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espn ls 2 renal
ESPN LS2 RENALBB
| Question | Answer |
|---|---|
| The kidneys lie on either side of the vertabrae. This position is referred to as?? | costo vertebral |
| The inner layer of the kidney is the | Medulla |
| The outer layer of the kidney is the | Cortex |
| The tough connective tissue surrounding the kidney is the | Renal Capsule |
| What percent of the cardiac output goes directly to the kidneys | 25% |
| This is a hormone secreted by the kidneys to stimulate bone marrow to produce more RBC. It is secreted in response to what ??? | Erythropietin Hypoxia |
| The functional unit of the kidney is the | Nephron |
| The part of the nephron that filters out the fluid from the blood is called the ??. That fluid is called ??? | Glomerulus Glomerular Filtrate |
| There is a conscious desire to urinate at ?? ml. and we become somewhat uncomfortable at ?? | 250 450 |
| What kind of tissue is the bladder | Muscle |
| What is the primary nerve supply to the bladder | Parasympathetic |
| The prostate surrounds which structure in the urinary tract | male urethra |
| Antidiuretic hormone (ADH) increases or decreases water reabsorption | increases |
| The movement of water across a semi permeable membrane from an area of low concentration of solutes to an area of high concentration of solutes is called | osmosis |
| The movement of particles (solutes) across a semi permeable membrane from an area of high concentration is called | diffusion |
| Aldosterone causes increased re-absorption of ?? and increases secretion of ??? | Sodium Potassium |
| When the concentration of hydrogen ions increases, the PH ??/ | Decreases |
| Kidneys help maintain normal pH by secreting | Sodium bicarb |
| The normal amount of urine produced per day is | 1 - 2 Liters |
| Normal urine is ?%water | 95% |
| The normal range for urine pH is | 4.6 - 8 |
| Protein, glucose and ketones are normally present or absent from the urine | Absent |
| The more concentrated the urine, the higher or lower the specific gravity | Higher |
| The type of urine specimen that is best for a culture and sensitivity is a | Straight catheter |
| When sending a specimen for a C & S to the lab, it is important to notify them ??? & ??? | type of specimen & any antibotics |
| Why is it important to take urine specimens to the lab immediately after obtaining them | To prevent bacteria from multiplying |
| Confusion increases when which kidney function test increases | BUN |
| What are 2 things the patient shoue avoid prior to a creatinine test | Strenuous Exercise and high protein meal |
| What kind of urine specimen is necessary for a creatinine clearance | 24 hour |
| What 3 conditions can cause an elevated PSA? | Prostate Cancer, Prostatitis, BPH |
| What does a KUB stand for and what conditions do we commonly use it for | Kidney, Urine, Bladder Renal stones |
| Why do patients get a bowel prep prior to an IVP | Stool and gas interfere with a clear picture |
| What structures make up the upper urinary tract | Kidney & ureters |
| What structures make up the lower urinary tract | Bladder and urethra |
| A possible complication of a renal biopsy that can have serious consequencecs is | Hemorrhage |
| Why do hemorrages occur during a renal biopsy | Very vascular |
| To prevent hemorrage from a renal biopsy from occuring, pressure needs to be applief or how long and bed rest for how long | pressure for 30 minutes and 8- 24 hours of bed rest |
| List 4 things that need to be monitored closely after an angiography | Vital signs, peripheral pulse, neuro vascula extremities, urinary output |
| What artery is usually used for a renal angiography | femerol |
| Glomerulonephritis usually follows what kind of illness | acute streptococcal |
| What part of the kidney is affected whith glomerulonephritis | Glomeruli |
| What is the origin of pain | Swelling and stretching of renal capsule |
| Describe the characteristics of urine assoc. with glomerulonephritis | Hematuria with changes in urine, color from cola or changes in voiding, amount of urine output,, smokey and foamy |
| Why is the B.P. elevated with Glomerulonephritis | urinary retention, fluid retention increased renin secretion, glomeruli not working properly |
| Why doees CHF sometimes develop with Glomerulonephritis | Vascular fluid overload |
| What kind of diet is prescribed for Glomerulonephritis | high calorie, low protein, low sodium |
| How is Glomerulonephritis treated | antibiotics and diuretics to control fluid, anti hypertension |
| What happens to BUN and Creatinine levels | elevated |
| What teaching needs to be done prior to discharging the Glomerulonephritis patient | Meds take all of antibiotic, diet, report bloody urine, H/A and edema |
| A common clinical finding in a patient with Glomerulonephritis is swelling of the ?? especially around the >>> | Face, eye |
