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Renal PNP1
Renal Nursing Concepts
| Question | Answer |
|---|---|
| Oliguric Phase in AKI | < 400 ml/day uo, Signs: oliguria, edema, chf, pulmonary edema Cause: nephrotoxicity TX: Hemodialysis |
| Hemodialysis | Removes waste, fluid and regulates electrolytes, regulates blood pH and blood pressure |
| Lithotripsy | Breaks up stones; nurses strain all urine; Post procedure back pain and pink urine common; encourage hydration. Report fever, bloody urine, and retention |
| Arterial Venous Fistula | Surgically created connection between artery and vein for hemodialysis. Do not wear tight clothing, or carry heavy items or sleep on fistula. Check for site for bleeding, bruit and thrill. Monitor pulse distal to graft. |
| Clean catch urine method | Collect urine by urinating into toilet then midstream placing sterile cup under urine flow to collect sample. |
| Benign Prostatic Hyperplasia (BPH) | Enlarged prostate presents with frequency, urgency, dribbling, weak stream. Inability to urinate requires foley catheterization. |
| Acute renal failure recovery phase | Depends on treating cause such as infection, dehydration or medications. Staying hydrated and avoiding NSAIDS can improve alertness, output, less fatigue, less nausea, normalize bp, and stabilize BUN and creatinine |
| Hydronephrosis | Swelling of the kidney due to urine build up. Symptoms are pain radiating to back, dysuria and frequency. Surgical treatment nephrostomy, ureteral stent, pyeloplasty or lithotripsy. Nurses monitor u/o, electrolytes, BUN/creat levels and bp |
| Chronic Kidney Disease | Condition where kidneys lose their ability to filter waste and remove fluid. 5 stages. DM and HTN most common cause, as well as polycystic kidney disease and glomerular diseases. Symptoms include fatigue, foamy urine and decreased alertness. |
| Glomerular Filtration Rate | Blood test that measures how well kidneys are filtering waste and fluids . GFR >90 is normal. |
| Proteinuria | Foamy urine may indicate chronic kidney disease or diabetes related nephropathy |
| Renal calculi | Kidney stones that can affect any part of urinary tract. Cause diet high in purines, gout, dehydration. Signs flank pain and hematuria Fever if infection present. Pain management is a top priority for clients with renal stones. |
| 24 hour urine collection | Diagnostic test to evaluate kidney function. Avoid certain medications prior to collection. Collect all urine in special dark container, discard first void of 24 hour collection and collect all other voids. Keep container on ice or refrigerated. |
| Peritoneal dialysis | Dialysis treatment using lining of abdomen to filter waste and fluids from blood. Soft tube placed in abdomen, warm dialysate or cleansing fluid introduced to abdominal cavity, dwells for 4 hours then drained. Performed 3-5 times/day. Sterile technique. |
| Risk factors for peritoneal dialysis | Risk factors include: infection at the catheter site or peritonitis, hematuria, hernias, edema due to fluid retention, inadequate dialysis. |
| Transurethral Resection of the Prostate (TURP) | Surgical procedure used to treat male urinary enlarged prostate. Risk include urethral stricture, infections, bladder injury and bleeding. |
| Urolithiasis | Formation of stones in the urinary tract. Symptoms flank pain, hematuria, nausea and vomiting, fever and chills. Diagnostic test ultrasound or CT scan, ua, blood test. Treatment hydration, and pain management, lithotripsy. |
| Urinary tract infection | Urinary system infection caused by bacteria E. Coli most common. Other factors sexual activity. Symptoms: dysuria, cloudy dark urine, foul smelling, hematuria, fever, chills |
| Hemodialysis nurse documentation | Record vital signs, weight and AV fistula condition, medications given or held. |
| Kidney transplant | Surgical procedure to replace failing kidney using living donor or cadaver kidney. Signs of rejection include edema, anuria, htn, pain, fever and chills. |
| Electrolytes in CKD | Imbalances in K(hyperkalemia)>5.5, Na (hyponatremia), BUN>21, Creatinine>1.2, Ca (hypocalcemia) <8, P (hyperphosphatemia) >4.5 levels seen in CKD |
| Diuresis phase AKI | Phase of recovery. Kidney begins to excrete fluids, but urine not concentrated. Urine production increases >3 liter/day. Nurses must monitor for dehydration signs. |
| Bladder Cancer | Cells of bladder cancerous. Symptoms: hematuria, cola colored urine, dysuria, back pain, edema. Diagnostic: cystoscopy. Treatment: Cystectomy, chemo, radiation |
| Cystectomy | Removal of bladder. |
| Ileal conduit | Urinary diversion surgery performed when the bladder is removed to provide urine exit from the body using segment from ileum to create conduit for urine flow. Urine flows though stoma to urostomy bag. |
| Mucous threads | Mucous threads are common in ileal conduit because the ileum portion produces mucus. |
| Specific gravity | Urine specific gravity measures concentration of particles in urine. Normal 1.001-1.025 Low specific gravity = overhydration High specific gravity = dehydration |
| Acute Renal Failure Diet | Low Na, Low K, Low Phosphorus, High calcium, High carbohydrates and fats, Fluid restriction |
| Urinalysis Values | Spgr 1.005-1.030- pH 4.5-8 color-yellow and clear WBC 0-5 RBC 0-3 Ketones Neg Protein Neg-trace Glucose Neg Nitrites Neg-indicate bacterial activity Bilirubin Neg-indicates liver, hepatitis, or bile duct obst. Urobilinogen 0.1-1.0 |
| Post streptococcal glomerulonephritis | Rare inflammatory kidney disease caused by group A streptococcus bacteria such a strep throat. |
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