urinary assessment chap 45 Flashcards

1
Q

which med taken by a renal pt is concerning to a nurse?

A

ibuprofen (NSAIDS) is processed by the kidneys.

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2
Q

if nurse cannot palpate kidney is that bad?

A

No- kidneys should not be felt upon palpation

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3
Q

what should nurse expect to see in a pt after cystoscopy?

A

blood tinged urine

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4
Q

Rifampin

phenazopyridine

A

turns urine bright red

turns urine dark orange

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5
Q

where is kidney located?

A

retro- perineal in the back. Right one should be felt in a very skinny person, but not the left one.

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6
Q

kidneys

A
run on a lot of hemodynamic control. 
about size of the person's fist 
located retro peritoneally
adrenal gland on top of each 
cushioned by fat and connective tissue
Hilus is on he medial side
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7
Q

nephron

A

functional unit of kidney

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8
Q

Loop of Henley

A

where Lasix (furosemide) takes effect

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9
Q

Blood supply of kidneys

A

Renal artery arises from aorta

-

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10
Q

GFR glomerular filtration rate (in adult)

A

Normal is 125mL/min
measured by 24 hour urine collection have pt void then start collecting all urine for 24 hours and store it on ice until 24 hours is up. to compare to creatinine clearance from labs

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11
Q

BUN

A

blood, urea, nitrogen= wastes that kidneys are filtering off helps us determine the function of the kidneys
elevated BUN= kidneys not doing a good job of condensing

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12
Q

other functions of kidney?

A

creation of erythropoietin

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13
Q

Ace inhibitors

A

work by preventing angiotensin 1 from changing to angiotensin 2

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14
Q

ureters

A

drain from kidneys to the bladder

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15
Q

bladder

A

reservoir for urine. can hold 600mL to 1 L at a time -

-detrusor muscle contracts bladder and stops and starts urination

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16
Q

Trigone muscle

A

controls ability of urine to pass through the bladder

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17
Q

aging and kidneys

A

between age 30 and 90- size and function decrease by 20-30%

by 7th decade loss of 30-50% of glomerular function,

18
Q

atherosclerosis

A

accelerates the decrease of kidneys

19
Q

aging changes of bladder?

A

prostate enlargements

loss of elasticity and muscle support

20
Q

Assessment of Urinary system

A
subjective- 
past hx?
Meds? 
surgery or other treatments? 
functional health patterns? 
nutritional/metabolic pattern?
elimination pattern? 
exercise pattern? 
sleep/rest?
21
Q

Assessment of US- physical exam

A

Inspection of skin, mouth , face, extremeties abdomen.
weight - general health

Palpation -
left kidney rarely palpable
right kidney
bladder (full bladder- not empty)
Percussion: kidney punch to see if pain aka costrovertebral
bladder (or use a bladder scanner which is easier!)
Auscultation- listen for bruit

22
Q

anasarca

A

generalized edema?

23
Q

US exams

A

Urinalysis-
first morning void
examine urine within 1 hr

24
Q

Urinary System exams

A

Urinalysis-
first morning void
examine urine within 1 hr

25
Q

creatinine clearance

A

collect 24 hour urine specimen
creatinine clearance closely approximates GFR
(should be close to equal to GFR)

26
Q

urodynamics

A

not done often- place hoses into ureters or urethra

27
Q

contrast test (IVP)

A

be sure kidneys are healthy enough to handle the dye- serum level should be 1.6 or lower and pt cannot be allergic to shellfish or iodine

28
Q

cystogram

A

like and endoscope= can go in bladder and look for damage, tumors, foreign objects

29
Q

cystoscopy = assessment finding requires IMMEDIATE

attention by the nurse

A

back pain =

30
Q

UTI risk

A
Female 
diminished host defenses 
Urinary tract abnormality 
blockage of urinary tract 
urinary retention 
suppressed immune system 
catheterization and other procedures  (over 48 hrs increases chance of UTI)
31
Q

catheter can be used for

A

strict I and O required
palliative care for terminally ill
if has skin issue that would be affected by incontinence

32
Q

upper UTI

A

pyelonephritis (fever, chills, flank pain) kidney infection can cross from urine into the blood = Urosepsis

33
Q

lower UTI

A

cystitis

urethritis

34
Q

urosepsis

A

pathogen has become blood borne can cause death in the elderly

35
Q

HAI

A

hospital acquired infection - cause is usually due to use of antibiotics, instrumentation and catheterization

36
Q

CAUTI

A

catheter associated UTI

bacteria biofilms develop on inner surface of catheter

37
Q

UTI labs

A

CBC elevated WBC- neutrophils (basically signs of infection and inflammation)

38
Q

Urinalysis - microscopic UA

A

tells urine specific gravity, pH, urine culture and sensitivity

39
Q

drugs for UTI antispasmodic

A

oxybutynin, tolteridine (Detrol)

40
Q

UTI analgesics

A

phenazopyridine == turns urine bright orange

Urised (methenamine/phenyl salicylate

41
Q

bladder irritants

A

smoking (increases risk of bladder cancer)