| Chronic Glomerulonephritis may progress to | Renal Failure |
| What part of kidney is affected with nephrotic syndrome | Glomerulus |
| What labs will be abnormal for nephrotic syndrome | Hypoalbuminia, hyperlipidemia, serum albumin, protein in urine |
| What kind of diet is prescribed for Nephrosis | Protein replacement and restriction of sodium, adequate carbs |
| Describe the characteristics of urine assoc. with nephrosis | foamy, from presence of protein, bloody |
| How is the condition treated | corticoseroids |
| Nephrosis is characterized by what symptoms | Marked protein uria edema hypoalbuminia |
| Create a flow chart that shows why patients experience anasarca | blood protein allows to pass into urine causing a loss of serum protein. This decreases serum osmotic pressure then allows flid to seep into interstitial tissue |
| What causes the damage to the nephrons with hyronephrosis | Obstruction of normal urine flow |
| What are the possible causes of hydronephrosis | Calculus, scar tissue, tumors kinks in the ureter |
| The aim of initial intervention for a client with a urinary obstruction is to | control pain and relieve obstruction |
| Prolonged pressure from accumulate urine proximal to an obstruction can cause _?__ & _?__ damage to kidney | Hydronephrosis Irreversible |
| What is the cause of polycystic | Genetics Chronic Kidney disease |
| What is the pathophysiology in polycystic kidney | Diabetes High BP |
| What are complications associated with polycystic kidneys? | Death in infants ESRF adults |
| Patients with polycystic disease lose.retain sodium | lose |
| Urinary stones are more likely to be passed if the patient ? & ? | |
| What part of the urinary tract is the most frequent site of stone formation | Urethers |
| How are urinary tract stones diagnosed | KUB, abdominal Ct. Scan, Kidney MRI, IVP, Ultrasound, Pyelogram |
| Where is pain felt with a kidney ston e in men | lower ab, testicles |
| Where is the pain felt with a kidney stone in woman | Pressure above pubic bone |
| What causes the pain with a kidney stone | Severe pain when they travel |
| How many ml. of fluid should a pt. with a kidney stone drink per day and why? | |
| Why are patients who take diuretics predisposed to renal calculi | It is a side effect of diuretics |
| What does "Supersaturation" of urine mean | High concentration of urine contributes to calcium oxylate |
| What are the methods of relieving pain for pts. who are trying to pass a stone | |
| What medications may be used to prevent re-occurrence of uric acid stones | |
| Why is it important to force fluids after a lithotripsy | to encourage the flushing of any remaining gravel |
| What are the important post - op priorities for a pt. who has undergone a nephrolithotomy | |
| What are the important post - op priorities for a pt. who has undergone a nephrolithotomy with a nephrostomy tube? | |
| After a nephrostomy, the patient is turned to the affected or unaffected side to facilitate drainage | |
| Why might fluids be restricted immediately following a nephrectomy | |
| Acquired urethral structures may be caused by | |
| The classic symptom of cancer in the urinary tract is | |
| The most common site in the urinary tract for cancer is the | |
| The ?? of the urinary bladder have the potential to become cancerous and are removed when detected | |
| The cause of BPH is unclear, but may be influenced by | sex and age Male over 50 |
| How is BPH initially diagnosed? | Enlarged Prostate Gland |
| TURP stands for | Trans Urethral Resection of the prostate |
| Why are stool softeners used in client with prostatitis | |
| Define hypertrophy | A nontumorous enlargement of an organ or a tissue as a result of an increase in the size rather than the number of constituent cells: muscle hypertrophy. |
| Define hyperplasia | An abnormal increase in the number of cells in an organ or a tissue with consequent enlargement |
| What determines how fast CBI fluid should run | |
| Initially the CBI drainage will be ?? to ??? in color. | |
| CBI catheter drainage tubes should be checked frequently for what | |
| Why is prolonged sitting avoided after a TURP | |
| The pt. needs to be informed that once the catheter comes out he may initially experience ?, ? & ? | |
| The 3 goals of a radical prostatectomy are ? | |
| Male ptients > age ? should have annual or biannual ?? ?? & a yearly ?? | |
| What size is the balloon on a foley used for TURPs | |
| Why does the physician exert traction on the CBI catheter before taping it into place? | |
| How soon does a transplanted kidney begin to work? | |
| What is the major post op complication in a transplant client | |
| What is the most common type of urinary diversion | |
| What is the priority nursing consideration in patients with urinary diversions | |
| What type of drugs (2) will pts. be put on for life following a kidney transplant | |
