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TERM 4 N2261 KNLG 3 > UROLOGY > Flashcards

UROLOGY Flashcards

1
Q

How are kidneys related to bones?

A
  1. Regulate levels of calcium, phosphorus, PTH, and vitamin D
  2. Activate vitamin D
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2
Q

What is creatinine?

A

Waste product of protein breakdown

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3
Q

What is the term for a test performed to analyze changes in cellular structure related to malignancy​?

A

Urine cytology

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4
Q

What is the term for an invasive test where contrast is instilled into the bladder via cystoscope or catheter to visualize bladder and vesico-ureteral reflux?​

A

Cystography

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5
Q

How is a renal biopsy usually performed, and what is the most important risk to remember?

A

Under CT or US guidance

Risk for bleeding

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6
Q

What is the term for an invasive endoscopic study that utilizes a scope to examine the bladder under local or general anaesthesia?

A

Cystoscopy

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7
Q

What are the three systems which maintain pH balance?

A

Buffer system
Respiratory system
Renal system

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8
Q

How do the kidneys maintain pH balance?

A

Reabsorb and create bicarbonate (HCO3-)

Excrete hydrogen ions (H+)

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9
Q

What is the term for an acid-base imbalance related to carbon dioxide?

A

Respiratory acidosis/alkalosis

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10
Q

What is the term for an acid-base imbalance related to bicarbonate?

A

Metabolic acidosis/alkalosis

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11
Q

What are 2 causes for metabolic alkalosis?

A

Vomiting and NG suction (loss of stomach acid > excess HCO3-)

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12
Q

What are 3 causes for metabolic acidosis?

A
  1. Diarrhea (loss of HCO3- from intestines)
  2. Renal failure (H2 retention)
  3. DKA
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13
Q

What are 2 causes for respiratory acidosis?

A
  1. Conditions that cause CNS depression (low RR):
    -Head trauma
    -Post-op
    -Opioids & alcohol
  2. Conditions that cause impaired gas exchange:
    -COPD
    -Asthma
    -Pneumonia
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14
Q

What is the cause of respiratory alkalosis?

A

Conditions that cause increased RR, e.g. panic attack

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15
Q

What is the normal range for pH?

A

7.35-7.45

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16
Q

What is the normal range for CO2?

A

35-45

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17
Q

What is the normal range for HCO3?

A

22-26

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18
Q

How to determine if a person is in acidosis or alkalosis?

A

Determine which side the pH leans to more

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19
Q

How to determine whether an acid-base imbalance is metabolic or respiratory?

A

Match the pH with its partner

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20
Q

How to determine if an acid-base imbalance is compensated, uncompensated, or partially compensated?

A
  1. Compensated: pH normal
  2. Uncompensated: pH abnormal, one value of A+B is normal
  3. Partially compensated: pH abnormal, A+B abnormal
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21
Q

What is the most common cause of AKI?

A

Acute tubular necrosis (ATN)

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22
Q

What are the 2 most common causes of CKD?

A

Diabetes & hypertension

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23
Q

What are the 3 categories of etiologies for AKI?

A

Prerenal: impaired blood flow

Intrarenal: impaired filtration

Postrenal: impaired urine flow

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24
Q

What 2 values are used to classify AKI?

A

GFR & urine output

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25
What is the most common early symptom of renal cell carcinoma?
Asymptomatic
26
What are 4 examples of procedures for noninvasive bladder cancer?
1. Electrocautery (transurethral resection with fulguration) 2. Laser photocoagulation 3. Open loop resection of polyp 4. Segmental cystectomy
27
What is the indication for partial or radical cystectomy with urinary diversion formation?
Invasive bladder cancer or involving the trigone
28
What are 4 uses for central lines?
1. Frequent, long-term, or rapid administration of fluids/medications 2. Hemodynamic monitoring 3. Blood sampling 4. Dialysis
29
What information is essential to have before using a central line?
1. Placement verification (e.g. x-ray, telemetry) 2. "Ok to use" physician's order
30
What information about the indication for a central line is essential to know?
1. Where the tip is placed 2. Why it was and still is placed
31
What 4 features of a central line are essential to know?
1. Valved/non-valved 2. Power-injectable 3. How it is secured (e.g. sutured, implanted, securement device, dressing type) 4. How much of the line is exposed (measure to confirm)
32
What assessments need to be performed for a central line, usually q12h?
Flush the lumens and aspirate for blood
33
What equipment needs to be at the bedside at all times for a patient with a central line?
Kelly clamps
34
What does the presence of multiple lumens mean for the administration of incompatible medications?
They never touch and exit at different spots, so incompatible medications can be administered simultaneously
35
Why does a central line have a risk of arrhythmias?
Migration of the tip may irritate the heart
36
What is a potential cause of blockage of a central line?
Thrombus at catheter tip
37
How may an air embolism occur with a central line?
If line is snapped or pulled out inadvertently
38
How long is a CVC expected to stay in place for?
Short term use
39
What is another term for a tunneled CVC?
Hickman line
40
How is a tCVC placed?
Surgically or radiologically placed by tunnelling line through subcut tissue
41
How long is a tCVC expected to stay in place for?
Long term use (e.g. for dialysis)
42
What are 2 advantages to a PICC line?
1. Can be placed at the bedside 2. Less infection risk
43
How long is a PICC line expected to stay in place for?
1-6 months (e.g. longterm abx, TPN)
44
What is important to remember when caring for a patient with a PICC?
Do not use PICC arm for BP, bloodwork, or IV access
45
What is another name for an implanted venous access device (IVAD)?
Portacath
46
What are the unique features of an IVAD?
1. Port implanted in subcut tissue and attached to CVC 2. Silicone septum can be punctured by special needle for access
47
How long is an IVAD expected to stay in place for?
Years
48
What symptoms are suspicious of an air embolism associated with a central line?
Coughing Tachycardic New confusion Chest pain
49
What position is used when an air bubble is suspected due to a snapped/pulled out central line?
Left side lying tredelenberg
50
How may an air embolism be treated?
Percutaneous removal
51
What is important to remember about dialysis as a replacement for kidney function?
Can only filter wastes Cannot activate vitamin D, produce EPO or renin
52
What are 3 access devices used for hemodialysis?
1. CVC 2. Arteriovenous fistula (AVF) 3. Arteriovenous graft (AVG)
53
What are 5 things to do before sending a patient to dialysis?
1. Vitals 2. Weights 3. Labs: Lytes, bicarb 4. Hold medications that may be dialyzed out 5. Assess AVF/AVG for bruit/thrill
54
What assessment finding after dialysis may indicate a complication?
Muscle cramps may indicate too much or too rapid fluid removal May require fluid replacement
55
What is the term for hemodialysis performed on a continuous basis when the client is too hemodynamically unstable to manage intermittent dialysis runs?
Continuous renal replacement therapy (CRRT)
56
For clients using peritoneal dialysis, how often is the procedure done per day?
4 times
57
What 3 steps in the process of peritoneal dialysis?
1. Dialysate infused into peritoneum through catheter 2. Dialysate left to dwell so that filtration/diffusion can occur 3. Dialysate drained
58
What are 4 possible causes for pain associated with peritoneal dialysis?
1. Catheter touching an organ 2. pH of dialysate 3. Peritonitis 4. Air entry
59
What are 3 possible causes for reduced outflow associated with peritoneal dialysis?
1. Constipation 2. Kinked catheter 3. Catheter migration
60
What are 5 advantages to peritoneal dialysis?
1. Less diet restriction 2. Can be done at home 3. Less dependence of antihypertensives 4. Less problem with anemia 5. Greater hemodynamic stability
61
Other than pain and infection, what are 3 complications of ureteral stenting?
1. Encrustation 2. Causes obstruction 3. Stent fracture
62
What is the purpose of a nephrostomy?
Divert urine flow (e.g. around an obstruction)
63
How is a nephrostomy performed?
Tube inserted via flank under radiological guidance into renal pelvis
64
What is the term for an incontinent urinary diversion where the ureters are connected to the abdominal wall?
Cutaneous ureterostomy
65
What is the term for an incontinent urinary diversion where the ureters are attached to a segment of bowel that creates a stoma in the abdominal wall?
Ileal conduit (urostomy)
66
What is the term for a continent urinary diversion where urine is stored in reservoir created from bowel that is catheterizable or controlled by a sphincter?​
Kock or Indiana pouch
67
What is another name for a neobladder?
Orthotopic bladder substitution
68
When is monitoring bowel function especially important in clients who have a urinary diversion?
When portion of bowel was used to create the urinary diversion
69
Why is monitoring urinary catheter patency especially important for patients after renal transplant?
Normal to be passing clots in urine which may clog the tube
70
Why is a LOW creatinine in a hospitalized patient not a cause for concern?
If patient is not moving around very much they will not product much creatinine
71
What is the minimum urine output expected from patients?
0.5 ml/kg/hr

TERM 4 N2261 KNLG 3 (9 decks)

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