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urinary and visual Flashcards

1
Q

chemical burns to eyes management

A

flush with saline or water

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2
Q

metbaloic acid causes

A 
GI loss such as diahrea
ketoacidosis (DM, etoh, starvation)
lactic acidosis (sepsis, hypoperfusion)
-renal failure (hemodilasis)
-salicylate toxicty
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3
Q

anxiety, claustroboic

A

resp alka

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4
Q

vomiting

A

met alkalosis

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5
Q

precenting UTI

A

increasef lfuid intake
wipe front to back
avoid synthetic dabrix such as nylon and spandex
-avoid spermicidal contraceptive jelly bc it supress the prod of protective vaginal flora
-avoid douching and using femine perineal progs
-take showers instad of baths

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6
Q

pursed lip breathing

A

helps iwth sob and prevent airway collapse

  • promotes co2 elimination
  • reduces air trapping in COPD
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7
Q

pursed lip tedchnique

A

Relax the neck and shoulders

Inhale for 2 seconds through the nose with the mouth closed (Option 4)

Exhale for 4 seconds through pursed lips. If unable to exhale for this long, exhale twice as long as inhaling

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8
Q

prior to dilausis

A

assess pt weight, bp, edema, lung and heart sounds

  • assess fistula and graft
  • vital signs
  • heprain is added to the blood not given subq
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9
Q

important consideration before dialysis

A

dont give bp meds becauseit causes hpotension and during dialysis it is already making pt prone to hypotension
-also any meds that are given can be removed after dialysis

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10
Q

AV fistula sound

A

thrill can be felt when papating

briot can be heard during asuculatation

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11
Q

retinal detchament signs

A

curtain, sudden flashes of light, floaters, loss of vision

-med emergency

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12
Q

retinal detachment post op

A

avoid act that increase ICP such as rubbing eyes and straining
-report sudden pain, flashes of light , sion loss or bleeding
-avoid docused act such as reading ,sweing and writing which can cause rapid eye movmeent
-wear an eye patch or shield to prevent rubbing and scratching of the eye
-

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13
Q

prioirty when urinary retention suspected

A

assess suprapuboc area

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14
Q

what is an expected SE of opiod meds at renal

A

urinary retention

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15
Q

renal coloic pain

A

sharp, stabbing,
tossing in bed unable to find comfortable position
pain riadating to the groin area

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16
Q

pyleonphritis pain

A

flank pain back of the costvertebral angle toward the umbilicus

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17
Q

peritoneal dialysis insuffiecient outflow

A

consitpation and bowel mov should be mointored and give stool outners

  • check for kinks and clots
  • maintain drainge bag below the badomen
  • reposition client to side lying or assist with ambulation

if none of these work then xray needed to check the location of the catheter

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18
Q

bladder catherization

A
  • below the bladder
  • irrgate using small amounts of sterile aline solution (<5ml) using gentle pressure to avoid damanging renal tissues
  • secure it by taping to clients leg so it is below the blaffer
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19
Q

matureing the fistula

A

make the client perform hand excercises

such as sqeezing rubber ball

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20
Q

trill and bruit

A

thrill (vibration)

bruit (blowing or swooshing sound)

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21
Q

clot formation in the fistula signs

A

absence of trill or bruit

  • numbess or tinlng
  • decrease cap refill
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22
Q

during periotneal dialsysis client should be moinroted for

A

resp compromise such as diff breathing, rapid resp and crackles

HIGH BP IS NORMAL IN KIDNEY FAILURE

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23
Q

kidney biospy complication

A

bleeding so mointor vital signs q 15mins for the first hour and mointor for hypotension, tacy and tacypnea

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24
Q

before kidney biosy

A

discontinue all anitcog and plalets for ONE WEEKS

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25
Q

post op kidney biopsy

A

position on the affected side for 30-60 mins to provide pressure and prevent bleeding but during the procedre the are faced prone

