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TERM 4 N2261 KNLG 3 > UROLOGY > Flashcards

UROLOGY Flashcards

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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
Q

What is the most common early symptom of renal cell carcinoma?

A

Asymptomatic

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26
Q

What are 4 examples of procedures for noninvasive bladder cancer?

A
  1. Electrocautery (transurethral resection with fulguration)
  2. Laser photocoagulation
  3. Open loop resection of polyp
  4. Segmental cystectomy
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27
Q

What is the indication for partial or radical cystectomy with urinary diversion formation?

A

Invasive bladder cancer or involving the trigone

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28
Q

What are 4 uses for central lines?

A
  1. Frequent, long-term, or rapid administration of fluids/medications
  2. Hemodynamic monitoring
  3. Blood sampling
  4. Dialysis
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29
Q

What information is essential to have before using a central line?

A
  1. Placement verification (e.g. x-ray, telemetry)
  2. “Ok to use” physician’s order
30
Q

What information about the indication for a central line is essential to know?

A
  1. Where the tip is placed
  2. Why it was and still is placed
31
Q

What 4 features of a central line are essential to know?

A
  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
Q

What assessments need to be performed for a central line, usually q12h?

A

Flush the lumens and aspirate for blood

33
Q

What equipment needs to be at the bedside at all times for a patient with a central line?

A

Kelly clamps

34
Q

What does the presence of multiple lumens mean for the administration of incompatible medications?

A

They never touch and exit at different spots, so incompatible medications can be administered simultaneously

35
Q

Why does a central line have a risk of arrhythmias?

A

Migration of the tip may irritate the heart

36
Q

What is a potential cause of blockage of a central line?

A

Thrombus at catheter tip

37
Q

How may an air embolism occur with a central line?

A

If line is snapped or pulled out inadvertently

38
Q

How long is a CVC expected to stay in place for?

A

Short term use

39
Q

What is another term for a tunneled CVC?

A

Hickman line

40
Q

How is a tCVC placed?

A

Surgically or radiologically placed by tunnelling line through subcut tissue

41
Q

How long is a tCVC expected to stay in place for?

A

Long term use (e.g. for dialysis)

42
Q

What are 2 advantages to a PICC line?

A
  1. Can be placed at the bedside
  2. Less infection risk
43
Q

How long is a PICC line expected to stay in place for?

A

1-6 months (e.g. longterm abx, TPN)

44
Q

What is important to remember when caring for a patient with a PICC?

A

Do not use PICC arm for BP, bloodwork, or IV access

45
Q

What is another name for an implanted venous access device (IVAD)?

A

Portacath

46
Q

What are the unique features of an IVAD?

A
  1. Port implanted in subcut tissue and attached to CVC
  2. Silicone septum can be punctured by special needle for access
47
Q

How long is an IVAD expected to stay in place for?

A

Years

48
Q

What symptoms are suspicious of an air embolism associated with a central line?

A

Coughing
Tachycardic
New confusion
Chest pain

49
Q

What position is used when an air bubble is suspected due to a snapped/pulled out central line?

A

Left side lying tredelenberg

50
Q

How may an air embolism be treated?

A

Percutaneous removal

51
Q

What is important to remember about dialysis as a replacement for kidney function?

A

Can only filter wastes

Cannot activate vitamin D, produce EPO or renin

52
Q

What are 3 access devices used for hemodialysis?

A
  1. CVC
  2. Arteriovenous fistula (AVF)
  3. Arteriovenous graft (AVG)
53
Q

What are 5 things to do before sending a patient to dialysis?

A
  1. Vitals
  2. Weights
  3. Labs: Lytes, bicarb
  4. Hold medications that may be dialyzed out
  5. Assess AVF/AVG for bruit/thrill
54
Q

What assessment finding after dialysis may indicate a complication?

A

Muscle cramps may indicate too much or too rapid fluid removal

May require fluid replacement

55
Q

What is the term for hemodialysis performed on a continuous basis when the client is too hemodynamically unstable to manage intermittent dialysis runs?

A

Continuous renal replacement therapy (CRRT)

56
Q

For clients using peritoneal dialysis, how often is the procedure done per day?

A

4 times

57
Q

What 3 steps in the process of peritoneal dialysis?

A
  1. Dialysate infused into peritoneum through catheter
  2. Dialysate left to dwell so that filtration/diffusion can occur
  3. Dialysate drained
58
Q

What are 4 possible causes for pain associated with peritoneal dialysis?

A
  1. Catheter touching an organ
  2. pH of dialysate
  3. Peritonitis
  4. Air entry
59
Q

What are 3 possible causes for reduced outflow associated with peritoneal dialysis?

A
  1. Constipation
  2. Kinked catheter
  3. Catheter migration
60
Q

What are 5 advantages to peritoneal dialysis?

A
  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
Q

Other than pain and infection, what are 3 complications of ureteral stenting?

A
  1. Encrustation
  2. Causes obstruction
  3. Stent fracture
62
Q

What is the purpose of a nephrostomy?

A

Divert urine flow (e.g. around an obstruction)

63
Q

How is a nephrostomy performed?

A

Tube inserted via flank under radiological guidance into renal pelvis

64
Q

What is the term for an incontinent urinary diversion where the ureters are connected to the abdominal wall?

A

Cutaneous ureterostomy

65
Q

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?

A

Ileal conduit (urostomy)

66
Q

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?​

A

Kock or Indiana pouch

67
Q

What is another name for a neobladder?

A

Orthotopic bladder substitution

68
Q

When is monitoring bowel function especially important in clients who have a urinary diversion?

A

When portion of bowel was used to create the urinary diversion

69
Q

Why is monitoring urinary catheter patency especially important for patients after renal transplant?

A

Normal to be passing clots in urine which may clog the tube

70
Q

Why is a LOW creatinine in a hospitalized patient not a cause for concern?

A

If patient is not moving around very much they will not product much creatinine

71
Q

What is the minimum urine output expected from patients?

A

0.5 ml/kg/hr

TERM 4 N2261 KNLG 3 (9 decks)

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