Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NURS 3512 acute & chronic > Week 10 elimination issues > Flashcards

Week 10 elimination issues Flashcards

1
Q

What are the 6 things nurses monitor for with someone with altered kidney function and why?

A
  1. Fluid balance - hemodynamic status influences kidney function & specific gravity/osmolality
  2. Serum BUN & creatinine - indicator of kidney function
  3. Serum K - kidneys process most K+ so too much = kidneys not doing well
  4. Acid base balance - increase in uric acid
  5. Pain - can lead to hypotension
  6. Signs of infection - kidney damage and possibly lead to sepsis / septic shock
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Why is K+ high in someone with kidney issues?

A

90% of K+ is secreted through the kidneys. If Kidneys can’t manage the K then serum increases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the diagnostic tests for UTI?

A
  1. Urine culture (C&S)
  2. Urine analysis (nitrates, leukocytes, blood)
  3. Blood work (urea, creatinine, WBC)
  4. Xray
  5. CT (if severe)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the symptoms of complicated Cystitis?

A
  1. Fever
  2. Chills and rigor
  3. N&V
  4. Malaise
  5. Flank pain
  6. Costovertbral angle tenderness (on the back)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the top 3 classic symptoms of uncomplicated UTI?

A
  1. Frequency
  2. Urgency
  3. Dysuria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are some common symptoms of UTI apart from frequency, urgency, Dysuria?

A
  1. Suprapubic pain/tenderness
  2. low back pain
  3. Nocturia
  4. Incontinence
  5. Hematuria
  6. Pyuria
  7. Bacteriuria
  8. Retention
  9. feel like can’t empty bladder
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What symptoms do acute pyelonephritis and complicated cystitis share?

A
  1. Fever
  2. chills
  3. flank pain
  4. N&V
  5. Malaise
  6. Tender at costovertebral angle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What symptoms are unique to acute pyelonephritis and not seen in complicated cystitis?

A
  1. Tachycardia
  2. Tachypnea
  3. abdominal discomfort
  4. recent cystitis or treatment for UTI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

In older adults, are changes in mental status and falls reliable predictors of UTI?

A

No - must fully assess with diagnostics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the thing that causes most UTIs in general?

A

E. Coli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the thing that causes most UTIs in geriatric care?

A

Foly catheters

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What organ is involved in uncomplicated cystitis?

A

bladder invovlement only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What organs are involved in complicated cystitis?

A

More than the bladder - has travelled up

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Who is classified as complicated cystitis automatically?

A

Pregnant
immunocompromised
people with a penis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Why do we encourage fluid intake with UTIs?

A

to maintain dilute urine unless UTI is in someone with fluid restriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How much urine do we want to see?

A

1.5 L/day
7-12 voids per day
30ml/hr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How much fluid do we encourage someone with a UTI to drink?

A

2-3L per day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What do we teach patients so that they can prevent UTIs?

A
  1. Drink 2-3L water/day
  2. Sleep, rest, nutrition (immune support)
  3. Don’t use spermacides
  4. females - clean front to back
  5. females- avoid scented products of all kinds down there
  6. females - pee before and after intercourse
  7. don’t hold in your pee - release helps get rid of bacteria
  8. notify doc of burning, retention, increased frequency right away
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

When is surgery indicated for UTI?

A
  • structural abnormality causing consistent UTI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the Drug therapy for uncomplicated UTI?

A

-Antipyretic (Acetaminophen)- fever
-Antispasmodic (Ditropan) – helps relax the bladder
-Antibiotics (Trimethoprim/sulfamethoxazole)- uncomplicated UTI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is different regarding route of Antibiotic administration between uncomplicated UTI and complicated UTI?

A

uncomplicated = PO
complicated = IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the drug therapy for complicated UTI?

A

Antipyretic (Acetaminophen)- fever
Antispasmodic (Ditropan) – helps relax the bladder
IV antibiotics/broadspectrum (complicated UTI)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How do we minimize hospital acquired infection through catheters?

A

1.Hand hygiene/aseptic technique
2.Assess need daily
3.Leave in place only as long as it is indicated
4.Maintain a closed system
5.Obtain urine samples aseptically

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the reasons a person might need a catheter?

A

-very close I&O incontinence accurate measurements
-ICU unstable patient
-hemodynamically unstable
-Unable to urinate
-Open wound no matter how much wound care we do that aren’t healing in that area
-some urologic procedures require it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What indicator helps us predict the likelihood of someone with an indwelling catheter getting a UTI in hospital?

A

amount of time it is in
- longer time = greater chance of UTI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

When someone has a catheter, their chance of infection increases each day. What is the % of increased chance of infection?

A

3-10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are 3 main reasons for Urinary obstruction?

A
  1. Urolithiasis
  2. BPH
  3. Hydronephrosis/hydroureter
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the most common cause of stone formation ?