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26
Q

what is normal and not normal in urinalysis

A

few wbc are normal

glucose is not normal and could indicate DM

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27
Q

comonnly held meds before dilasysi

A 
water soluble like B AND  and folic acid
-abx
-dignxoin
-bp meds
=bp lowering meds such as lasix
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28
Q

what med should you take before dilaysis

A

photphate binders because dilasysis doesnt filter it (calciym carbonate)

  • lispro
  • vit e can be given and it is afat souble and helps prevent leg cramps assoicate withdialysis clients
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29
Q

prostatectomy complications

A 
reduced urine strwam
persistent bledeing and blood clots
rentention of urine
fever
dysruia

-REPORT ALL OF THESE TO HCP

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30
Q

clients should avoid what afte rprostatectomy

A

valsalva for 8 weeks

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31
Q

CKD retains

A

phosphours
potasium
fluid

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32
Q

what contains postassium

A

diary products such as milk and yogurt

fruits (oranges, banaas, cocunuts, watermelons, avacaods)

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33
Q

posphorus foods

A

diary

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34
Q

foods that are allowed CKD

A 
apples
grapes
pineapple
blackberries
blueberries
plum
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35
Q

what can increase ICP

A 
coughing
vomting
straingng to lift obj >5
bending at the waist
give antiemtic meds following opthalmic surgery
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36
Q

expected signs of menire disese

A

vertigo

NV

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37
Q

calcium gluconate

A

does not decrease potassium level but stabllizes the myocardium by raising the threshold for the dyrthmia
-after stablizaing then give the iv regular insulin with dextrose

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38
Q

iv dectrose inusline

A

temp corrects the hyperkalemia by shifting the potassium into the cells

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39
Q

retinal detachmened may rsult from

A

blunt force trauma and if not treated permanent blindness can occur

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40
Q

BPH signs

A

age >50

  • urinary retention
  • sensation of incmplete emptying or increased urgency to void
  • strainng or diff initating voiding (hesitancy)
  • weak or intermittent stream of urine
  • freq voiding patterns throughout the day (urinating more than once every 2 hours)
  • nocturia
  • urgency
  • FREQ OF SEXUAL INTERCOURSE IS NOT RELATED
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41
Q

CKI is at risk for

A

hypotensive encephalthy- HTN crisis characterized by nauea, vomiting, and headache
- need treatedment within one hour to prevent damage to teh ehart kidney and brain

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42
Q

Dialysis disequilibrium syndrome (DDS) can be prevented by

A

life threaning complication that can be prevented by slowing the rate of dilaysis or stopping

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43
Q

Dialysis disequilibrium syndrome (DDS) what happens

A

solutes such as urea are removed more quickly from the blood than from the brain cells and csf creating a concentration gradient that can lead to excess fluid in the brain cells and increased ICP

44
Q

Dialysis disequilibrium syndrome (DDS) signs

A 
NV
headahcec
resltness
change in mentation
seizure
45
Q

Dialysis disequilibrium syndrome (DDS) suspected

A

contact HCP

46
Q

trendelenburg increases

A

cerebral edema and dont do for pt with Dialysis disequilibrium syndrome (DDS)

47
Q

cataract surgery education

A

avoid avt that increase ICP
-may take 1-2 weeks before viual acuity is improved
=common to exp itching (sand) in the eyem photphobia, mild pain for several days
-sleep with 2 pillows elevated to decrease ICP

48
Q

CKD pt are at risk for

A

fluid overload and hyperkalemia

49
Q

CKD diet

A

soidum rsitriction
potassiumum rest suchas carrots and tomatoes
-fluid restriction
-low protein diet
-low phospherous such as chicekn turkey and diary

50
Q

Percutaneous nephrolithotripsy

A

procedure to remove large kidney stones from the renal pelvis.

