Flashcards in Chapter 53 Renal Assessment Deck (23):
What is part of the assessment for chief complaint?
• urinary frequency and urgency
• difficulty urinating
• pain on urination
• flank pain
What questions are asked about health history?
• Major illnesses
• Recurrent minor illnesses
•Accidents or injuries
• Surgical procedures, and
• Related disorders such as
• Have you ever had a urinary infection?
• Are you taking herbal medications or prescription, over-the-counter, or recreational drugs?
• Do you have pain or burning on urination?
• Is initiating urination difficult?
• What color is your urine?
• Are you allergic to drugs, foods, or other products? If yes, describe the reaction you experienced.
• Have you ever had a sexually transmitted disease (STD)?
What questions should be asked regarding family history?
Ask if blood relatives have ever been
treated for renal or cardiovascular disorders, diabetes, cancer, or
other chronic illness.
What are the components of urinalysis and urine culture?
• Urine color
• Urine clarity and odor
• Urine pH and specific gravity
• Tests to detect protein, glucose, and ketone bodies in the urine (proteinuria, renal glycosuria, and ketonuria, respectively)
• Microscopic examination of the urine sediment after centrifugation to detect RBCs (hematuria), white blood cells (pyuria), casts (cylindruria), crystals (crystalluria), and bacteria (bacteriuria)
What is specific gravity?
An expression of the degree of concentration of the urine that measures the density of a solution compared to the density of water (1.000)
What does osmolality measure?
Urine osmolality evaluates the diluting and concentrating ability
of the kidneys. It may aid in the differential diagnosis of polyuria,
oliguria, or syndrome of inappropriate antidiuretic hormone secre-
What are renal function tests and what do they measure?
Renal concentration tests, creatinine clearance and serum creatinine and blood urea nitrogen. Renal function tests are used to evaluate the severity of kidney disease and to assess the status of the patient’s kidney function.
What are renal radiological imaging tests?
Radiologic and imaging studies help screen for renal and urologic
abnormalities. These studies include computed tomography (CT)
scan, excretory urography, kidney-ureter-bladder (KUB) radiogra-
phy, magnetic resonance imaging (MRI), radionuclide renal scans,
renal angiography, ultrasonography, and voiding cystourethrography.
What are renal CT scans used for?
In a renal CT scan, the image’s density reflects the amount of radiation absorbed by renal tissue, thus permitting identification of masses and other lesions.
What is excretory urography?
After I.V. administration of a contrast medium, this common pro-
cedure (also known as I.V. pyelography) allows visualization of
the renal parenchyma, calyces, pelvises, ureters, bladder and, in
some cases, the urethra.
What is KUB radiography?
The KUB study, consisting of plain, contrast-free X-rays,
shows kidney size, position, and structure as well as calculi and
What is renal MRI used for?
MRI can provide precise images of anatomic detail and important biochemical information about the tissue examined and can efficiently visualize and stage kidney, bladder,
and prostate tumors.
What is a radionuclide renal scan?
I.V. injection of a radionuclide, followed by scintiphotography. Observation of the uptake concentration and radionuclide transit during the procedure allows assessment of renal blood flow, nephron and collecting system function, and renal structure.
What is renal ultrasonography used for?
The pulse-echo transmission technique of this test determines the kidney’s size, shape, and position. It also reveals internal structures and perirenal tissue and helps the practitioner
diagnose complications after kidney transplantation.
What are CT and MRI used for in the renal patient?
They provide excellent cross=sectional views of the anatomy of the kidney and urinary tract. They are used to evaluate genitourinary masses, nephrolithiasis, chronic renal infections, renal or urinary tract trauma, metastatic disease, and soft tissue abnormalities.
What is retrograde pyelography and why is it used?
Catheters are advanced through the ureters if IV urography provides inadequate visualization.
What is cystography used for?
Evaluating urine backflow into the ureters.
What is voiding cystourethrography?
In voiding cystourethrography, a urinary catheter inserted into the
bladder allows instillation of a contrast medium by gentle syringe pressure or gravity. Fluoroscopic films or overhead radiographs demonstrate bladder filling and then show excretion of the con-
trast medium as the patient voids.
What is renal angiography?
It provides an image of the renal arteries.
What is a MAG3 Renogram?
A relatively new scan to further evaluate renal function.
What is a urologic endoscopic procedure?
Endourology is used to directly visualize the urethra and bladder. The cystoscope is inserted through the urethra into the bladder, providing a magnified, illuminated view of the bladder.
What is a brush biopsy?
Using a cystoscope, a brush is passed over abnormal cells to obtain a very small sample for analysis.