A

dehydration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are the 3 nursing priorities for someone with urolithiasis and why?

A
  1. Pain management - severe pain can = cause hypotension
  2. Infection prevention- don’t make it worse
  3. Urinary obstruction- emergency- can lead to damaged kidney function
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What are the two most common symptoms of Urolithiasis?

A
  1. severe unbearable pain
  2. oliguria/anuria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What diagnostic tests are done for someone with Urolithiasis and why?

A
  1. urinalysis - 24 hr
    - Urine specific gravity and osmolality - high = dehydration. Low = too much fluid (diluted)
    - PH = type of stone
    - Hematuria = stones damaging tissues
    - WBC + bacteria = infection
    - Cloudiness & odor - infection
  2. Serum labs (blood work)
    - WBC
    - increased particles = contribute to stone formation ( calcium, phosphate, uric acid)
  3. CT of abdomen/pelvis
  4. Ultrasound
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What diagnostic test confirms stones?

A

CT scan of abdomen and pelvis
- if no CT- can do xray but not as good
- if preggers - can do ultrasound but not as good

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

do most stones pass with or without intervention?

A

Without

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What medications are given to manage urolithiasis and why?

A
  1. Pain - Opioids, NSAIDS (careful with kidney impairment & bleeding folks)
  2. Overactive bladder - Oxybutynin
  3. Infection - antibiotics
  4. increase urine volume - thiazide diuretic
  5. decrease urine PH - Allopurinol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What are 2 things a patient can do to help manage their urolithiasis?

A
  1. Hydration (balance - not over/under hydrating)
  2. Walking - helps pass stone naturally
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Why do we strain urine to catch stones?

A

because we want to obtain the stone to see what kind it is and then determine the cause of it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is ECSL?

A

Lithotripsy (shock waves break up stones)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

If a stent is placed in the ureter so that the fragments/stones can pass through without ruining the ureter, what 3 symptoms would we expect to occur ?

A
  1. some bruising
  2. some blood in urine after procedure
  3. some cramping
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What are the 3 surgical interventions for urolithiasis?

A
  1. Ureteroscopy (endoscopic procedure)
  2. Percutaneous ureterolithotomy & percutaneous nephrolitotomy
  3. Open surgical procedure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What 3 interventions can be done via ureteroscopy?

A
  1. remove stones
  2. stent ureters
  3. lithotripsy - break up stones
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What does a percutaneous ureterolithotomy & percutaneous nephrolithotomy do ?

A

removes stone in ureter or kidney
- go through the skin not through the urethra

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Which surgical intervention for urolithiasis is a nephrostomy tube left in place?

A

Percutaneous ureterolithotomy & percutaneous nephrolithotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What 4 complications do we watch for post Percutaneous ureterolithotomy & percutaneous nephrolithotomy?

A
  • bleeding
  • nephrostomy tube - pink 24-48 hrs, then urine colour
  • pneumothorax (lung collapse)
  • S&S of inffection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is open surgery for urolithiasis and when it is used?

A
  1. used when other methods have failed
  2. remove large, impacted stones
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

How often should a nephrostomy be flushed post-surgey?

A

possibly Q 8 hr
be careful and gentle - avoid infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

This intervention may require nephrostomy tube, ureteral stent, wound drain.

A

Open surgery for urolithiasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What are 2 risk factors for BPH?

A
  1. male
  2. age (increases with age)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What two components of assessment are vital to assessing BPH and why?

A
  1. History - urinary issues/symptoms
  2. Physical- LUTS symptoms (lower urinary tract symptoms) - retention, leaking, incontinence
49
Q

What 2 diagnostic methods are used to determine BPH?

A
  1. Digital rectal exam (DRE)
  2. Transrectal ultrasound (TRUS)
50
Q

If symptoms aren’t too bad with BPH what is the first recommended intervention?

A

behaviour modification
- don’t drink before bed
- don’t drink lots at once
- limit alcohol and caffeine

51
Q

Why should someone tell HCPs that they have BPH?

A

b/c some meds can cause worse urinary retention and increase symptoms

52
Q

If BPH symptoms become bothersome, what is the first line of action ?

A

Drug therapy
1. Tamsulosin - Alpha-adrenergic antagonist
2. Finasteride & Dutasteride) - 5 alpha-reductase inhibitors

53
Q

What is the FIRST intervention if BPH symptoms are bothersome and ACUTE?

A

Catheterization

54
Q

What are the 3 minimally invasive procedures for BPH?

A
  1. prostate artery embolization
  2. TUNA (transurethral needle ablation)
  3. TUMT (transurethral microwave therapy)
55
Q

What does Prostate artery embolization do?

A

-small catheter into groin
- reduces blood flow to prostrate
- shrinks prostrate

56
Q

What does TUNA (transurethral needle ablation) do?

