Urinary System Flashcards
Dysuria
Pain when urinating
What should the nurse do if urine dipstick test shows protein in urine?
Ask what meds patient takes, medication can affect testing.
Nephron
Functional unit of the kidney
GFR
Amount of blood filtered per minute by the kidneys ( normal is 125 mL/ min)
Costovertebral angle (cva)
Landmark useful in locating kidneys- formed by rib cage and vertebral column.
Anuria
Urine output < 100 mL per 24 hrs.
Basically no urine
Enuresis
Involuntary nocturnal urination
Oliguria
Scant urine
100-400mL per day
Polyuria
Large amount of urine in a given time
Why is acetazolazide given?
To alkalize urine
Why is mannitol given?
To decrease intracranial pressure
( for cerebral edema)
2 side effects of furosemide Lasix- loop diuretic
Remember works on loop of Henley ( loops lose calcium!)
Ototoxicity ( ringing ears)
Hypokalemia
Will remove calcium, chloride ect.
Hydrochlorothiazide
Works on distal convoluted tubule.
Calcium SPARING
Triamterene
Potassium SPARING. Gets rid of sodium
Spironolactone
Potassium sparing. Could cause hyperkalemia.
S/E gynocomastia
Arythmia.
Causes of kidney damage?
Acute:
dehydration
Hypovolemia
Chronic:
Diabetes
Renal artery stenosis
Acute renal failure- cause of prerenal?
Poor renal perfusion
Hypovolemia
Injury
Dehydration
Heart failure
A renal stone in the pelvis of the kidney will alter the function of the kidneys by interfering with
The collection and drainage of urine from the kidney
Intrarenal
Direct damage
Pyelonephritis
Infections
Nephrotoxic medications
Direct injury
Post renal
Urinary obstruction
BPH
Renal stone
Stricture
( anything that causes stasis)
Renal failure
Retain waste products
Sodium
Potassium
What happens in chronic kidney disease
Malaise Hypertension Proteinuria Hyperkalemia -arrhythmia Mineral and bone disorders Neuropathy Metabolic acidosis Severe uremia- pruritis , CNS depression Edema Oliguria
A patient with kidney disease has oliguria and a creatinine clearance 40 ML per minute. These findings most directly reflect abnormal function of
Glomerular filtration
The nurse identifies a risk for urinary calculi in a patient who relates a past history that includes
Hyperparathyroidism
Diminished ability to concentrate urine, associated with aging of the urinary system, is attributed to
Decreased function of the loop of Henley and tubules
During the physical assessment of the urinary system the nurse
Auscultated over each CVA to detect impaired renal bloodflow
Severe uremia
Pruritis
CNS depression
Normal findings expected by the nurse on physical assessment of the urinary system include
A nonpalpable left kidney and no CVA tenderness elicited by kidney punch
A diagnostic study that indicates renal bloodflow, glomerular filtration, tubular function, and excretion is
A renal scan
Dialysis
Major fluid shifts! Monitor BP
No BP IN ARM with shunt
Thrill and bruit
Can feel a thrill!
Auscultation for bruit!
Pyelonephritis
Assessment: Dysuria Fever Fatigue Flank pain N & V
I’m reading the urinalysis results of a dehydrated patient, the nurse would expect to find
Specific gravity of 1.035
Glomerulonephritis
Inflammation of the glomeruli which affects both kidneys equally and is 3rd leading cause of ESKD in the US.
Foods high in purine
Sardines, mussels, liver, kidney, meat soups sweetbreads.
Medium levels- chicken , salmon, crab
Foods high in calcium
Milk, fish with bones, dried fruits, nuts, ovaltine, chocolate.
