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ABSN NUR 326 > Week 3: Urology > Flashcards

Week 3: Urology Flashcards

1
Q

What is Nephrolithiasis?

A

Kidney Stones

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2
Q

Cause of obstruction in renal pelvis?

A

renal calculi

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3
Q

Causes of obstruction in ureter?

A

renal calculi, pregnancy, tumors

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4
Q

Causes of obstruction in bladder and urethra?

A

bladder cancer, neurogenic bladder, prostatic hyperplasia (BPH), prostate cancer, urethral strictures (narrowing)

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5
Q

Complications with urological obstructions?

A

stasis of flow, increase chance of infection, back up pressure causing hydronephrosis and hydroureter, AKI

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6
Q

Who is at risk for kidney stones

A

men, white, age 20-30, family hx, renal defect, weather (increase temp=increase risk of dehydratio), obesity

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7
Q

What are kidney stones?

A

crystallized solutes in urine

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8
Q

What are the 3 types of kidney stones?

A

calcium oxalate, struvite (staghorn), uric acid

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9
Q

Risks for calcium oxalate related kidney stones

A

family hx, hypercalcemia, oxaluria

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10
Q

Risk for struvite related kidney stones

A

UTIs

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11
Q

Risk for uric acid related kidney stones

A

gout

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12
Q

S/S of kidney stones

A

renal colic (waves of pain when ureter moves urine), nausea, flank pain, diaphoresis, tachycardia, tachypnea, and s/s of UTI

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13
Q

Treatment for kidney stones

A

help with pain, hydration (IV or PO)

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14
Q

Preventative meds for kidney stones

A

calcium oxalate= thiazide dieuretics
struvite= antibiotics
urate (uric acid)= allpurinol (med for gout)

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15
Q

Protective factors in urine to prevent UTI

A

pH, uni-directional, urea, immune system, women=urethral gland secretions, men=prostatic secretions

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16
Q

UTI risk factors

A

women, CAUTI, age, pregnancy, sexual activity, urinary obstruction, immobility, incontinent

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17
Q

What is pyelonephritis?

A

inflammation of the kidneys

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18
Q

Etiology of pyelonephritis

A

an ascending infection from lower UTI or blood infection

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19
Q

S/S of pyelonephritis

A

fever, chills, CVA tenderness, UTI

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20
Q

Complication of pyelonephritis

A

urosepsis

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21
Q

Treatment of pyelonephritis

A

bactrim, cipro, and vanco

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22
Q

Most common kidney cancer

A

renal cell carcinoma (85%)

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23
Q

S/S of kidney cancer

A

early=NONE, late= CVA tenderness, hematuria, palpable mass, and possible metastasis symptoms (lung= resp distress, etc)

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24
Q

Treatment of kidney cancer

A

surgery and chemo

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25
Q

Risk factors for kidney cancer

A

SMOKING, obesity, age, male and genetics

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26
Q

Most common bladder cancer

A

urothelial carcinoma (>90%)

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27
Q

Risk factors for bladder cancer

A

SMOKING, male, exposure to toxins, and decreased fluid intake

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28
Q

S/S of bladder cancer

A

early=hematuria, late=urinary frequency, urgency, and dysuria

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29
Q

Treatment for bladder cancer

A

stage 1 (early)= intravesical chemo
late= systemic chemo

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30
Q

Define intravesical chemo

A

chemo that is administered locally to the effected area

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31
Q

BCG vaccine

A

intravesical treatment for bladder cancer

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32
Q

MOA for BCG vaccine

A

stimulates an inflammatory response where it is injected

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33
Q

S/E of BCG vaccine

A

bladder irritation and risk of infection

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34
Q

Instructions for administering BCG vaccine `

A

empty bladder before administration, wait 2 hours and change positions q15

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35
Q

Azotemia definition

A

the s/s due to decreased kidney filtration

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36
Q

Oliguria definition

A

decreased urine output (<400mL/day)

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37
Q

Glomerular Fraction Rate (GFR) lab

A

amount of blood that is being filtered through the kidneys (mL/min)

38
Q

Normal BUN value

A

10-20mg/dL

39
Q

Normal Cr value

A

0.5-1.2mg/dL

40
Q

Normal BUN/Cr ratio

A

10:1

41
Q

Normal GFR value

A

<90mL/min

42
Q

Chronic Kidney Disease (CKD) definition

A

kidney damage for more than 3 months with or without a GFR <60

43
Q

Risk factors for CKD

A

family hx, age >60, male, african american, HTN, DM, smoking, and obesity

44
Q

Someone with CKD cannot…

A

maintain acid-base balance, remove waste production from metabolism, or maintain F/E balance

45
Q

Three key characteristics of CKD

A

glomerulosclerosis, interstitial fibrosis, and interstitial inflammation

46
Q

GFR for Stage 1

A

> 90 (normal)

47
Q

GFR for Stage 2 CKD

A

60-89

48
Q

GFR for Stage 3 CKD

A

30-59

49
Q

GFR for Stage 4 CKD

A

15-29

50
Q

GFR for Stage 5 CKD (end-stage)

A

<15

51
Q

S/S for Stage 1 CKD

A

asymptomatic

52
Q

S/S for Stage 2 CKD

A

asymptomatic w/ possible HTN

53
Q

S/S for Stage 3 CKD

A

HTN

54
Q

S/S for Stage 4 CKD

A

Manifestations start showing, s/s of F/E imbalance, acid-base imbalance, and inability to rid of metabolic waster.
This is often when someone would get diagnosed

55
Q

S/S for Stage 5 CKD

A

s/s of all stages and uremia (retention of metabolic waste, shown in BUN)

56
Q

What s/s come from F/E imbalance in CKD?

