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NURS 366 > Adult Genitourinary > Flashcards

Adult Genitourinary Flashcards

1
Q

What can proteins and ketones mean if they are found in urine?

A

diabetic ketoacidosis

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2
Q

Normal hourly output of urine in an adult

A

60 mL/hr

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3
Q

When is action needed for urine output (what amount)?

A

Less than 30mL/hr

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4
Q

When does the urge to void normally happen?

A

at 150-300 mL full in the bladder

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5
Q

If there is a high WBC/RBC concentration in the urine, what may this be a sign of?

A

infection

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6
Q

Normal adult output of urine in 24 hours

A

1500-1600mL

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7
Q

What in the normal SPG for a urinalysis?

A

1.0020-1.0030

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8
Q

What is the normal pH of urine?

A

5-7

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9
Q

Which values should show up as negative on a urinalysis?

A

protein, glucose, ketones, bili, blood, nitrate

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10
Q

Normal WBC/RBC levels in a urinalysis

A

0-2

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11
Q

What are causes of pre-renal failure?

A

decreased perfusion
Caused by:
Altered peripheral resistance
Cardiac pump failure
Hypovolemia
Impaired renovascular blood flow

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12
Q

What are causes of altered peripheral vascular resistance that lead to pre-renal failure?

A

sepsis, anaphylactic rxn

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13
Q

What are causes of a cardiac pump failure that leads to pre-renal failure?

A

MI, HF, and/or cardiogenic shock

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14
Q

What are causes hypovolemia that lead to pre-renal failure?

A

dehydration, blood loss, burns

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15
Q

What happens during intra-renal failure?

A

direct kidney damage such as:
Nephrotoxic agents, transfusion reaction, glomerulonephritis and acute tubular necrosis, renal neoplasms, chronic disease, infection

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16
Q

What are nephrotoxic agents that can lead to intra-renal failure?

A

antibiotics, chemotherapies, and contrast media

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17
Q

What kind of transfusion reaction causes intra-renal failure?

A

hemolytic

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18
Q

Which chronic diseases can lead to intra-renal failure?

A

DM, HTN, SLE, Lupus

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19
Q

What is post-renal failure?

A

outflow obstruction

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20
Q

What causes post-renal failure?

A

outflow obstructions, such as:
obstructions within the urethra, bladder, or ureters
prostatic hypertrophy
neurogenic bladder
pelvic tumors

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21
Q

What are examples of obstructions in the urethra, bladder, or ureters that causes post-renal failure?

A

caliculi, clots, tumors, strictures

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22
Q

What can cause prostatic hypertrophy that leads to post-renal failure?

A

BPH

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23
Q

What should the normal adult GFR be?

A

above 60

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24
Q

What is normal BUN for urinary labs?

A

6-24 mg/dL

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25
Q

What are normal creatinine levels for urinary labs?

A

.7-1.3 mg/dL

26
Q

If a GFR is less than 15, what does this mean?

A

Kidney Failure

27
Q

What happens to the urinary system as we age?

A

decreased GFR, increased renal labs, decreased tissue and function of the urinary tract, decreased ability to concentrate

28
Q

Common urinary issues experienced by older adults

A

nocturia, urinary frequency, urinary retention

29
Q

Where do sensory impulses come from in regards to urination?

A

micturition center in sacral spinal cord

30
Q

What parasympathetic impulse happens with micturition?

A

stimulates detrusor muscle to contact rhythmically

31
Q

What are the steps that happen that lead to the conscious need to void?

A

bladder contracts –> impulses to spinal cord–> pons–> cortex–>conscious need to void

32
Q

What is micturition?

A

the action of urinating

33
Q

What element is not able to be filtered by the kidneys in chronic renal failure?

A

PO4 (soda and eggs)

34
Q

How long does the GFR have to be less than 60mL/hr to have chronic renal failure?

A

longer than 3 months

35
Q

What causes chronic renal failure?

A

recurrent infections, Urinary tract obstructions, diabetes (32%), Long-term HTN (28%), glomerulonephritis (1%)

36
Q

What are the stages of chronic renal failure?

A

renal impairment–> renal insufficiency–> renal failure

37
Q

How much nephron loss is there before renal failure is diagnosed?

A

> 85%

38
Q

What percentage of functional nephron loss is associated with renal insufficiency?

A

75-80%

39
Q

What is the functional nephron loss for renal impairment?

A

40-75% and there is a decreased renal reserve

40
Q

What kind of taste will patients report if they have chronic renal failure?

A

Metallic taste

41
Q

What happens to the CV system of a patient with CRF?

A

increased BP, pitting edema, periorbital edema, increased CVP, pericarditis

42
Q

If a patient is having CRF, how will they be presenting when you do their pulmonary assessment?

A

SOB, depressed cough, thick sputum

43
Q

What is an ammonia odor to the breath, mouth/gum ulcerations, and anorexia with n/v associated with?

A

CRF

44
Q

Which elemental serum level will rise in patients that are in end stage renal failure?

A

potassium

45
Q

What will be seen on an integumentary assessment of a patient with CRF?

A

dry, flaky, itchy skin that has ecchymosis and purpura and it has a yellow-gray tint

46
Q

Why do patients in CRF have leg cramps?

A

hypocalcemia

47
Q

What causes palpitations in patients with CRF?

A

hyperkalemia

48
Q

What causes SOB in patients with CRF?

A

fluid overload

49
Q

What are the dietary restrictions on a patient that has CRF?

A

protein restriction (~.5g/kg/day)
Na+ restriction (low sodium foods)
K+ restrictions (tomatoes, etc.)
PO4 restrictions (soda, eggs, etc.)

50
Q

What vitamin supplementation needs to be given to someone with CRF?

A

Iron, Folate, B12, Calcium

51
Q

What is the fluid restriction of someone that has CRF?

A

1000-1500 mL/day

52
Q

What are the electrolyte imbalances associated with CRF?

A

hyperkalemia
hypocalcemia
hyperphosphatemia
metabolic acidosis

53
Q

How is hyperkalemia treated for CRF?

A

kayexalate

54
Q

How is hypocalcemia treated for patients with CRF?

A

calcium supplements

55
Q

How is hyperphosphatemia treated for patients with CRF?

A

phosphate binding agents

56
Q

How is metabolic acidosis treated for patients with CRF?

A

bicarbonate solutions

57
Q

How is anemia treated for patients with CRF?

A

PO erythropoietin or transfusion PRN

58
Q

What happens with uremic syndrome?

A

increase in nitrogen, creatinine, potassium, phosphorus
decrease in calcium and albumin
and CNS changes as well as n/v

59
Q

What can emergent hemodialysis lines be used for?

A

only for dialysis

60
Q

When would an emergent hemodialysis line be placed?

A

for acute kidney injury

61
Q

What needs to be done as the nurse if someone has an emergent hemodialysis line put in?

A

Do weights with strict I&Os, hold medications, monitor vital signs Q15 minutes

62
Q

Is peritoneal dialysis a sterile or clean procedure?

A

sterile

NURS 366 (29 decks)

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