A
  • low frequency energy
  • shrink prostrate
  • post temporary catheter to help drain urine
  • sometimes prophylactic antibiotics
57
Q

What does TUMT (transurethral microwave therapy) do?

A
  • microwave energy
  • destroys some of the prostrate
  • catheter
  • takes several months to see results
58
Q

What are the indications of surgery for BPH?

A

1.Acute urinary retention (AUR) d/t obstruction
2.Chronic urinary tract infections
3.Hematuria
4. Hydronephrosis (urine back up d/t outlet obstruction)
5. Persistent pain with decrease in urine flow

59
Q

What is TURP (Transuretheral resection of the prostate) ?

A
  • remove enlarge portion of prostrate through endoscope
  • removes transition zone area of prostrate
  • some damage to uretheral lining
60
Q

What is the post-op care for TURP?

A

1.Pain
2.Manage continuous bladder irrigation (CBI)
3. Clots/hematuria, output flow, bladder distention (CBI)
4. Ins & Outs
5.Bladder spasms
6.Risk for infection
7.Early ambulation

61
Q

What kind of syringe do we use to irrigate a catheter of a CBI if there is no output?

A

60 cc to resolve clot

62
Q

What do nurses do if the CBI isn’t flowing and irrigation doesn’t work right away or there is frank blood ?

A

Call the doc!

63
Q

What is the goal with Hydronephrosis/Hydroureter intervention?

A

treat the cause of obstruction

64
Q

What is nephrolithiasis?

A

stones in the kidney

65
Q

What is ureterolithiasis?

A

stones in the ureter (tube from kidney to bladder)

66
Q

What is BPH?

A

Enlarged prostate gland - can cause bladder outlet obstruction (BOO)

67
Q

What is Hydronephrosis/hydroureter?

A

-enlargement of kidney (d/t back up) or ureter (d/t back up)
-happens because of outflow obstruction
ie) kidney stones, tumors, trauma

68
Q

What 2 problems can Hydronephrosis/Hydroureter lead to if not treated in a timely manner?

A
  1. Kidney damage
  2. Necrosis
69
Q

What are the 2 physical symptoms of Hydronephrosis/Hydroureter ?

A
  1. flank pain
  2. abdominal pain
70
Q

What are the 3 imaging tests for Hydronephrosis/Hydroureter and why?

A
  1. PVR - bladder scan- how much urine is in there still
  2. CT - source of obstruction
  3. Ultrasound - source of obstruction
71
Q

What labs are taken for Hydronephrosis/Hydroureter and why?

A
  1. Urine analysis (what’s in the urine)- infection, blood, WBC, etc
  2. Chem & CBC - b/c kidneys aren’t working and blood flow
72
Q

What are the risk factors for bladder cancer?

A
  1. tobacco use
  2. exposure to gasoline and diesel fuels
  3. chemical exposure
73
Q

What are the symptoms of bladder cancer?

A
  1. painless blood in the urine
  2. dysuria
  3. frequency
  4. urgency
74
Q

What diagnostics are used for bladder cancer?

A

CT/MRI/US
cystoscopy (biopsy)

75
Q

What risk factors are unique to Renal cancer compared to bladder cancer?

A
  1. exposure to heavy metals
  2. asbestos
76
Q

What are the symptoms of renal cancer?

A
  1. flank pain - dull or aching
  2. blood in urine - LATE SIGN
77
Q

What diagnostics are used for renal cancer?

A

CR/MRI/US
Cystoscopy (biopsy)

78
Q

What is the risk factor for prostate cancer?

A

Advancing age

79
Q

What is one diagnostic test unique to prostate cancer that Bladder cancer and renal cancer don’t have?

A

DRE - digital rectal exam

79
Q

What are the early/late symptoms of Prostate cancer ?

A

early:
- bladder outlet obstruction
late:
- gross hematuria
- abdominal pain

80
Q

What type of non-surgical chemo intervention is done in someone with Urothelial (bladder ) cancer?

A

Intravesical chemo (in the bladder)
- usually for 6 weeks, once a week
- chemo is drained before they go home

81
Q

What do people who are undergoing intravesical chemo need to do at home?

A
  1. use separate toilet
  2. wash clothes in 10% bleach - ie undies to remove cytotoxic meds
82
Q

What is Transurethral resection of the bladder tumor (TURBT) ?

A

-surgery to remove tumour
- early stage cancer

83
Q

What is complete cystectomy/simple cystectomy/radical cystectomy ?

A
  • Full removal of the bladder
  • for more extensive cancers
84
Q

What do people struggle with after a cystectomy?

A

Anxiety
body image
sexuality
b/c they don’t have a bladder - they have a permanent appliance

85
Q

What is a Ureterostomy?