High oxalate foods
Dark roughage, spinach, rhubarb, cabbage, celery, parsley, chocolate, instant coffee, tea
When teaching a patient with pyelonephritis about the disorder the nurse informed the patient that the organisms that cause Pyelonephritis most commonly reach the kidneys through
And ascending infection
The immunologic mechanisms involved in a post streptococcal glomerulonephritis include
Thickening of the GBM from auto immune microangiographic changes
The edema that occurs in nephrotic syndrome is due to
Decrease colloidal osmotic pressure caused by loss of serum albumin
A patient has admitted to the hospital with severe renal colic. The nurse is first priority and management of the patient is to
Administer opioids as prescribed
A patient with a Ureterolithotomy returns from surgery with the nephrostomy tube in place. Post operative nursing care of the patient includes
Encouraging fluids of at least 2 to 3 L per day after nausea has subsided
A patient has had a cystectomy and ilio conduit diversion performed. Four days postoperatively, mucus threads are seen in the drainage bag. The nurse should
Chart that has a normal observation
What descriptions characterize acute kidney injury
The primary cause of death is infection and the disease course is usually reversible
RIFLE defines three stages of a KIA based on changes in the
Serum creatinine or urine output from baseline
During the oliguric phase of AKI, the nurse managers the patient for
ECG changes and pulmonary edema
If a patient is in the diuretic phase of AKI, the nurse must monitor for which serum electrolytes and balances?
Hypokalemia and hypo natremia
A patient is admitted to the hospital with chronic kidney disease. The nurse understands that this condition is characterized by
Progressive irreversible destruction of the kidneys
Nurses need to teach patients at risk for developing chronic kidney disease. Individuals considered to be at risk include
Older African-Americans, patients over 60 years old, those with a history of hypertension, and those with a history of type two diabetes
Patients with chronic kidney disease experience an increased incidence of cardiovascular disease related to
Hypertension, vascular calcification’s, and hyper insulinemia causing dyslipidemia
Nutritional support and management or essential across the entire continuum of chronic kidney disease. Which statements would be considered true related to nutritional therapy?
Fluid is usually restricted for patients receiving peritineal dialysis, sodium and potassium maybe restricted in someone with advanced chronic kidney disease, decreased fluid intake and low potassium diet or hallmarks of the diet for a patient receiving hemodialysis
And ESKD patient receiving hemodialysis is considering asking a relative to donate a kidney for transportation. In assisting the patient to make a decision about treatment, the nurse informed the patient that
A successful transplantation usually provides better quality of life than that offered by dialysis
To assess the patency of a newly placed arteriovenous graft for dialysis, the nurse should
Palpate the area of the graph to fill a normal thrill, listen with the stethoscope over the graph to detect a bruit, frequently monitor the pulses and neurovascular status distal to the graft
A major advantage of peritoneal dialysis is
The diet is less restricted and dialysis can be performed at home
A kidney transplant pt complains of having fever, chills, and dysuria over the past two days. What is the first action that the nurse should take
Assess the temperature and initiate work up to rule out infection
Acute kidney injury
Sudden loss of renal function due to poor circulation or renal cell damage
- usually reversible
Which of the following patients highest risk for a urinary tract infection?1
Grade: 1
A 78-year- old female with dementia and incontinence
A 23-year- old female with anemia and history of inguinal hernia repair
A 78-year- old male with urinary urgency
A 56-year- old female with uterine prolapse
A 78-year- old female with dementia and incontinence
Glomerulonephritis is _____________.1
An inflammatory disorder of the glomerulus caused by immunological reaction
Your patient is receiving peritoneal dialysis. Which of the following should you report to the physician immediately?
Cloudy outflow
Which statement from a patient would cause you to suspect renal calculi?
“I have sudden sharp pain that goes from my back to my testicles.”
Which of the following is an important dietary recommendation for patients with chronic kidney disease?
low potassium
The signs and symptoms of your patient with acute kidney injury result from the kidneys inability to regulate fluid and electrolytes. True or false?
TRUE
The most common cause of acute kidney injury is from the prerenal phase. What is this?
decrease in blood flow to the kidney
Your dialysis patient has a fistula. You assess for a bruit and a thrill but do not hear/feel it. What is your first step before calling the physician?
There is not a nursing intervention; you must call the MD for further orders
_______________ is the most common cause of urosepsis.
use of urinary catheter
Nephrotic syndrome is __________________.
a kidney disease where protein is lost by plasma into the urine
For stable patient with chronic kidney disease that is continuing to decompensate, what will most likely be initiated?
dialysis