51
Q

Percutaneous nephrolithotripsy post procedure

A

temp nephrostomy tube is placed to prevent obstruction by stone fragments and to promote healing of injured tissue
-mainting tube patency is imp

52
Q

Percutaneous nephrolithotripsy if no driange or flank pain is present

A

indicate obstruction

-irragate the nephrostomy tube with small amt of normal sterile saline

53
Q

hemoldilasis and potassium

A

do only whenother non invasive ways werent effective and puting on a cathter takes time so not the best route if you want to get rid of K quick

54
Q

peritonitis signs

A

low grade
cloudy
tacy

55
Q

glucoma

A

increased intraocular pressure

  • grad loss of peripheral (tunnel vision)
  • normal central vision
  • halo around birght lights
  • sensitity to glare
56
Q

macular degneration

A

grad loss of central vision

peripheral vision is intact and fine

57
Q

catartact

A 
cloudiness
opacity
older adult
painless
blurry vision
glare and halos
worse at night
decreased color preception
58
Q

cystoscopy complications

A

urinary retentioning
hemm
infection

59
Q

cystoscopy notify hcp if

A 
bright red blood
blood clots
inability to urinate
fever greater 100.4
chills abdominal pain
60
Q

cystoscopy expected finding

A 
pink tinged urine
freq
dyruia
are expected for 48 hours 
-abdominal discomfort and baldder spasms can occur up to 48 hours 
-
61
Q

cystoscopy education

A

4-6 glasses water to dilute urine
avoid etoh and caff 24-48 hours
-take mild anagesic such as actea and ibuprohen and a warm tub sitz bath unless you have UTI

62
Q

Overflow urinary incontinence occurs

A

occurs due to compression of the urethra (eg, uterine prolapse, prostate enlargement) or impairment of the bladder muscle (eg, spinal cord injury, diabetic neuropathy, anticholinergic medications).

63
Q

Overflow urinary incontinence leads to

A 
urinary retention
imcomplete bladder emptying
oversitening
overfulling of the bladder
involuntary dripping of the urine
64
Q

patients with incontinence intervevntion

A

implement fixed voiding schedule (every 2 hours to prevent bladder overfilling)
-instrcut the client to use valsuva manuerver or crede manuever (gently applying pressure to the lower abdomen) to help emotying
-assess perneial area for break down
-measure postvoid residual volume to ensure that they are not retaining large amts of urine
-instruct to wait 20-30 seconds after voiding and then attempt to void a second time (double voiding) to help empty residual volume
DONT RESTRICT FLUIDDDD

65
Q

meiere disease

A

excessive fluid accumlation in the inner ear

66
Q

symtoms of meniere disease

A 
vertigo
tinnutius
hearing loss
feelings of fulnnes
pressure in ear
67
Q

meinere effects

A

only one ear and lead to permanent hering loss

68
Q

what to clients report with meniere

A

feeling loss of propriotcepion
report feeling pulled to the ground (dropped attacks)
sp client safiety is important

69
Q

meinere teaching

A

avoid folickering lights watching tv limits

70
Q

stress incontience modifications

A

highest priority is preventing skin breakdown and UTI
so BLADDER TRAIN to pee every 2 hours and every 4 hours at night
-pelvic floor evecises- kegel
-natural bladder irratant (smoking, caff)

71
Q

A pessary is a

A

non-surgical way to treat pelvic organ prolapse and sometimes incontinence.

72
Q

cretiene clearance requires a

A

24 hour urine collection
- first urine is discarded and the time is noted
all other voided urine is collected in a container and kept cool

73
Q

midstream

A

urinalysis or urine culture

74
Q

Extracorporeal shock wave lithotripsy (ESWL)

A

break up kidney strones into small fragments that can be excreted in the urine

75
Q

after ESWL procedure

A

increase fluid intake to help flush out the kidney stone frag

  • expect some brusing and pain on the back or flank of the affected side
  • expect to see blood in the urine for couple hours but if it is more than 24 hours then concering
  • report signs of infection such as fever and chills to HCP
  • ernouage abumtion NOT BED REST
76
Q

BPH increased risk for

A

uti because of incomplete bladder emptying and retention

77
Q

residual urine volume of what indicates urinary retention

A

> 100

78
Q

what value shows uti

A

> 10k

79
Q

cystoscopy normal

A

normal for burning sensation when voiding for a day or two

80
Q

Transurethral resection of the prostate (TURP)

A

inserts scope to remove obstructing protstate itssue

81
Q

Transurethral resection of the prostate (TURP) what is initated afte

A

Continuous bladder irrigation (CBI) with a 3-way Foley catheter

82
Q

Transurethral resection of the prostate (TURP) expected

A

painful bladder spasms- treat with antispasmodics

  • The total Foley output should be more than the CBI input, as the Foley output includes CBI fluid (not processed through the kidneys) plus the normal renal output of urine.
  • An obstruction is indicated if the CBI input is equal to or greater than the Foley output.
  • first 24 hours, the urine color changes from reddish-pink to pink. Small clots may occur for up to 36 hours. However, the nurse adjusts the irrigation flow to keep the urine light pink without clots.
83
Q

kidney stones risk factors

A

fam history
dietary inbalnces
immbolization
deh

84
Q

kidney stone maesfitifications

A

sudden severe abdominal flank pain
NV
IMMBOLITY SOOO WALKKK

85
Q

kdieny stone interventions

A 
analgesics
rehydration up to 3 L
ambultation
heat therpy but DONT MASAGE
- strain urine
86
Q

retinal detachment pain

A

painless
ERMGENCYYYYYY
gnat or hairnet appearcne in the vision field

87
Q

common clinical manifestation of UTI in the elderly

A

confusion

88
Q

decrease ablity to see things up close

A

presbyopia

89
Q

if something sharp gets in your eye

A

protect the eye using eye shield such as stryoform cup or paper cup to ensure that whatever you are sheilding does not touch the froegin body you are using to cover
0 the eyes work in synchrony to each other so the non injured eye should also be patched to prevent further eye movement
-DONT FLUSH EYES because it can move
the splinter
-dont instill antibiotic treamtent bc it inteferes the opthalmogloic med examination

90
Q

Arteriovenous fistula (AVF) complication

A

Aterial steal syndrome where the vein steals too much arterial blood

91
Q

arterial steal syndrome signs

A

distal ext ischemia (skill pallor, pain, numbess, tingling, diminshed pulses, poor cap refill)
-intevention is needed or limb necoriss happens

92
Q

urniary retention happens afte

A

surgery bc of the adm of opiods

odler men who have bph

93
Q

interventions for urinary retention

A

get the up first if they are men
- then do bladder scan if they are unable to urinate
DO LEAST INVASIVE FIRST

94
Q

Asthma exacerbation signs

A
  • accessory resp muscle use
  • chest tightness
  • cough
  • increased mcuus prod
  • diminshed breath sounds
  • high pitched expiratory wheezing
  • prolonged exp phase
  • tacypnea
95
Q

tell tale symtom of bladder cacer

A

PINALESS HEMATURIA

96
Q

primary cuase of baldder cancer

A

cigar smoking or tabacoo so ask if they smoke and number (PRIORITY QUESTION)

97
Q

pessary education

A

can remain secually aactive while wearing it

  • proper fit in the HCP office but clients can remove and clean and replace themselves
  • surgery not req
  • can have sex with it on
98
Q

side effect os pessary

A

vaginal discharge but not important unless odor is there

99
Q

urge incontinene intevention

A

lose weight

  • anticholingic meds can be given such as oxybutin to decrease bladder spasms and dry mouth is AE
  • avoidance of bladder irrtants
  • pevlic floor excecises
  • bladder training
100
Q

urinary retention treated with

A

rapid , complicate bladder decompression

101
Q

manesitifcations of rapid decompression

A

hypotension
hematuria
and dirusis
bradycardia

102
Q

glucoma characerized by

A

increased ictroclar presusre

can lead to peranent blindness

103
Q

glucoma mesitications that are considered med emergnecy

A 
Sudden onset of severe eye pain
    Reduced central vision
    Blurred vision
    Ocular redness
    Report of seeing halos around lights
104
Q

effective tretament of osa

A

cpap

105
Q

OSA signs

A

hypoxia

hypercapnia

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