Ch. 25 & 27 Disorders of Renal Function

Question 1

What are the most common cause of obstruction which develop in the kidneys and are excreted un urine?

Answer 1

Urinary Calculi/urolithiasis (Renal Calculi)

Question 2

What are the manifestations of renal calculi?

Answer 2

• PAIN

- Hematuria

Question 3

What type of pain does renal calculi cause?

Answer 3

• Acute, intermitting, excruciating
• Flank, upper and outer abdominal quadrant
• Worsens with increase of fluid intake

Question 4

Which pain medication is a wonder drug for renal calculi?

Answer 4

Toradol

Question 5

Renal calculi can be passed in urine if it is what size?

Answer 5

<5mm

Question 6

To treat renal calculi what should be encouraged?

Answer 6

Fluid intake (or IV)

Question 7

What is one of the number one causes of UTI?

Answer 7

E.coli from vaginal or perianal areas

Question 8

What is a nosocomial infection?

Answer 8

An infection the people providing care caused.

Question 9

What is urethrovesical?

Answer 9

urine from urethra moves into bladder (UTI)

Question 10

What is vesicoureteral?

Answer 10

urine from bladder moves into ureters

Question 11

What is the problem with UTI obstruction?

Answer 11

Urine remains in urinary tract and acts as a medium for bacterial growth

Question 12

What are UTI manifestations?

Answer 12

• Frequency
• Urgency
• Dysuria
• Lower abdominal/back discomfort
• cloudy/foul smelling urine

Question 13

How can a UTI be diagnosed?

Answer 13

• U/A
• Culture and sensitivity
• leukocytes

Question 14

What is the treatment for a UTI?

Answer 14

• Antibiotics 3-7 days
• Cranberry juice
• Increase fluid intake

Question 15

What is the leading sign of a UTI in the elderly?

Answer 15

AMS

Question 16

Acute Pyelonephritis (kidney infection) is what type of disorder?

Answer 16

Tubulointerstitial

Question 17

Infection and inflammation of the tubules is what?

Answer 17

Acute Pyelonephritis

Question 18

Bacteria ascending from the lower urinary tract causes what?

Answer 18

Acute Pyelonephritis

Question 19

Does acute pyelonephritis cause fever and chills?

Answer 19

Yes

Question 20

Does acute pyelonephritis cause headache, flank pain, and CVA (costovertebral) tenderness?

Answer 20

Yes

Question 21

Similarly to a UTI does acute pyelonephritis also cause dysuria, frequency, and urgency?

Answer 21

Yes

Question 22

Does acute pyelonephritis cause malaise?

Answer 22

Yes

Question 23

What is the treatment for acute pyelonephritis?

Answer 23

• Antibiotics (typically IV)
• Fluids (oral or IV)
• Tylenol for fever

Question 24

Chronic Pyelonephritis (progressive) is what type of disorder?

Answer 24

Tubulointerstitial

Question 25

What is the most common cause of Chronic Pyelonephritis?

Answer 25

Reflux

Question 26

Inflammation, scarring, deformation of renal chalices and pelvis is caused by what tubulointerstitial disorder?

Answer 26

Chronic Pyelonephritis

Question 27

What is Chronic Pyelonephritis?

Answer 27

A bacterial infection with obstructive abnormality or reflux.

Question 28

Chronic pyelonephritis can have s/s of an acute infection or what else?

Answer 28

Can be insidious

Question 29

What are the manifestations of chronic pyelonephritis?

Answer 29

- Polyuria - Nocturia - Mild proteinuria

Question 30

Chronic Pyelonephritis is the cause of 10-20% of what?

Answer 30

Renal failure patients

Question 31

What is glomerulonephritis?

Answer 31

Inflammatory injury to the glomerulus.

Question 32

An acute glomerulonephritis infection occurs when?

Answer 32

2-3 weeks after streptococcal infection

Question 33

A chronic glomerulonephritis infection occurs when?

Answer 33

after acute phase or slowly over time

Question 34

Periorbital and facial edema is a manifestation of what type of infection?

Answer 34

Glomerulonephritis

Question 35

Anorexia, pallor, lethargy, and hypertension are manifestation of what type of infection?

Answer 35

Glomerulonephritis

Question 36

What type of urinary related manifestations are seen in glomerulonephritis?

Answer 36

- Decreased urinary output - Proteinuria - Cloudy, smoky, brown colored urine (hematuria)

Question 37

An increased BUN, increased creatinine and proteinuria are diagnostic test to determine what?

Answer 37

Glomerulonephritis

Question 38

What are complications of glomerulonephritis?

Answer 38

- Renal failure - Hypertensive encephalopathy - Pulmonary edema - heart failure

Question 39

What are interventions for glomerulonephritis?

Answer 39

- Daily weight - Sodium and water restriction - Administer diuretics

Question 40

A 10-year old with glomerulonephritis reports a headache and blurred vision. What should the nurse do immediately?

Answer 40

Obtain the child's BP

Question 41

What syndrome is caused by protein wasting caused from diffuse glomerular damage?

Answer 41

Nephrotic Syndrome (Fluid volume overload)

Question 42

What is the hallmark sign of nephrotic syndrome?

Answer 42

Generalized edema

Question 43

What is the most important intervention for a patient with nephrotic syndrome?

Answer 43

Daily Weights!

Question 44

The nurse determines that interventions for decreasing fluid retention have been effective when the child with nephrotic syndrome demonstrated evidence of what?

Answer 44

Decreased abdominal girth

Question 45

What is the most important thing to do if a Wilms Tumor is suspected?

Answer 45

Avoid palpating the abdomen.

Question 46

What is one of the most common childhood tumors of the abdomen and the most common type of kidney tumor?

Answer 46

Wilms Tumor

Question 47

What are the manifestations of a Wilms Tumor?

Answer 47

- *Swelling in abdomen - Abdominal pain - Blood in urine (not as common)

Question 48

A client seen in the Emergency Department reports dysuria, frequency, and urgency. What condition would the nurse suspect?

Answer 48

Cystitis (UTI/bladder infection)

Question 49

As compared to younger adults, older adults who experience UTIs tend to exhibit the following primary manifestations?

Answer 49

Cognitive impairment and anorexia