A

edema, hyperkalemia, hyperphosphatemia, hypermagnesemia , acidosis

57
Q

What s/s come from not urinating in CKD?

A

anorexia, malnutrition, itching and CNS changes

58
Q

What s/s come from decreased erythropoietin in CKD?

A

anemia

59
Q

What s/s come from decreased vitamin D in CKD?

A

renal osteodystrophy

60
Q

Treatment for CKD

A

treat the HTN with an ACE or ARB, treat the HLD with a statin, and treat the symptoms/complications of CKD

61
Q

Pharmacotherapy for CKD

A

ACE or ARB, statin, loop diuretic, sodium bicarbonate, calcium carbonate, calcitriol, and erythropoietin

62
Q

Indication for Sodium Bicarbonate

A

metabolic acidosis

63
Q

Indication for Calcium Carbonate

A

hyperphosphatemia

64
Q

Indication for Calcitriol

A

renal osteodystrophy

65
Q

Indication for erythropoietin

A

anemia

66
Q

Calcium carbonate MOA

A

binds to phosphate, so you MUST take with meals bc majority of PO4 intake is through diet

67
Q

S/E of calcium carbonate

A

hypercalcemia

68
Q

MOA for calcitriol

A

activated form of Vitamin D which stimulate absorption of Ca and PO4

69
Q

S/E of calcitriol

A

hyperCa, HyperPO4, GI upset, bone pain, cardiac arrhythmias, neuro changes

70
Q

What medication are contraindicated with CKD?

A

Digoxin, DM meds= glyburide, metformin, antibiotics= vanco (must be renally dosed), opioids

71
Q

What is the functional unit of the kidney

A

nephrons

72
Q

Define glomerulonephritis

A

inflammation of glomeruli, can be local (1 kidney) or diffuse (both kidneys)

73
Q

What is glomerulus?

A

network of arterioles within the bowmans capsule in the kidneys

74
Q

What are the three layers of the glomerulus?

A
  1. endothelium
  2. basement membrane
  3. podocytes (special epithelial cells)
75
Q

Etiology of glomerulonephritis

A

2 types
1. Type II sensitivity where anti-GBM antibodies attack basement membrane (5% of accounts)
2. Type III sensitivity where antibodies deposit complexes in the basement membrane (90% of accounts)

76
Q

Triggers for glomerulonephritis

A

post infection, Berger (primary disease), systemic autoimmune (Lupus, Goodpasture)

77
Q

S/S of glomerulonephritis

A

H.A.R.P= hematuria, azotemia, retention, and proteinuria
HTN, increased BUN, increased Cr, fluid retention, and oliguria

78
Q

Pharmacotherapy for glomerulonephritis

A

steroids, diuretics, immunosuppressants, ACE and ARBS for HTN
possible dialysis if serious enough

79
Q

Causes of glomerulopathy

A

DM nephropathy, and hypertensive glomerular disease

80
Q

Pathology of glomerulopathy caused by DM nephropathy

A

thickening of basement membrane

81
Q

Pathology of glomerulopathy caused by HTN

A

decreased renal prefusion causes sclerotic glomerular changes

82
Q

What is nephrotic syndrome ?

A

the glomerulus is too permeable to plasma proteins (albumin) so there is an increase in urine (>3g/day)

83
Q

S/S of nephrotic syndrome

A

edema, HTN, HLD, hypercoagulation (due to loss of antithrombin II and plasminogen)

84
Q

What is an Acute Kidney Injury (AKI)

A

decreased volume and perfusion to the kidneys due to exposure to toxins or sepsis

85
Q

What are the three classes on AKI

A
  1. prerenal
  2. intrarenal
  3. postrenal (RARE)
86
Q

What is the prerenal class of AKI?

A

inadequate prefusion

87
Q

What is the s/s of prerenal AKI

A

decreased BP, hypovolemia, sepsis, vasoconstriction, and renal artery stenosis (narrowing)
decreased GFR

88
Q

What is intrarenal AKI?

A

acute tubular necrosis

89
Q

What are the s/s of intrarenal AKI?

A

hypotension and volemia inflammatory response

90
Q

What is postrenal AKI?

A

urinary tract obstructions, super rare

91
Q

Lab changes for AKI

A

decreased GFR, decreased UOP, increased BUN, increased Cr,

92
Q

Treatment for AKI

A

stabilize
the patient until kidney function returns and treat the cause

ABSN NUR 326 (10 decks)

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