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Medical Surgical > Urinary System > Flashcards

Urinary System Flashcards

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USMLE® Step 1 flashcards
1
Q

What is urolithiasis?

A

Kidney stones

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2
Q

Glomerulonephritis has what in the urine?

A

Blood and protein in the urine

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3
Q

How do we tx glomerulonephritis

A

Amoxicillin, penicillin, and corticosteroids

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4
Q

Glomerulonephritis can cause which symptoms

A

Blood in urine and hypertension

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5
Q

What is glomerulonephritis caused by?

A

Autoimmune, frequently caused by strep infections

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6
Q

Tx for both pyelonephritis and glomerulonephritis

A

Antibiotics

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7
Q

Both pyelonephritis and glomerulonephritis can cause?

A

Nephrotic syndrome and protein in the urine

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8
Q

Tx of pyelonephritis?

A

Bactrim, gentamicin, and vancomycin

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9
Q

Pyelonephritis can cause?

A

Fever

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10
Q

What is pyelonephritis?

A

When there is bacteria and leukocytes in the urine

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11
Q

Both BPH and prostatitis can be Dx by?

A

Digital rectal exam

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12
Q

What usually causes pyelonephritis?

A

Untreated UTI

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13
Q

What should pt avoid with prostatitis?

A

Avoid sexual activity unless chronic or non infectious

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14
Q

BPH and prostatitis can both be treated with?

A

Tamsulosin

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15
Q

Cystitis

A

Inflammation of the bladder most common cause E. Coli

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16
Q

Symptoms of cystitis

A

Dysuria, frequent scat urine, urgency, hematuria, cloudy urine, pelvic pain, nocturia

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17
Q

Complication of catheters

A

Infection, dislodgment, urinary reflux

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18
Q

What is a TURP?

A

transurethral resection of the prostate

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19
Q

Everyone that has a TURP comes out with?

A

Must have tri lumen catheter

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20
Q

What is the most common cause of prostatitis?

A

UTI or infection

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21
Q

How do we know if someone has urinary retention?

A

Bladder scan, Input/ output does not match, bladder distention- assessed by percussion or palpation

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22
Q

Do we do a bladder scan anytime?

A

No we do it post void

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23
Q

What are some causes of neurogenic bladder?

A

Trauma to spinal cord or brain, brain tumor, spinal bifida, multiple sclerosis

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24
Q

What medications do we give for UTI?

A

Antibiotics and phenazopyridine

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25
Q

What are some symptoms of high potassium?

A

Dysrhythmias, tachycardia, chest pain, sensation of fluttering in the chest, palpitations

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26
Q

What ECG changes do we expect to see in a pt with hyperkalemia?

A

Peaked T waves

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27
Q

With kidney problems we would see what electrolyte imbalances?

A

High K+, high Na+, low Ca+, high Ph+

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28
Q

What are the symptoms of hypernatremia?

A

Decreased LOC, fatigue, seizures, dehydration, thirst

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29
Q

Does sodium have any effect on the ECG?

A

No

30
Q

K+ causes what change in ECG

A

Peaked T waves

31
Q

How does Ca+ affect the ECG?

A

Short QRS

32
Q

Acute kidney failure is?

A

Sudden, treatable depending on cause

33
Q

What are the 3 phases of acute kidney failure?

A

Oliguria,diuresis, and recovery

34
Q

What can cause acute kidney failure?

A

Obstruction in kidney, decreased perfusion to the kidney

35
Q

What medications are nephrotoxic?

A

NSAIDs, vancomycin, gentamicin, chemotherapy drugs, furosemide

36
Q

Chronic renal failure/ chronic kidney disease

A

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

37
Q

Hemodialysis is?

A

Filters blood through a machine, can be used in an emergency

38
Q

Peritoneal dialysis

A

Done at home, filtered through the peritoneal cavity, high risk of infection

39
Q

Hypertension and kidney disease correlation

A

Each one can cause the other

40
Q

Acute kidney injury or acute renal failure

A

A failure of the kidneys to filter blood on an acute level. Meaning less than 3 months

41
Q

Causes of AKI

A

Obstruction of the kidney, decreased perfusion to kidney, infection of the kidney (pyelonephritis), decreased cardiac output, nephrotoxic meds.

42
Q

How do we know if a pt is in AKI/ ARF

A

Clinical symptoms combined with BUN and creatinine test.

43
Q

First phase in AKI/ARF

A

Oliguria

44
Q

Second phase in AKI

A

Diuretic

45
Q

Oliguric phase

A

BUN and creatinine rise, urine output is less than 30 ml/hr, hyperkalemia, hypernatreamia, edema, hypertension

46
Q

Diuretic phase

A

Urinary output improving, increases by 1-2 L/day up to 5L/day, hypovolemia, hypotension, hypokalemia, hyponatremia

47
Q

Recovery phase

A

GFR increases, BUN and creatinine decrease, recovery can last up to a year

48
Q

Medical management for AKI

A

Treat electrolyte imbalances, especially hyperkalemia, monitor intake and output, low protein diet, high carbs, manage sodium abnormalities as needed, low potassium diet.

49
Q

Chronic kidney disease

A

Occurs when the pt is unable to regain kidney function from AKI. Progressive and irreversible loss of kidney function

50
Q

Common causes of CKD

A

Pyelonephritis, chronic glomerulonephritis, sclerosis of the glomeruli, sever hypertension, diabetes.

51
Q

What do we look at in patients with CKD?

A

BUN and creatinine are monitored, GFR is used to see how far along the kidney disease is

52
Q

Pt with kidney disease frequently have?

A

Low platelets, low WBCs, Low RBCs (due to anemia caused by lack of erythropoietin)

53
Q

How can we prevent CKD

A

Tx of acute kidney disease, drink lots of water, treat your diabetes and hypertension, early detection via physical, good diet, low salt, exercise

54
Q

Other complications of kidney failure

A

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.

55
Q

Nursing interventions for chronic kidney disease

A

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.

56
Q

Normal BUN

A

10-20

57
Q

Normal K+

A

3.5-5.0

58
Q

Normal eGFR

A

> 90 (greater than)

59
Q

Normal creatinine

A

0.7-1.4

60
Q

Hyperkalemia interventions

A

Kaexylate, sodium polystyrene sulfonate, IV regular insulin, decrease potassium in diet

61
Q

Hypernatremia interventions

A

Decrease sodium, sometimes we give furosemide

62
Q

Low calcium level intervention

A

Increase calcium and diet, aluminum hydroxide- phosphate binder

63
Q

Hyponatremia interventions

A

Moderate amount of salt

64
Q

Elevated triglycerides

A

Decrease fatty foods, give anti-cholesterol medicines as ordered

65
Q

Anemia interventions

A

Erythropoietin, watch for hypertension and myocardial infarction, increase iron

66
Q

Metabolic acidosis interventions

A

Ivy foods, sodium bicarbonate, prepare Patient for dialysis

67
Q

Fluid overload interventions

A

Limit fluids, Lasix, monitor intake and output, monitor daily weight (greater than 2lbs a day or 3lbs per week)

68
Q

Acute kidney injury causes

A

Obstruction, hemorrhage, trauma, infection, and decreased cardiac output.

69
Q

Medications that are nephrotoxic

A

Chemo drugs, NSAIDs, gentamicin, vancomycin, penicillin, and cephalosporins

70
Q

Acute kidney Injury is characterized by?

A

Rise in BUN and creatinine levels with or without decreased urine output and elevated potassium levels

71
Q

Oliguric phase is?

A

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.

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