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Med Surg I > Wk 5 Urinary Labs and Diagnostics > Flashcards

Wk 5 Urinary Labs and Diagnostics Flashcards

1
Q

What does turbid mean concerning urine?

A

Very cloudy urine

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2
Q

Who has cloudy urine?

A

Someone who has a UTI

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3
Q

What does amber or honey colored urine indicate?

A

Dehydration

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4
Q

What does syrup or a brown ale colored urine indicate?

A

Liver disease or severe dehydration

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5
Q

What does pink to reddish colored urine indicate?

A 
Hematuria
Kidney disease
Tumors
UTI
Prostate problems etc
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6
Q

What does urine that looks dark brown like Coca Cola indicate?

A

Obstructive jaundice

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7
Q

What causes the dark brown Coca Cola colored urine?

A

Water soluble bilirubin in the urine

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8
Q

What is the normal serum creatinine?

A

0.5-1.2 mg/dL

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9
Q

What is the most reliable indicator of renal function?

A

serum creatinine

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10
Q

The BUN is not specific to the __

A

kidneys

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11
Q

Creatinine is specific to the __

A

kidneys

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12
Q

What is creatinine?

A

Breakdown of muscle and protein metabolism

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13
Q

Creatinine is released at a __ rate

A

consistent

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14
Q

When would you see a creatinine level that was too low? (Below 0.5 mg/dL)

A

Muscle atrophy, malnourished

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15
Q

What is the normal range for blood urea nitrogen?

A

10-20 mg/dL

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16
Q

What are 3 things that can cause an elevated BUN?

A

High nitrogen/high protein tube feeds/diet
GI bleed
Hydration status

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17
Q

Why does a high nitrogen diet raise BUN?

A

Nitrogen is the end product of protein breakdown

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18
Q

Why would a GI bleed raise BUN levels?

A

Blood is protein rich, so you will digest the blood in the GI tract and it will drive up the BUN

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19
Q

If a patient has an elevated BUN and NOT an elevated creatinine, what could be the cause? (3)

A

High nitrogen/protein diet
GI bleed
Hydration status

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20
Q

How might the nurse determine if the patient is experiencing a GI bleed and that is the reason for the elevated BUN?

A

Look at their H&H and see if it is going down

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21
Q

If someone is very hydrated, what effect would this have on BUN?

A

It would decrease the BUN, the BUN would be diluted

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22
Q

If someone is very dehydrated, what effect would this have on BUN?

A

It would raise the BUN, the BUN would be concentrated

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23
Q

What is the normal potassium range?

A

3.5-5 mEq/L

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24
Q

The kidneys secrete the majority of what electrolyte?

A

Potassium

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25
Q

If a patient has kidney disease, they will have __-kalemia

A

hyper

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26
Q

Which electrolyte is one of the first to become abnormal with kidney disease?

A

potassium

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27
Q

What potassium level does a patient experience cardiac dysrhythmias and muscle weakness?

A

Greater than 6 mEq/L

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28
Q

If a patient’s potassium level is greater than 6 mEq/L, what symptoms might they have? (2)

A

dysrhythmias

muscle weakness

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29
Q

What is the normal range for calcium?

A

9-10.5 mEq/L

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30
Q

In chronic kidney disease, what do calcium levels look like?

A

They are decreased

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31
Q

Why are calcium levels decreased in chronic kidney disease?

A

There is decreased reabsorption

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32
Q

What does decreased reabsorption of calcium lead to in chronic kidney disease?

A

Renal osetodystrophy

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33
Q

What is renal osteodystrophy?

A

Weakening of the bones

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34
Q

A patient with chronic kidney disease is at risk for __ breaks

A

Bone

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35
Q

What is the normal range for phosphorous?

A

3.0-4.5 mEq/L

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36
Q

What is the chemical abbreviation for phosphorous?

A

PO4++

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37
Q

What is phosphorous inversely related to?

A

Calcium

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38
Q

What is calcium inversely related to?

A

Phosphorous

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39
Q

What two electrolytes are inversely related?

A

Calcium and phosphorous

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40
Q

What do phosphorous levels look like in a patient with chronic kidney disease?

