Urinary System Study Guide Flashcards
Stress Incontinence
734
Loss of less than 50 ml, caused by coughing, sneezing, laughing.
Occurs after birth/menopause in women
Occurs after prostatectomy and radiation in men
Functional Incontinence
734
Caused by environmental, or physical barriers
e. g furniture
e. g loss of memory, or disorientation
Uremia
758-759
Urea in blood, that if untreated causes death very quickly! Is caused by CKD, can be treated with CRRT (Continuous Renal Replacement Therapy) in conjunction with hemodialysis.
Purpose of Erythropoietin
719
Production of Erythrocytes in bone marrow
Nephrotoxic Meds (Antibiotics) 758
Antibiotics
- Aminoglycosides
- Tetracyclines
- Sulfa drugs
- Cefalosporins
- Amphotericin B
Nephrotoxic Meds (Analgesics) 758
Analgesics
- Acetaminophen
- NSAIDS
- Salicylates
Nephrotoxins (Heavy Metal)
758
Heavy Metal
- Arsenic
- Gold
- Lead
- Lithium
- Copper
- Mercury
Nephrotoxins (Contrast Media)
758
Contrast Media, used in diagnostic tests such as IV Pyelograms, and Cardiac Catheters.
Nephrotoxins (Organic Solvents)
758
Organic Solvents
- Gasoline
- Glycols
- Kerosene
- Tetrachloroethylene
- Turpentine
Nephrotoxins (Other Drugs)
758
Other Drugs
- Ace Inhibitors
- Heroin
- Interleukin 2
- Cisplatin
- Dextran
- Mannitol
- Amphetamines
How much Urine should PT void per hr?
30 ml
What do we always tell PT’s about Antibiotics?
Take them all!
SATA What do you do if PT has elevated Potassium?
- Telemetry
2. Report to HCP
SATA, Fistula Care
- No restrictive clothing
- Bruit and Thrill
- No Needle Sticks
Hemodialysis
Definition: The use of artificial kidneys to remove waste products, and excess fluid from the blood.
How Long: Treatment lasts 3-4 hrs
What it Treats: Good for fluid-overload treatment, such as those that occur during HF.
Side Effects: Weakness, Fatigue, PT may be too tired to eat. Sudden drop in BP, Dizziness, Nausea. Muscle cramps due to fluid and electrolyte drop causing lethargy.
Major Side Effects: Cardiac Arrthymias, Agina
Meds: PTs given large amounts of heparin (anticoagulant) to keep blood from clotting while in the kidneys. This may cause bleeding at site, GI tract, Nose, or injury sites.
CRRT Continuous Renal Replacement Therapy
Define: Therapy used to remove fluid and solutes in a controlled, but continuous way in unstable patients such as those with AKI. It’s used as a less drastic alternative to hemodialysis. Replacement fluids and electrolytes can be given via vascular access.
How long: Can be used up to 1 month.
Nursing Measures: Monitor I&O’s, fluid & electrolytes, daily weight, hourly vitals, and vascular access.
Purpose of Dialysis
Used to bring Fluid Balance to the body when Patients, develop signs of severe overload, high potassium levels, acidosis, pericarditis, vomiting, lethargy, fatigue, or life-threatening uremia. Also used to treat drug over-dose
What is the most accurate way to determine PT’s Fluid Balance?
Daily Weight, at the same time every day, in similar clothes.
Normal Vs Abnormal Urinalysis
727
Smell
Good: Aromatic
Bad: Foul Smell=Infection Fruity Smell= Diabetic Ketoacidosis
pH
Good: 4.5-8.0
Bad: Low= metabolic acidosis, starvation, diarrhea
High= Infection, renal disease, vomiting
Protien
Good: Less than 20 mg, 24 hr urine 30-150 mg Bad: Foamy urine=damaged glomerulus=Renal Disease
All Good Things: Glucose: Negative Ketones: Negative Bilirubin: Negative Nitrate: Negative RBC's: less than 5 WBCs: less than 5 Leukocyte: Negative Casts: None-Rare
Pyelogram
X-ray of renal tissue, calyces, pelvises, ureters, bladder, with or without (contrast media)
Possible Abnormal Findings: Abnormal kidney shape/size, no kidneys, polycystic kidney disease, tumors, hydronephrosis, renal vascular hypertension.
Pre/Post Care
Pre: Enema evening before, test to empty colon
Post: Monitor urine output
Nephrostomy Tube or Stent
When kidneys stones cannot be removed nephrolithotomy is done by making an incision with a nephroscope, this breaks up the stone and then it is removed, after a (nephrostomy tube or stent is inserted to insure the urine flow does not get obstructed.)