A

tube goes from kidney to uretostomy that sticks out of the skin
- need pouch for life

86
Q

What is a conduit post bladder surgery?

A
  1. Ileal (Bricker’s) conduit - urine collected in part of intestine then comes out as a stoma
  2. Colon conduit - same thing
    - needs pouch for life
87
Q

What is a sigmoidostomy?

A
  • urine is diverted to large intestine
  • no stoma
  • urine exits with feces
  • bowel incontinence may happen
88
Q

What is Ileal Reservoire (Kock’s pouch)?

A

-part of Intestine is made into a pouch that urine drains into
- person self- catheterizes through the stoma into the pouch
- bag not needed

89
Q

What therapy is sometimes effective for bladder cancer (non-surgical)

A

Microwave therapy

90
Q

What treatment that is typically used for cancer, is not as effective for renal cancer?

A

Chemo

91
Q

What surgical intervention is used for Renal cancer?

A

Nephrectomy (removal of part of the kidney)

92
Q

what 5 things must a nurse monitor post nephrectomy surgery in someone with renal cancer?

A
  1. Urine output - we want the remaining one still >30ml/hr
  2. Pain managment
  3. Hemorrhage - highly vascular area
  4. Adrenal gland insufficiency - b/c of proximity to kidney & surgery
  5. Infection
93
Q

Post nephrectomy, what is the first sign of adrenal gland insufficiency/damage?

A

hypotention

94
Q

What are the 4 interventions for Prostate cancer?

A
  1. Active surveillance - watch & wait
  2. Radiation therapy (external or internal)
  3. Drug therapy (chemo)
  4. surgery
95
Q

What is the most common curative intervention of prostrate cancer?

A

Surgery
- often laparoscopic for localized cancer
- sometimes open surgery

96
Q

Which type of cancer would we likely see PCA for pain post surgery?

A

Prostate cancer

97
Q

What are 3 ways to decrease DVTs post prostate cancer surgery?

A
  1. Early mobilization (get up day 1)
  2. SCDs (the leg compression thingies)
  3. DB & C
98
Q

What should someone avoid post prostate cancer surgery?

A

rectal procedures
- enemas
- prostate assessment

99
Q

What should patients do post prostate cancer surgery with urinary incontinence?

A

Kegal exercises

100
Q

what antibiotic is nephrotoxic?

A

Vancomycin

101
Q

What is the most important thing we watch for in people with Kidney trauma?

A

hypovolemic shock
- are they bleeding?
- I&O
- hematuria

102
Q

What do we watch for in the urine of people with kidney injury (trauma)?

A

Myoglobinuria
- Myoblobin d/t Rabdo

103
Q

What type of fluid do we give with AKI typically?

A

Isotonic solution
1-3L

104
Q

What are the next steps if there is no improvement in someone with AKI who has been given lasix?

A

Hemodialysis or ICU

105
Q

What is someone with CKD at high risk for and why?

A

Fractures
Too much phosphate - kidneys can’t secrete well

106
Q

What mineral should people with CKD avoid?

A

Magnesium

107
Q

What should someone’s diet restrict when they have CKD and why?

A
  1. Na+ b/c of RAAS (will hold in Na+)
  2. K+ b/c not enough being secreted
  3. Phosphate b/c not enough being secreted
108
Q

What are 2 psychosocial impacts of CKD on people?

A
  1. Fatigue
  2. Social impact - isolation, change, dialysis
109
Q

Why would someone get CRRT?

A

(continuous renal replacement therapy)
1. don’t respond to lasix & are hemodynamically unstable still
2. can’t handle the lytes changes that come with regular dialysis

110
Q

What are 2 main issues with Peritoneal Dialysis and why?

A
  1. Infection - b/c it goes right into the body
  2. Constipation - because it’s close to the colon
111
Q

What are some hemodialysis indications in CKD?

A
  1. pulmonary edema
  2. severe uncontrollable hypertension
  3. hyperkalemia with ECG changes & symptomatic
  4. severe electrolyte or acid/base problems
  5. some overdoses
  6. Pericarditis
112
Q

What are uremic symptoms?

A

N&V
Confusion
seizure
severe bleeding from platelet dysfunction

113
Q

What is a complication of renal disesase?

A

severe bleeding from platelet dysfunction

114
Q

When do we weigh a dialysis patient?

A

before and after hemodialysis

115
Q

Will we see decrease or increase in BP after dialysis?

A

Decrease BP

116
Q

Why do people on dialysis sometimes get muscle cramps?

A

extremem fluid shifts

117
Q

What is disequilibrium syndrome?

A
  • rapid removal of filtrates and fluids
  • confusion
  • N&V
  • headache
  • restlessness
118
Q

How do we lessen disequalibrian syndrome?

A

-slow the rate of dialysis
- give meds after the treatment

NURS 3512 acute & chronic (29 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions