Urinary System Flashcards
What is urolithiasis?
Kidney stones
Glomerulonephritis has what in the urine?
Blood and protein in the urine
How do we tx glomerulonephritis
Amoxicillin, penicillin, and corticosteroids
Glomerulonephritis can cause which symptoms
Blood in urine and hypertension
What is glomerulonephritis caused by?
Autoimmune, frequently caused by strep infections
Tx for both pyelonephritis and glomerulonephritis
Antibiotics
Both pyelonephritis and glomerulonephritis can cause?
Nephrotic syndrome and protein in the urine
Tx of pyelonephritis?
Bactrim, gentamicin, and vancomycin
Pyelonephritis can cause?
Fever
What is pyelonephritis?
When there is bacteria and leukocytes in the urine
Both BPH and prostatitis can be Dx by?
Digital rectal exam
What usually causes pyelonephritis?
Untreated UTI
What should pt avoid with prostatitis?
Avoid sexual activity unless chronic or non infectious
BPH and prostatitis can both be treated with?
Tamsulosin
Cystitis
Inflammation of the bladder most common cause E. Coli
Symptoms of cystitis
Dysuria, frequent scat urine, urgency, hematuria, cloudy urine, pelvic pain, nocturia
Complication of catheters
Infection, dislodgment, urinary reflux
What is a TURP?
transurethral resection of the prostate
Everyone that has a TURP comes out with?
Must have tri lumen catheter
What is the most common cause of prostatitis?
UTI or infection
How do we know if someone has urinary retention?
Bladder scan, Input/ output does not match, bladder distention- assessed by percussion or palpation
Do we do a bladder scan anytime?
No we do it post void
What are some causes of neurogenic bladder?
Trauma to spinal cord or brain, brain tumor, spinal bifida, multiple sclerosis
What medications do we give for UTI?
Antibiotics and phenazopyridine
What are some symptoms of high potassium?
Dysrhythmias, tachycardia, chest pain, sensation of fluttering in the chest, palpitations
What ECG changes do we expect to see in a pt with hyperkalemia?
Peaked T waves
With kidney problems we would see what electrolyte imbalances?
High K+, high Na+, low Ca+, high Ph+
What are the symptoms of hypernatremia?
Decreased LOC, fatigue, seizures, dehydration, thirst
Does sodium have any effect on the ECG?
No
K+ causes what change in ECG
Peaked T waves
How does Ca+ affect the ECG?
Short QRS
Acute kidney failure is?
Sudden, treatable depending on cause
What are the 3 phases of acute kidney failure?
Oliguria,diuresis, and recovery
What can cause acute kidney failure?
Obstruction in kidney, decreased perfusion to the kidney
What medications are nephrotoxic?
NSAIDs, vancomycin, gentamicin, chemotherapy drugs, furosemide
Chronic renal failure/ chronic kidney disease
More gradual, irreversible unless you get a kidney transplant if bad enough pt will be on dialysis.
Diabetes and hypertension put you at high risk
Hemodialysis is?
Filters blood through a machine, can be used in an emergency
Peritoneal dialysis
Done at home, filtered through the peritoneal cavity, high risk of infection
Hypertension and kidney disease correlation
Each one can cause the other
Acute kidney injury or acute renal failure
A failure of the kidneys to filter blood on an acute level. Meaning less than 3 months
Causes of AKI
Obstruction of the kidney, decreased perfusion to kidney, infection of the kidney (pyelonephritis), decreased cardiac output, nephrotoxic meds.
How do we know if a pt is in AKI/ ARF
Clinical symptoms combined with BUN and creatinine test.
First phase in AKI/ARF
Oliguria
Second phase in AKI
Diuretic
Oliguric phase
BUN and creatinine rise, urine output is less than 30 ml/hr, hyperkalemia, hypernatreamia, edema, hypertension
Diuretic phase
Urinary output improving, increases by 1-2 L/day up to 5L/day, hypovolemia, hypotension, hypokalemia, hyponatremia
Recovery phase
GFR increases, BUN and creatinine decrease, recovery can last up to a year
Medical management for AKI
Treat electrolyte imbalances, especially hyperkalemia, monitor intake and output, low protein diet, high carbs, manage sodium abnormalities as needed, low potassium diet.
Chronic kidney disease
Occurs when the pt is unable to regain kidney function from AKI. Progressive and irreversible loss of kidney function
Common causes of CKD
Pyelonephritis, chronic glomerulonephritis, sclerosis of the glomeruli, sever hypertension, diabetes.
What do we look at in patients with CKD?
BUN and creatinine are monitored, GFR is used to see how far along the kidney disease is
Pt with kidney disease frequently have?
Low platelets, low WBCs, Low RBCs (due to anemia caused by lack of erythropoietin)
How can we prevent CKD
Tx of acute kidney disease, drink lots of water, treat your diabetes and hypertension, early detection via physical, good diet, low salt, exercise
Other complications of kidney failure
Waste products accumulating in the brain space can cause uremic encephalopathy, the heart failure, fractures, due to decrease in bone density, fractures due to decrease in ability to activate vitamin D.
Nursing interventions for chronic kidney disease
Reduce protein and diet, once patient has dialysis eat regular protein, increase carbohydrates, low, potassium, low sodium, increase calories, monitor intake and output, encourage activity, be careful with skin, prior to dialysis treatment is management of electrolytes.
Normal BUN
10-20
Normal K+
3.5-5.0
Normal eGFR
> 90 (greater than)
Normal creatinine
0.7-1.4
Hyperkalemia interventions
Kaexylate, sodium polystyrene sulfonate, IV regular insulin, decrease potassium in diet
Hypernatremia interventions
Decrease sodium, sometimes we give furosemide
Low calcium level intervention
Increase calcium and diet, aluminum hydroxide- phosphate binder
Hyponatremia interventions
Moderate amount of salt
Elevated triglycerides
Decrease fatty foods, give anti-cholesterol medicines as ordered
Anemia interventions
Erythropoietin, watch for hypertension and myocardial infarction, increase iron
Metabolic acidosis interventions
Ivy foods, sodium bicarbonate, prepare Patient for dialysis
Fluid overload interventions
Limit fluids, Lasix, monitor intake and output, monitor daily weight (greater than 2lbs a day or 3lbs per week)
Acute kidney injury causes
Obstruction, hemorrhage, trauma, infection, and decreased cardiac output.
Medications that are nephrotoxic
Chemo drugs, NSAIDs, gentamicin, vancomycin, penicillin, and cephalosporins
Acute kidney Injury is characterized by?
Rise in BUN and creatinine levels with or without decreased urine output and elevated potassium levels
Oliguric phase is?
Fluid retention and decreased urine output lasting several weeks to months. Fluid overload, metabolic acidosis, hyponatremia, hyperkalemia, accumulation of waste in the body and brain.