A

They are high

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41
Q

Why are phosphorous levels high in a patient with chronic kidney disease?

A

Because the calcium levels are low due to decreased reabsorption

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42
Q

What is the normal range for serum magnesium?

A

1.3-2.1 mEq/L

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43
Q

What do magnesium levels look like in chronic kidney disease?

A

They are high

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44
Q

When is the best time to do a UA?

A

first in the morning

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45
Q

Why should you do a UA in the morning?

A

Because it is most concentrated at that time

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46
Q

How soon should a UA be given to the lab?

A

Within the hour

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47
Q

What should urine NOT have on a UA?

A 
Bilirubin
Glucose
Ketones
Protein
WBC
RBC
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48
Q

What is the normal pH of urine?

A

4.6-6.0

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49
Q

What is the normal range for urine specific gravity?

A

1.010-1.030

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50
Q

What is the normal odor for urine?

A

Aromatic

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51
Q

Is aromatic smelling urine expected or unexpected?

A

Expected

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52
Q

What does glucose in the urine indicated?

A

Possible diabetes

53
Q

What does a urine specific gravity measure?

A

Measures the concentration of solutes in the urine

54
Q

What does a low urine specific gravity mean?

A

Patient is very hydrated

55
Q

What does a high urine specific gravity mean?

A

Patient is dehydrated

56
Q

What would a urine specific gravity look like for a patient who is very hydrated?

A

Low, diluted

57
Q

What would a urine specific gravity look like for a patient who is very dehydrated?

A

High, concentrated

58
Q

Is an ammonia-like odor an expected or unexpected finding for urine?

A

Unexpected

59
Q

What is a creatinine clearance?

A

measures how well creatinine is removed from your blood by your kidneys

60
Q

The creatinine clearance test approximates __

61
Q

What is the definition of the GFR?

A

Amount of blood filtered per minute by the glomeruli

62
Q

The amount of blood filtered per minute by the glomeruli is the…

63
Q

How do we use to test for a creatinine clearance?

A

24 hour urine

64
Q

A 24 hour urine should be kept

65
Q

How do you start a 24 hour urine?

A

Have the patient void and discard first urine

66
Q

Which urine do you keep in a 24 hour urine, first or the last?

A

Keep the last

67
Q

What test should also be collected during a 24 hour urine?

A

Serum creatinine

68
Q

What test does the National Kidney Foundation recommend to use to assess GFR?

A

calculated eGFR from a prediction equation

69
Q

Why does the National Kidney Foundation not recommend 24 hour urine as a test for GFR?

A

Impractical and failure to collect entire specimen

70
Q

What 4 factors does an eGFR take into consideration?

A

Age
Gender
Weight
Ethnicity

71
Q

What can be used at the bedside to non invasively assess how much urine is in the bladder?

A

Bladder scan

72
Q

What does a bladder scanner do?

A

Calculated presence of residual urine

73
Q

What does a clean-catch urine do?

A

Confirms suspected UTI and identifies causative agents

74
Q

How should a patient do a clean catch?

A

Clean urethra, collect urine 1-2 seconds after voiding starts

75
Q

What is a cystoscopy?

A

When the provider takes a look at the inside of the bladder with a scope

76
Q

What is the main goal of a cystoscopy?

A

To inspect interior of bladder wall

77
Q

What is it called when a HCP uses a scope to look at the inside of the bladder?

A

Cystoscopy

78
Q

What position would a patient be in during a cystoscopy?

79
Q

What needs to be signed before a cystoscopy?

A

Consent form

80
Q

Is it normal to have burning after a cystoscopy?

81
Q

Is it expected to have pink-tinged urine after a cystoscopy?

82
Q

Is it expected to have polyuria after a cystoscopy?

83
Q

Is it expected to have bright red blood in the urine after a cystoscopy?

84
Q

What does KUB stand for?

A

Kidney, ureter, bladder

85
Q

What is a KUB procedure?

A

X-ray of the abdomen and pelvis

86
Q

What is an x-ray of the pelvis/abdomen typically called?

87
Q

What might be ordered for the patient before a KUB?

