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Med Surg Exam 6
| Question | Answer |
|---|---|
| What are the main organs of the urinary system? | Kidneys, ureters, bladder, urethra |
| What is the functional unit of the kidney? | Nephron |
| What are the main functions of the kidneys? | Urine formation, fluid balance, electrolyte balance, acid-base balance, vitamin D activation, erythropoietin and renin production |
| What is the normal GFR? | 100–125 mL/min |
| What does decreased GFR indicate? | Kidney damage or failure |
| What is normal urine output per day? | 1000–2000 mL |
| What is normal urine specific gravity? | 1.005–1.030 |
| What does low specific gravity indicate? | Dilute urine |
| What does high specific gravity indicate? | Concentrated urine |
| What is normal urine pH? | 4.5–8.0 |
| What is the best indicator of fluid balance? | Daily weight |
| What are signs of fluid overload? | Edema, crackles, weight gain |
| What is uremic frost? | Urea crystals on skin from severe kidney failure |
| When is the best time to collect a urine specimen? | First morning |
| When should urine be analyzed? | Within 1 hour |
| When should a urine culture be collected? | Before antibiotics |
| What happens if a 24-hour urine collection is incomplete? | Results are inaccurate |
| What labs assess kidney function? | BUN, creatinine, GFR |
| What is pre-care for renal biopsy? | NPO, sedative, check labs |
| What is post-care for renal biopsy? | Monitor VS, bleeding, site, urine |
| What is a KUB used for? | Detect stones, tumors, kidney size |
| What must be checked before contrast tests? | Allergies and creatinine |
| What is contrast-induced AKI? | Kidney injury from contrast dye |
| What are risk factors for contrast-induced AKI? | Low GFR, diabetes, nephrotoxic drugs |
| What is cystoscopy? | Scope into bladder |
| What is expected after cystoscopy? | Blood-tinged urine and dysuria |
| What is stress incontinence? | Leakage with coughing/laughing |
| What is urge incontinence? | Sudden strong urge to void |
| What is overflow incontinence? | Bladder overdistention causing leakage |
| What is total incontinence? | Continuous leakage |
| What is urinary retention? | Inability to empty bladder |
| What residual urine indicates retention? | 150–200 mL |
| What is the best catheter type to reduce infection? | Intermittent catheter |
| Is incontinence a reason for Foley catheter? | No |
| What are justifications for indwelling catheter? | Shock, obstruction, neurogenic bladder, burns |
| What is suprapubic catheter care? | Clean site, monitor output, secure catheter |
| What is the most common cause of UTI? | E. coli |
| What are UTI symptoms? | Urgency, frequency, dysuria, cloudy urine |
| What are UTI symptoms in older adults? | Confusion, delirium |
| What is pyelonephritis? | Kidney infection |
| What are signs of pyelonephritis? | Fever, flank pain, chills |
| What medication relieves UTI pain? | Phenazopyridine (Pyridium) |
| What teaching is important for UTIs? | Finish antibiotics, increase fluids |
| What is urosepsis? | Sepsis from UTI |
| What causes kidney stones? | Concentrated urine forming crystals |
| What are symptoms of kidney stones? | Severe flank pain, hematuria, nausea |
| What diagnostic test is best for kidney stones? | CT scan |
| What is treatment for small kidney stones? | Fluids, pain meds, tamsulosin |
| What is treatment for large kidney stones? | Lithotripsy or surgery |
| What nursing action is critical for kidney stones? | Strain all urine |
| What are complications of kidney stones? | Infection, hydronephrosis, sepsis |
| What is hydronephrosis? | Kidney swelling from urine backup |
| What causes hydronephrosis? | Obstruction |
| What is treatment for hydronephrosis? | Relieve obstruction |
| What is the most common urinary cancer? | Bladder cancer |
| What is the biggest risk factor for bladder cancer? | Smoking |
| What is the earliest sign of bladder cancer? | Painless hematuria |
| What are late symptoms of bladder cancer? | Pelvic pain, dysuria |
| What is an ileal conduit? | Urostomy draining urine into bag |
| What is a neobladder? | New bladder made from intestine |
| What are risk factors for kidney cancer? | Smoking, obesity, hypertension |
| What are symptoms of kidney cancer? | Hematuria, flank pain, mass |
| What is treatment for kidney cancer? | Nephrectomy |
| What is glomerulonephritis? | Inflammation of glomeruli |
| What causes glomerulonephritis? | Immune response (post-strep) |
| What are symptoms of glomerulonephritis? | Hematuria, edema, HTN |
| What is nephrotic syndrome? | Protein loss in urine |
| What are signs of nephrotic syndrome? | Edema, foamy urine |
| What is acute kidney injury (AKI)? | Sudden kidney failure |
| What are causes of AKI? | Prerenal, intrarenal, postrenal |
| What is the priority prevention for AKI? | Check GFR before contrast |
| What are signs of AKI? | Oliguria, increased creatinine |
| What is chronic kidney disease (CKD)? | Progressive kidney failure |
| What are common causes of CKD? | Diabetes and hypertension |
| What are symptoms of CKD? | Fluid overload, hyperkalemia, anemia |
| What diet is used in CKD? | Low protein, low sodium, low potassium |
| What is hyperkalemia? | High potassium (life-threatening) |
| What is hemodialysis? | Blood filtered through machine |
| What is the best vascular access? | AV fistula |
| What must be assessed in AV fistula? | Thrill and bruit |
| What should be avoided on dialysis arm? | BP, IV sticks |
| What is peritoneal dialysis? | Dialysis using peritoneal membrane |
| What are the steps of peritoneal dialysis? | Fill, dwell, drain |
| What is required after kidney transplant? | Anti-rejection medications |
| AKI Phases (4) | Initiating, Oliguric, Diuretic, Recovery. (pg 709) |
Created by:
yolandalemon719