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GRCC PN 132 test1
GRCC PN132 Urinary & Urinary calculi
| Question | Answer |
|---|---|
| Use sterile technique to obtain a specimen from the drainage tubing if an indwelling catheter is in place | Methods to collect for Urinalysis |
| Midstream clean catch technique to collect specimen in a sterile container | Methods to collect for Urinalysis |
| Steps in collecting urine specimen from an indwelling catheter. | Wash your hands - Clamp the proximal drainage tubing directly below the aspiration port with a rubberband or clamp to ensure a sufficient amount of pooled urine for a specimen. 15 min is generally sufficient time to wait to pull urine. |
| Supplies needed for collecting specimen from an indwelling catheter. | Rubber band or screw clamp - sterile syringe- Sterile 20-gauge needle - Alcohol sponge - Sterile specimen collection container - Identification labels and laboratory request slips |
| 24 hour urine collection | Methods to collect for Urinalysis |
| Culture sensitivity | Urine is placed on a growth medium to identify drugs that inhibit bacterial growth. |
| Mid-stream clean-catch technique, straight catheterization, or from indwelling catheter using sterile technique. | Methods in collecting specimen for culture and sensitivity test. |
| Intravenous pyleogram (dye) | Uses a contrast medium and x-rays to evaluate the urinary tract. |
| This test allows evaluation of renal function (by measuring the time required for filteration), and the position, size, shape, and structure of urinary tract organs | Intravenous pyleogram (dye test) |
| This test includes both chemical & microscopic analysis of urine. It is used to identify cells (blood cells or bacteria) casts, (protein structures that develop in the tubules of the kidneys), or crystals. | Purpose of urinalysis |
| KUB (kidney ureter bladder) | Abdominal x-ray to evaluate the size, shape, and position or organs in the urinary tract. The bladder should be either filled or emptied. |
| Cystoscopy | Endoscope is used and done with general anesthesia, versed, conscious sedation. NPO before given amnesia. |
| Assess for hematuria and voiding | Cystocopy |
| This test assess conditions such as urethral strictures, bladder stones, tumors, and congenital abnormalties. | Purpose of Cystoscopy |
| Normal urine | clear to pale yellow; aromatic;turbidity (sediment in urine, cloudy urine); |
| Turbidity urine | Sedimant in urine or cloudy urine may mean infection. |
| Specific gravity | measures concentration 1.0 to 1.03 |
| Normal PH | 4.5 - 8: no glucose in urine is normal, no ketones is normal |
| Not normal if bacteria, crystals, RBC's, protein if found in urine | If these are present in urine, then this could mean cervical cancer, kidney stones, infection, inflammation, and stress. |
| Inflammation of urinary bladder | Cystitis (AKA uti) |
| Common esp; in women. Urethras shorter & closer to the vagina & rectum | Cystitis (AKA uti) |
| Most are bacterial, others; virus, fungi, yeast | Cystitis (AKA uti) |
| Urea | Formed the metabolism of dietary and body proteins |
| Creatinine | Is produced in relatively constant quantities by muscle cell metabolism |
| Upper urinary tract infection - inflammation of the renal pelvis | Pyelonephritis |
| Sterility is maintained due to adequate urine volume, unimpeded urine flow, and complete bladder emptying | Urinary tract |
| How does bacteria from the intestines (most common is ecoli) infect the urinary tract? | Bacteria ascends from the perineal area inot the lower urinary tract. |
| Urgency, frequency, Dysuria, hematuria, | manifestations of UTI's (cystitis) |
| Increased temperature, incontinence, bladder spasms, changes color, clarity of urine | manifestations of UTI's (cystitis) |
| Sulfonamide/antibiotic used to treat UTI's | Bacterium DS (double strength) |
| Macrodantin | anti-infective used for uti |
| Cipro | anti-biotic - broad spectrum |
| Pyridium | analgesic, anesthetic action on urinary tract; used with antiinfective for UTI |
| preventing UTI's | Wipe front to back; adequate fluid intake; cotton underwear; sterile technique when catheterizing; avoid soap, bubble bath |
| Urinary calculi | stones |
| Urolithiasis | Development of stones within the urinary tract and is the most common cause of obstructed urine flow. |
| Calculi (stones) | most made from calcium and form when a poorly soluble salt crystallizes. |
| High concentration of salt in urine will trigger crystallization. | How calculi are formed |
| What can you do to avoid stone development? | Drink plenty of fluid. |
| Acute obstruction | Causes sever pain in the flank region and possibly radiating to the genitals. |
| lithiasis | stone formation |
| urolithiasis | bladder stone formation |
| Ureteralithiasis | ureter stone formation |
| Stone formation risk factors | Personal or family history of stones, dehydration;excess calcium, oxalate, or protein intake; gout;hyperparathyroidism; urinary stasis. |
| Calcium and uric acid | Predisposition who has excess in system are risk factors for stone formation. |
| Dehydration | Stones more prominent when person is dehydrated. |
| Increased concentration of urine | Stones are likely to form |
| Immobility | Causes calcium formulated renal stones |
| Excess calcium and protein | Calcium formulated renal stones. |
| Flank pain location - Clinical manifestations of stones | Lower back pain |
| Hematuria | Blood in the urine is a manifestation of stones. |
| Renal colic | Spasms and wave of pain like giving birth are manifestations of stones |
| Nausea and vomiting | R/T pain are a manifestation of stones |
| oliuria | Little urine - Clinical manifestations of stones |
| anuria | no urine - Clinical manifestations of stones |
| Smelly urine | Clinical manifestations of stones |
| Symptoms of stones depends on what? | size and location; stones of any size may cause manifestations of UTI, chills, fever, frequency, urgency and dysuria. |
| What happens if the obstruction (stone) is unrelieved? | Kidney may be damaged |
| What happens urine production continues, but the obstruction blocks the outflow? | This leads to increased pressure and distention of the urinary tract behind the obstruction and may result in hydronephrosis and hydroureter. |
| Hydroureter | Distention of the ureter. |
| Hydronephrosis | Abnormal dilation of the renal pelvis and calcyes a nd can result from urinary tract obstructions or from vesicouretal reflux. |
| Name a test to help detect whether or not pt has a kidney stone? | Urinalysis- is done to detect hematuria. |
| Any stones passed are analyzed to identify their composition. The nurse often is responsible for retrieving stones. All urine is strained and may be saved. | Any visible stones or sediment are collected and sent to lab for evaluation. |
| A KUB xray is done to ID the presence of calculi in the kidneys and ureters and bladder. | Diagnostic test to detect if there are kidney stones. |
| Why would IVP be used to diagnose whether or not there is (calculi) stones | This may be used to locate calculi and id hydroureter or heydonephrosis. |
| Why would doctors chose cystoscopy as a diagnostic test of calculi (stones) | This is used to visualize and possibly remove calculi from the urinary bladder and distal ureters. |
| What type of drug is administered to treat acute renal colic? | Narcotic analgesic are used to provide analgesia and relieve ureteral spasms. |
| Lithotripsy | Crushing of renal calculi (stones) using sound or shock waves and is the preferred treatment. |
| Post-op procedure following lithotripsy | Assess for hematuria or any sediment. |
| Nephrostomy | small incision is made in the flank area and a nephroscope is inserted to visualize the renal pelvis. Stones my then be removed of crushed. Stones in renal pelvis or calyces may require this type of surgery. |
| Percutaneous lithotripsy | Stones are fragmented using small ultrasonic transducer or a laser beam. Fragments are removed by irrigation and suction. |
| Cystoscopy | This can be used to crush and remove stones. Also may used to advance a catheter into a ureter to remove a stone. |
| Nephrolithotomy | This surgery removes a staghorn calculus, which invades the calcyes and renal parenchyma. |
| If kidney damage sever as a result of stones | Nephrectomy may be performed- (removal of the kidney) |
| Nutritional therapy that may reduce the risk of stone development | Fluid is increased to 2.5 to 3 liters/daily. Intake should be consumed spaced out throughout the day. |
| What foods are restricted for calcium stones? | Dietary calcium and Vit D enriched foods are restricted. |
| Why would pt be advised to modify their diet towards foods that would lower their PH (from alkaline to acidic? | Because Calcium stones form readily in alkaline urine |
| Cheese, cranberries, eggs, grapes, meat and poultry, plums and purnes, tomatoes and whole grains. | Foods that acidify urine |
| Green veggies, fruit (except grapes, cranberries, plums, prunes) legumes, milk and milk products and rhubarb. | Foods that alkalinize urine |
| Beans and lentils, chocolate and cocoa, dried fruits, canned or smoked fish except tuna, flour milk and milk products. | Foods that high in calcium |
| Asparagus, beer and colas, beets, cabbage, celery, chocolate and cocoa, fruits, green beans, nuts, tea, tomatoes | Food that are high in oxalate (chemical compound that forms needle-shaped crystals) |
| Goose, organ meats, sardines and herring, venison, moderate in beef, chicken, crab, pork, salmon and veal | Foods in high purines (purines form Uric Acid Stones) |
| What are risk factors for UTI? | Catheterization, structural abnormalities, obstructions or strictures, incomplete bladder emptying, chronic disease such as diabetes. |
| What risk factors do women have for getting a uti? | Short, straight uretha; proximity of urinary meatus to the vagina & anus; tissue trauma & possible contamination during sexual intercourse;Use of a diaphgagm for birth control; personal hygiene practices;voluntary urinary retention |
| What risk factors do men have for getting a UTI? | An enlarged prostate gland |
| What risk factors do elderly have for getting a UTI? | Increased bacteria pH, promoting bacterial growth; Higher incidene of diabetes leading to glucose in the urine; Incomplete bladder emptying and urinary retention; changes in vaginal pH; decreased prostatic secretions in men |
Created by:
Wends1984
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