A

Bowel prep

88
Q

Why would a provider order bowel prep for a patient going to have a KUB done?

A

The stool may occlude the view

89
Q

What does a KUB do?

A

Delineates size, shape, and position of the kidneys

90
Q

What else does a KUB show?

A

Radiopaque stones

91
Q

What is an intravenous pyelogram abbreviated as?

92
Q

What does an IVP require?

A

Bowel prep

93
Q

What is the pyelogram referring to for an IVP?

A

The renal pelvis

94
Q

What sensitivity should you check for before an IVP?

A

Iodine sensitivity

95
Q

Why should you check for iodine sensitivity before an IVP?

A

Because it uses contrast to see the renal pelvis

96
Q

What is there a risk for when a patient has an IVP?

A

Anaphylaxis

97
Q

Why is a patient at risk for anaphylaxis during an IVP?

A

They could be allergic to the iodine in the contrast

98
Q

What is a nursing consideration for IVP?

A

Tell the patient to expect a flushed feeling when being injected with the IV contrast

99
Q

What should happen AFTER the IVP?

A

Force fluids

100
Q

Why are fluids forced after an IVP?

A

The contrast used can be nephrotoxic

101
Q

When should an IVP not be gone?

A

If the patient has an elevated creatinine

102
Q

What are 3 reasons a patient will have a retrograde pyelogram?

A

IVP doesn’t visualize adequately
Pt allergic to contrast
Pt has decreased renal function

103
Q

What is a retrograde pyelogram?

A

Take cystoscope, look up through ureteral catheters and look at the renal pelvis that way

104
Q

Is the prep different from retrograde versus intravenous pyelogram?

105
Q

What are the complications of a retrograde pyelogram?

A

Anaphylaxis

Nephrotoxicity

106
Q

Are the complications of a retrograde pyelogram the same as an intravenous pyelogram?

107
Q

If a patient has an anaphylactic allergy to the dye used, how are they able to have a retrograde pyelogram?

A

Because the dye doesn’t enter systemic circulation

108
Q

When would a renal biopsy be done?

A

Suspicions of cancer

109
Q

What is needed to be signed before a renal biopsy?

A

Consent form

110
Q

What should the nurse assess before a patient has a renal biopsy?

A

Coagulation history

111
Q

What labs would a nurse look at before a patient has a renal biopsy? (3)

A

PT/INR

Platelets

112
Q

What is the major risk to be concerned about for a patient having a renal biopsy?

A

Bleeding because the kidneys are very vascular

113
Q

What 2 drugs should a patient going for a renal biopsy not have?

A

Aspirin

Warfarin

114
Q

What position is a patient in during a renal biopsy?

A

They are on their side, hip is flexed toward the ceiling because it opens up the CV space for the provider to get close to the kidney

115
Q

After a patient had a renal biopsy, what type of dressing will they have?

A

Pressure dressing

116
Q

How long should a pressure dressing be on the patient after a renal biopsy?

A

30-60 minutes

117
Q

How long is a patient on bed rest after a renal biopsy?

118
Q

What should a nurse take with in the 1st hour after a renal biopsy?

A

Vital signs every 5-10 minutes

119
Q

Why are vital signs taken every 5-10 mins after a renal biopsy?

A

To assess for internal bleeding

120
Q

If a patient has internal bleeding, what will be one of the first vital signs to reflect that?

A

Tachycardia

121
Q

What will the blood pressure look like for a patient who has internal bleeding?

A

It will be normal until it can no longer compensate and then it will drop

122
Q

What will the nurse assess for on a patient who has just had a renal biopsy? (2)

A

Flank pain

Bleeding

123
Q

Where is your flank?

A

Soft part of your back just below the ribs (kidneys are here)

124
Q

A patient should avoid what for 7 days after a renal biopsy?

A

Heavy lifting

125
Q

What is a non-contrast spiral CT also called?

126
Q

What is a CT/KUB also called?

A

Non-contrast spiral CT

127
Q

What is the gold standard for diagnosing renal colic symptoms?

128
Q

What are 3 advantages of a CT/KUB?

A

Quick
Non-invasive
no IV contrast

Med Surg I (41 decks)

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