| Why is it necessary to drain a Kock pouch at regular intervals | |
| What are normal physiological mechanisms that help prevent cystitis | Adequate hydration & hygiene |
| Why is cystitis more common in women than men | Urethra is short and proximal to vagina & rectum |
| What is a hemorrhagic cystitis | Bleeding with cystitis |
| What is interstitial cystitis | Chronic pelvic pain disorder with recurring discomfort or pain in the urinary bladder inflammation not caused by bacteria of urine bladder |
| Why should people who are prone to cystitis avoid caffeine & alcohol | bladder irritant to bladder liner |
| How does frequent voiding help prevent cystits & uretthritis | Helps flush the system flushes out organisms & acteria |
| How does avoiding bubbles baths & wearing loose clothing/cotton underwear help prevent urethritis & cystitis | d/t not being able to breathe. bubble bath = perfume = irritant/loose clothing/cotton underwear allows moisture to evaporate = discourage bacteria |
| What micro organism is responsible for most UTI's | ECOLI gram neg microorganism |
| Urethritis is comonly associated with what kind of diseases | STD's sexual transmitted disease |
| Name 2 chronic health conditions that predispose s patients to a UTI | |
| Name the 3 most common symptoms associated with cystitits | |
| What part of the kidney does pyelonephritis effect | Renal pelvis, renal tubules 7 interstitial tissue and medullary tissue |
| What micro organism is the most common cause of pyelonephritis | |
| Describe the appearance of the kidney in pyelonephritis | |
| What serious complications from pyelonephritis may occur | diabetes mellitus, polycystic or hypertensive kidney diseasem scar tissue, & renal failure, bacteruremia septic shock d/t septicemia |
| What are 4 phases of acute renal failure ARF | hemmorhage trauma infection'decrease cardiac output |
| Why do hypotension and tachycardia occur during the diuretic phase | excessive urinary output diuresis decreases bp, fluid volume, blood volume, which makes heart beat more faster |
| When in renal failure why do patients become disoriented | azotemia, metabolic acidosis, potassium, BUN, Sodium |
| When in renal failure why do patients develop dsrhythmias | hyperkalemia |
| When in renal failure why do patients develop s/s of pericarditis | heart works harder |
| When in renal failure why do patients develop acidosis | toxin build up, too increase hydrogen ions, too much carbon acid |
| When in renal failure why do patients develop pruritis | concentrated urines build up of waste - on skin itching crystal |
| When in renal failure why do patients develop CHF & pulmonary edema | d/t oligeric |
| ESRD stands for ?? & is the same thing as CRF or | End Stage Renal Failure Chronic Renal Failure |
| how much of the kidney function is impaired before s/s develop | 75-80% |
| Why does specific gravity decrease in CRF | because kidneys tubule function decrease & failing to concentrate urine water goes out but not waste |
| Why do some patients with ESRD develop: Kussmaul respirations | lungs trying to blow off CO2 d/t metabolic acidosis |
| Why do some patients with ESRD develop: HTN | fluid retention - Increase production |
| Why do some patients with ESRD develop: Hypotension | anemia, dialysis process, decrease osmotic pressure loose sodium |
| Why do some patients with ESRD develop: Anemia | decreased production of erythropeoitein, ab draws, depletes folates - bruit decrease survival of RBC, only 60 days of ureic environment decreased blood gi system, loss during dialysis blood urine |
| Why do some patients with ESRD develop: Proteinurea | cannot metabolize protein properly as pre ESRD |
| Why do some patients with ESRD develop: Uremic Frost | urea crystals on skin, untreate renal failure increase urecic system |
| Name 6 foods or food supplements high in potassium | banana, prunes, chocolate, potates, tomato, high fiber cereal, greens, grapefruit |
| What stimulates erythropoitin production | hypoxia |
| A patient in renal failure is at risk for developing respiratory or metabolic acidosis or alkalosis | metabolic acidosis |
| The diet for renal failure patient is | low protein, high carb, low potassium and sodium |
| An elevated BUN can affect the patients | LOC |
| Hemodialysis works on principle | diffusion |
| peritoneal dialysis works on the principle of | osmosis and diffusion |
| the funtional unit of a hemodialysis machine is called a | dialyzer |
| The fluid in the machine is called ? and is composed of ? | dialysate fluid water and electrolyte |
| What medications are commonly held prior to hemodialysis and why | BP meds - filters back out, some narcotics d/t dialyzing out decreas bp, antibiotics d/t being dialyzed out |
| What precautions need to be taken in the extremity wuth a dialysis access device | Signs on bed, no bp taken on that arm, no venal puncture,no injection, no jewlry, no blood draws, no bp tight clothes, no heavy lifting, no sleepin on the access side protect from injury |
| What should you observe for in a patient with a fistrula or graft to make sure it hasn't cloted off | listen for bruit thrill feel |
| What is used as the semi permeable membrane with peritonela dialysis | peritoneum |
| What complication is of primary concern for the peritoneal dialysis client | peritonititis |
| What complication is of primary concern for the peritoneal dialysis client what are s/s | pain, fever, cloudy fluid, chills, hemorrhage, abdomen rigity, guarding abdominal tenderness |
| hypotension may occur after dialysis d/t | excessive sodium & fluid removal |
| Urinary stones are more likely to be passed if the patient | |
| How many ml. of fluid should a patient with kidney stone drin per day | 3000-4000 ml |
| Why should a person with stones drink so much water | Encourage flushing of the stones |
| What are the methods of relieving pain for patiens who are trying to pass a stone | |
| What medications may be used to prevent re-occurance of uric acid stones | |
| Why is it important to force fluids after a lithotripsy | to wash out stone fragments |
| What are important post op priorities for a patient who has undergone a nephrolithotomy | Monitor hourly I & O's |
| What are important post op priorities for a patient who has undergone a nephrostomy tube | empty every 4-6 hours 1/2 0 1/3 full |
| After a nephrostomy, the patient ususally is turned to the which side to facilitate draingage | the affected side |
| Why might fluids be restricted immediately following a nephrectomy | |
| Urinary stones are more likely to be passed if the patient | |
| How many ml. of fluid should a patient with kidney stone drin per day | 3000-4000 ml |
| Why should a person with stones drink so much water | Encourage flushing of the stones |
| What are the methods of relieving pain for patiens who are trying to pass a stone | |
| What medications may be used to prevent re-occurance of uric acid stones | |
| Why is it important to force fluids after a lithotripsy | to wash out stone fragments |
| What are important post op priorities for a patient who has undergone a nephrolithotomy | Monitor hourly I & O's |
| What are important post op priorities for a patient who has undergone a nephrostomy tube | empty every 4-6 hours 1/2 0 1/3 full |
| After a nephrostomy, the patient ususally is turned to the which side to facilitate draingage | the affected side |
| Why might fluids be restricted immediately following a nephrectomy | |
| Acquried urethral structures may be caused by | infection, tumor after radiation trauma |
| The classic symptom of cancer in the urinary tract is | painless hematuria |
| The most common site in the urinary tract for cancer is | bladder |
| What of the urinary bladder have the potential to become cancerous and are removed | papillomas |
| why are stool softeners used in clients with prostatitis | avoid bearign down putting pressure in prostate |
| What determines how fast the CBI fluid should run | the color of output |
| Initially the CBI drainage will be ?? & ?? in color | Pink to light red |
| CBI cathete drainage tubes should be checked frequently for what | KInks. |
| Why is prolonged sitting avooided in TURP | casue increaseee intra abdominal pressure that can cause the op site to bleed |
| The patient needs to be informed that once the catheter come out hemay experience | frequency voiding small amounts dribling |
| The 3 goals of a radical prostatectomy are | remove tumor pressure urine control preserve sex function |
| Male patients > age 40 should have annual or biannual ?? and a yearly ?? | Rectal exam PSA level |
| What size is the balloon on a foley used for TURP | 30-50 ml |
| ////////why does the physician exert traction on the CBI catheter before taping it into place | to put pressure on OP site and decrease bleeding |
| How soon does a transplanted kidney begin to work | Immediately |
| What is the major post op complication in a transplant client | graft rejection |
| What is the most common type of urinary diversion | ileal conduit |
| What is a priority nursing consideration in patients with urinary diversions | Skin problems |
| Why is it necessary to drain a KocK pouch at regular intervals | to prevent reabsorption of waste materials and reflux in ureters. Minimize reabsorption of waste |
| Name 2 chronic health conditionos that predispose patients to a UTI | DM, MS<, HTN, Spinal chord kidney disease |
| Name the 3 most common symptoms associated with cystitis | dysuria _ Painful urination pyuria _ pus in urin frequency in urination |
| What microorganism is most common cause of pyelonphritis | ecoli |
| describe the appearance of kidney in pyelonephritis | edamatous, inflamed bloody |
Created by:
gmabrender
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