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Medsurg 2
Urinary
Question | Answer |
---|---|
upper and lower tract consists of? | upper - ureters * kidneys; lower - bladder & urethra |
acute glomerulonephritis causes (5) | poor appetite, blood in urine, low urine output, headache/fever/malaise, fluid overload - CHF/pulmonary edema |
acute glomerulonephritis Dx | urine appears dark/smoky w/ blood, elevation in BUN and creatinine levels, biopsy needs of kidneys, loss of RBC & protein in urine, periorbital edema; mostly occurs in children and young adults |
acute glomerulonephritis NI (4) | monitor bp, I&O, educate regarding bedrest, check labs |
chronic glomerulonephritis def | slowly progressive disease characterized by inflammation of the glomeruli that causes irreversible damage to the kidney nephrons; autoimmune; 40% of ppl on diaylsis have it; kidneys shrink; nephrons loose ability to filter waste; irreversible |
chronic glomerulonephritis s/sx (4) | facial and body edema d/t fluid retention; urine becomes pale and dilute; mental changes d/t waste in blood; anasarca (total body edema) |
obstructive disorders (3) | urolithiasis, kidney stones, ureter stones |
obstructive disorders s/sx (5) | N/V, flank pain, hematuria, dysuria, increase in frequency |
at what percentage does nephrons fail? | 90% |
CRF etiology | associated w/ intrarenal conditions or a complication of a systemic disease; kidneys are so damaged they dont remove protein by-products, electrolytes from blood and dont maintain acid-base balance |
Renal failure s/sx of both | increase in bp d/t fluid retention, weight gain, decreased urine output, facial edema, dry mouth, pruitis, breath/body smell like urine, seizures, muscle spasms, bleeding ulcers |
3 categories of renal failure | pre-renal, intrarenal, post-renal |
ARF cause | obstruction of BF to nephrons or intra-renal conditions that destroy nephrons |
4 phases in ARF | intiation: decrease BF; oliguric: excretion of >30cc/hr w/in 48 hrs of onset - can last 10-14 days; diuretic: if nephrons recover diuresis begins - h20 excretees but wastes & electrolytes excretion is still impaired; recovery: can take 1-2 yr if at all |
3 stages of CRF | reduced renal reserve: usually w/ sx * 40-75% loss; renal insuffiency: 75-90% loss; ESRD: <10% remaining fx |
ESRD | dialysis or kidney transplant can maintain life; skin becomes excretory organ for substances the kidney usually clears from the body; a precipitate (uremic frost) forms on the skin; electrolyte imbalance occurs; osteodystrophy |
enuresis def | involuntary voiding during sleep |
oliguria amt | less than 400 ml/day |
anuria amt | less than 50 ml/day |
cystogram evaluates | abnormalities in bladder structure & filling through the instillation of contrast dye and radiography |
uroflowmetry evaluates | bladder and sphincter function |
cystometrogram evaluates | bladder tone and capacity |
a patient with a neurogenic bladder may not feel the urgency to void until ____ml of urine are in the bladder. what is a neurogenic bladder? | 500ml; neurogenic is the sensation to void |
the specific gravity of urine should be: | 1.003-1.029 |
There should be no what in urine? (4) | ketones, protein, WBCs, glucose |
to prevent bacterial growth or decomposition the should do what? | refrigerate urine |
normal BUN | 7-18ml/dl |
normal creatintine in males/females | males - .7-1.3mg/dl; females - .6-1.1mg/dl |
pyelonephritis | bacterial infection of kidney; can be acute or chronic; if treatment is not successful, and the infection returns its classified as chronic d/t bacteria backing up in kidney |
what is the most common form of bacteria responsible for pyelonephritis | E.Coli |
Pyuria | combo of bacteria and leukocytes in urine |
polycystic kidney disease | error in fetal develpoment |
ureteral stricture | rare; caused by scar tissue to accumulate in the ureter. |
Tumors of the kidney are almost always _______ | cancerous |
cystostomy is also known as? | clean intermittent catherization (CIC) |
What are the crede's maneuver and Valsalva maneuvers? | manual voiding or abnormal strain |
Length of urthera in female and males | females - 4cm; males 8inches or 20cm |
interstitial cystitis def | chronic inflammation of bladder mucosa |