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MCAI-FINALS--1
Urinary System
| Question | Answer |
|---|---|
| what is the responsibility of the bladder | to collect, hold, secret urine. |
| how many mLs cause moderate bladder distention? | 200 to 250 ml |
| how many mLs cause uncomfortable sensation? | 400 to 600 |
| what is the capacity of the bladder | 1 liter |
| what is another term for urination? | micturition and voiding |
| what are the assessment data for urinary system? | pain, urinary pattern, urine output, urine characteristics, peripheral edima (w/ kidney problem) |
| what is passing urin many times a day and only small amounts refers to? | frequency |
| what is dribbling? | passing of urine stream (strong or not steady), common in men with prostate problem. They pee a little bit at a time, not too steady. |
| what is retention? | urine building up inside even after voiding |
| what do you call the pain when passing the urine? | dysuria. |
| what are the dx tool apply to urinary system. | labs ( electrolytes, BUN, Creatinine, UA, C/S, radiological procedures , cystoscopy |
| what scope use for urinary system? | cystoscopy |
| what type of x-ray specifically use for urinary system? | KUB xray. |
| why BUN not specific for kidney? | if there is a bleeding or nitrogen issue |
| what are the causes of UTI? | frequency, urgency, burning upon urination, foul-smelling urine |
| What are UTI prevention? | "Younger, sexually active females more predisposed as well as people who hold urine and don’t |
| pee, females wiping back to front exposing urethra to E.coli, recommend that women pee after sexual intercourse." | |
| what are s/s of UTI | fevers, pain (back region or higher), hematuria |
| what are the UTI tx? | antimicrobial therapy sensitive to organism, analgesic, completion of antibiotic rx, adequate fluid intake, nutrition, rest and comfort, ask how they got it, teach prevention, and recurrence counseling |
| what is urethritis? | inflammation of urethra, caused by viral/bacteria, Sexually xmitted (gonorrhea in men) |
| s/s urethritis? | dysuria and frequency. |
| what is interstitial cystitis? | painful inflammation of the bladder, onset 40yo, more for women |
| s/s insterstitial cystitis? | dysuria relieved by urination, frequency, urgency |
| how to tx for interstitial cystitis? | no treatment med, treat sympomptoms (palliative), pee more frequently, don't hold |
| what are the problems of bladder control? | bladder emptying and bladder storage (incontinence) |
| what are the causes of urinary retention? | muscle can't stretch overdistended (hypertrophy/enlargmnt),stones, trauma to muscle, neurological/sensory prob(dementia, stroke pts), tumor obstruc, scar tissue due to sx (cystoscopies),sctricture( narrowing or tumor obstruction ), meds , lack of privacy |
| complications of urinary retention: | getting a bacterial infx, overdistended bladder could cause perforation; elevate BP and HR due to distention of bladder causes sympathetic response |
| what to assess pt that had cystoscopy and their system works? | ask the pt to urinate, take note of the urine color, consistency, stream(if unstable , scan bladder to check urine retention, if retention, call the doctor), ease, discomfort, burning? (1st few pees/days), |
| what are the s/s of blockage | pelvic region pain or discomfort and dribbling of urine but not enough to relieve pressure. |
| what is male retention problem? | large prostate (hugging the ureter). |
| what are the tx of urinary retention? | h/o of s/s , if problem persist, install urinary catheter even when they go home. This will prevents the urine go back to the ureter and cause UTI., Teach pt how to discontinue at home. |
| How sx and dx procedure (cystoscope) affect urine elimination and the properties of urine? | dysuria, hematuria (irritation, pink , cherry red, salmon color), |
| what are the s/s of enlarge protstate gland? | dysuria from enlargement and obstruction |
| What are the tx of enlarge prostate? | Digipan, Flomax(conservative meds for BPH), TURP (surgery to remove section of the prostate, TURBT (bladder tumor removal) |
| what is creatinine clearance normal values? | 70 to 135 |
| Nursing care for BPH | if bleeding or clot suspicion in the ureter, the bladder needs to be irrigated continously with N. Saline and not sterile water (too many electrolytes shift), I/O, Pain control, Nutrition, rest, comfort, observe s/s UTI. |
| what is urinary incontinence disease | uncontrolled / involuntary leakage of urine from the bladder. |
| what are the s/s of incontinence | frequency, urgency, urge incontinence |
| what are the types of incontinence? | stress(sneez, cough), urge(spasms in bladder), overflow(bladder fill up and overcome sphincter control), reflex(d/t spinal cord inj), trauma to spincter, functional(older can't go bathroom because they hold full bladder too long, or bathroom too far) |
| what are the dx test for urinary incontinence? | h&p, PE, labs, bladder scan |
| How to measure residual urine? | bladder scanner |
| What are altered urine production? | polyuria, oliguria, anuria , need to monitor for 24 hours |
| what is polyuria? | lots of urine, abnormal if other disease process , diabetes, neurological condition, ) |
| what is oliguria? | (too little urine) 100 to 400 ml per day (less than normal range) normal range is about 1500 ml per day |
| what is anuria? | (almost no urine) < 100 ml per day (very dehydrated) r/t renal failure or kidney disease. |
| what is the normal urine output | 60 ml/hour or 1500 ml/day, below 30ml (give 2 hours of information) per hour is acceptable |
| what is the most important nursing assessment for client with indwelling urinary cateter and why? | check if the catheter is patent, palpate bladder, flush bladder if needed, check cat. Bag |
| what is ileal conduit? | ileal loop /urinary diversion: cut a small piece of ileum (ex. 2 inches), take out bladder, connect ureter to small piece of ileum, connect small piece of ileum to abd wall. (suture the remaining ileum back GI tract) |
| what is ureterostomy? | connect ureter directly to abd wall. Not used anymore due to more complications. |
| what is ureteroileosigmoidostomy? | ureter connected to small piece of ileum, small piece of iluim connected to sigmoid colon. |
| what is nephrostomy | surgically insert catheter through the back of the pelvis, and connect the catheter right after the kidney. |
| what is neobladder | create bladder, no nerve, no sensation, scheduled pee use abd muscle to void. |
| what is acute pyelonephritis? | inflammation of renal parenchyma, lower UTI, urosepsis, septic shock |
| s/s pyelonephritis? | fatigue, chills, fever, vomiting , flank pain, dysuria, urgency, frquency, CVA pain. |
| what organism caused by pyelonephritis? | gram negative bacteria |
| what is glomerulonephritis? | inflammation of glomeruli., GFR < 125 per hour, autoimmune, streptococcus, acute vs chronic, 3rd leading cause of acute renal failure. |
| s/s glumerulonephritis? | hematuria, WBC, proteinuria, inc. BUN/creatine. |
| what is goodpasture syndrome? | cytotoxic autoimmune disease, affect kidney and lungs, yung male smoker. |
| what is nephrotic syndrome | loss of plasma protein, fluid shift and fluid retention, |
| causes of nephrotic syndrome | glomerular disease SLE, DM, Bcterial, viral, protozoal , leukemia, tumors, hodgkins, allergen, Drugs (NSAID, Captopril, heroin) |
| s/s nephrotic syndrome | labs and pt s/s |
| what is nephrolithiasis | kidney stones (renal calculi) |
| cause of nephrolithiasis | metabolic, dietary, genetic, lifestyle, and occupational. |
| what are the calculi? | ca phospate, ca oxalate, uric acid, cystine, struvite (mg ammonium phospate) |
| what is polycistic kidney disease | genetic, cysts that damage (need transplant) |
| alport sysndrome | gene mutation, altered synthesis of glomerular |
| foods to avoid with oxalate renal problem | spinach rhubarb, asparagus, tomatoes, chocolate, nuts, celery, and parsley |
| kidney pain of infection | flank pain |
| kidney pain of hydronephrosis | acute colicky pain. |
| bladder & pelvis obstruction | distentionn and pressure. |
| priority RN dx for pt with renal failure | fluid excess management |
| when should RN infuse 1 pack of blood xfusion | between 1 to 3 hours |
| sign of lower UTI | burning sensation while voiding |
| sing of pyeloneprhonitis | flank pain, costovertebral angle tenderness, chills |
| what tx for renal calculi pt | Opiods (NSAID and salicylates are anti-inflammatory) |
| tx specific to bladder | tylenol and pyridium (turn urine orange) |
| how much amount of water should pt with renal calculi drink per day | 3 liters (12 cups ) per day |
| Why pt with renal disease's skin feels itchy? | because of Calcium-phosphat deposits. |
| what to do if patient have muscle cramps after hemodialysis? | infuse N. Saline. Muscle cramp occurs when Na and Water are removed too quickly. |
| organisam in glomurelonephrotitis what could be the symptoms | streptococcus infection / sore throat problem. |
| what pt could be done to prevent recurrence of UTI? | Urinate every 2 to 3 hours |
| after TURP, notify provider any signs of: | infection such as fever, urinary frequency, or painful urination. |
| what nutrition diet of pt with renal problem? | fluid intake. Eat food low in K, Phos, and protein 'coz kidney can't excrete them and will retain inside the body. Eat food high in Calcium |
| signs of hyperkalemia | RR 28/min, nausea, dull headache, palpitation, general malaise. |
Created by:
rt-study
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