
Scleroderma

Question 10

What are s/sx of post-strep glomerulonephritis?

Answer 10

1-6 weeks post strep infection
Edema
HTN
Oliguria
Hematuria
Proteinuria
Periorbital edema
Red/brown urine
Abdominal/Flank Pain
—History is important here!!–

Question 11

What is nephrotic syndrome?

Answer 11

Glomeruli too permeable, especially to plasma proteins.
Causes MASSIVE proteinuria»>low plasma albumin and edema
Will have fat in urine (makes urine foamy)
Will be at risk of infection and risk for blood clots (hypercoagulability)

Question 12

What is nursing focus on with nephrotic syndrome?

Answer 12

Managing edema

Question 13

What is the most common composition of renal calculi?

Answer 13

Calcium oxalate (70-80%)

Question 14

What medication causes smooth muscle of ureter to relax?

Answer 14

Flomax (tamulosin)
–Given to help pass kidney stone–

Question 15

What are some common diagnostic studies done in renal calculi?

Answer 15

UA
CT
Ultrasound
Measuring urine pH can be helpful
Retrieval and stone analysis

Question 16

What is priority nursing done in renal calculi?

Answer 16

Pain management
Secondary:
Strain urine, Hydration,
Ambulation

Question 17

Teaching for kidney stones.

Answer 17

Hydration!!!!
Dietary changes
Sodium restrictions

Question 18

What is a urethral stricture?

Answer 18

Narrowing (usually at UPJ or UVJ)
Could be from trauma, urethritis, surgery, congenital defect.

Question 19

S/sx of urethral stricture?

Answer 19

Straining to void
Poor stream
Dribbling

Question 20

Tx of urethral stricture.

Answer 20

Dilation
Temporary stent
Urethroplasty

Question 21

What is nephrosclerosis?

Answer 21

Inadequate blood flow to kidneys leads to ischemia and necrosis

Question 22

What is aim of treatment for nephrosclerosis?

Answer 22

Restore perfusion to kidney ASAP

Question 23

What is renal vein thrombosis?
Treatment?

Answer 23

Thrombi in renal vein
Treatment aimed at busting clot and restoring perfusion

Question 24

Cause of polycystic kidney disease?

Answer 24

Genetic disorder
Cystic enlarged kidneys
–There is an acquired type that can happen after a pt is on dialysis for long time–

Question 25

What other organs can polycystic kidney disease affect?

Answer 25

Liver
Heart
Intestines
Blood vessels
Brain

Question 26

Treatment of polycystic KD?

Answer 26

No cure
Prevent/tx of UTI
Nephrectomy
Dialysis
Transplant
Med called Tolvaptam that can slow cyst growth

Question 27

What is procedure to break up kidney stones called?

Answer 27

Lithotripsy
Many different types like laser, ultrasonic, shock wave, etc.

Question 28

What is procedure to surgically remove stones?

Answer 28

—lithotomy
nephrolithotomy (kidney)
Ureterolithotomy
Pyelolithotomy (renal pelvis)
Depending on where incision is made to remove stone.

Question 29

What is aim at treating renal artery stenosis?

Answer 29

Control BP and restore kidney perfusion

Question 30

What is Tolvaptan used for?

Answer 30

Polycystic Kidney Disease
–slows progression–

Question 31

Risk factors for bladder cancer.

Answer 31

Smoking
White
Male
Obesity

Question 32

What is the most common cancer of the urinary system?

Answer 32

Bladder

Question 33

First s/sx of bladder cancer.

Answer 33

Painless hematuria
Bladder irritability with dysuria, frequency, urgency.

Question 34

First s/sx of kidney cancer.

Answer 34

Flank pain
Hematuria
–Presents with upper UTI symptoms-

Question 35

What are some common meds given to relax urethra and improve urine flow?
–these are classed as Alpha adrenergic blockers–

Answer 35

Flomax (tamulosin)
(All other meds in this class end in
—osin or zosin)
Examples:
alfuzosin
doxazosin
prazosin
silodosin
terazosin

Question 36

What med reduces prostate size?

Answer 36

finasteride (Proscar)

Question 37

What are some common meds for overactive bladder?
–classed as anticholinergics–

Answer 37

oxybutynin
tolterodine
fesoterodine

Question 38

In urinary retention, what is the normal amount of urine left in bladder? How much is a cause of concern?

Answer 38

50 ml=normal
200 ml=concerning