Urinary Tract Obstruction/Burns Flashcards
A noninvasive procedure to break up renal stones into sand-like particles through the use of shockwaves
Extracorporeal Shockwave Lithotripsy
An incision into the ureter to remove a urinary stone
Ureterolithotomy
Acute or chronic inflammation of the renal pelvis and parenchyma of the kidney calyces due to a bacterial infection
Pyelonephritis
Dilation of the kidney calyces due to a bladder outlet obstruction
Hydronephrosis
Stainless steel wire placed in the urinary tract system to hold back the walls thus allowing an unobstructed flow of urine
stent
Urinary Tract Stone
Urolithiasis or Nephrolithiasis
An incision into the kidney to remove a stone
Nephrolithotomy
X-Ray examination that visualizes the urinary tract after the administration of IV contrast material
Intravenous Pyelogram
Examination of the bladder through the use of a lighted scope
Cytoscopy
An incision into the renal pelvis to remove a stone
pyelolithotomy
When a catheter is inserted into the renal pelvis due to an obstruction of the ureter
Nephrostomy
Serum Creatinine Normal
0.6-1.5mg/100mL
What is creatinine?
The end product of muscle and protein metabolism and is liberated at a constant rate. Results are higher in men
BUN Normal
10-30mg/100mL
What is blood urea nitrogen?
Concentration of urea in blood is regulated by rate at which kidney excretes urea
Creatinine Clearance
waste product of protein breakdown. clearance of creatinine by the kidney approximate glomerular filtration rate.
Urine Osmolality
total concentration of particles in a solution.
Intravenous Pyelogram
allows visulization of urinary tract with contrast medium
Recommended fluid intake
2500mL/day
What is the purpose of Intravenous Pyleogram?
Allows visulization of urinary tract with contrast medium
How many hours NPO before intravenous pyleogram?
8 hours
What to look for during IVP
- anaphylaxis
- resp distress
- urticaria
- drop in BP
Emergency drugs for IVP
benadryl and epinephrine
Delayed reaction to contrast dye in IVP
- itching
- nausea
- resp. problems
- oliguria
What should you encourage after IVP?
fluid intake
What allergy should you be on alert for for an IVP?
- shellfish
- iodine
Purpose of cytoscopy
Use of a tubular lighted scope to inspect interior of bladder
What should the nurse encourage during cytoscopy?
relaxation actitivies, deep breathing
What should a client expect after a cytoscopy?
- burning with urination
- pink tinged urine
- urinary frequency
In clients with urinary tract obstruction, BUN does what?
is elevated
In clients with urinary tract obstructions, serum creatinine does what?
is increased
A client with a urinary tract obstruction will exhibit what?
- hematuria
- chronic urinary tract infections
- renal colic
- fever
- tenderness on palpation of renal area
Clients with urinary tract calculi may have a history of what?
- family members with urinary tract calculi
- sedentary lifestyle
- previous urinary tract stones
Metabolic factors contributing to urinary tract obstructions
increased urine levels of calcium, oxaluric acid, uric acid or citric acid
Climate factors contributing to urinary tract obstructions
warm climate that contributes to incidence of dehydration (increase fluid loss, low urine volume, concentrated urine)
diet factors contributing to urinary tract obstructions
- high protein diet that increases uric acid excretion
- excessive intake of tea or fruit juices that increase urinary oxalate levels
- high intake of calcium and oxalate in diet
- low fluid intake that increases urianry concentration
Genetic factors that contribute to urinary tract obstruction
family history of stone formation, cystinuria, gout, or renal acidosis
lifestyle factors contributing to urinary tract obstructions
sedentary occupation, immobility
Foods high in calcium
- milk
- cheese
- fish with bones
- ice cream
- beans
- chocolate
Foods high in oxalate
- spinach
- asparagus
- nuts
- tomatos
- chocolate
Foods high in purines
- sardines
- herring
- kidney
- liver
- goose
- mussels
- venison
Burn
injury to the tissues of the body caused by heat, chemicals, electrical current, or radiation
Common causes of burns in children
- hot water scalds most freq in toddlers
- flame related burns most common in older children
- 10-20% of documented cases of child abuse include burn injuries
- children playing with matches or lighters account for 1 in 10 house fires
Rule of Nines
guide for determining the total body surface area affected by a burn
Head and Neck
9
Each Arm
9
Anterior Trunk
18
Posterior Trunk
18
Each Leg
18
Peritneum
1
Palm
1
1st 24-48 hours Cardiovascular pathophysiology
increase vas. permeability in area of burn injury due to infammatory response –> Loss of plasma proteins and electrolytes –> increase in interstitial fluid –> Decrease in intravascular volume……damaged tissue at burn site
1st 24-48 hours respiratory pathophysiology
damage to airway secondary to direct burn injury or inhalation of noxious gases
1st 24-48 hours renal pathophysiology
decreased urinary output secondary to decreased renal blood flow, loss of protein at burn site, stress response to burn injury
What lab values would be expected in a burn patient?
BUN + CR increase, increase in BG
When does the diuretic phase take place after a burn?
24-48 hours
24-48 hours cardiovascular pathophysiology
interstitial to intravascular fluid shifts
24-48 hours renal pathophysiology
increased urinary output
What lab balues would be expected from a burn patient 24-48 hours after a burn?
diuresis and low specific urine gravity
Parkland Formula
4mL LR X body weight (kg) X % of body surface area burned = 24 hour total fluid replacement
Application of parkland formula
1/2 of total 24 hour fluid replacement in first 8 hours
1/4 of total 24 hour fluid replacement in second 8 hours
1/4 of ttotal 24 hour fluid replacement in third 8 hours
