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MS FINALS TOPICS > DIAGNOSTIC > Flashcards

DIAGNOSTIC Flashcards

1
Q

Provides important clinical information about kidney function and helps diagnose diseases

A

Urinalysis

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2
Q

Components of urinalysis

A

-Urine color
-Urine clarity and odor
- Urine pH and specific gravity
- Tests to detect protein, glucose, and ketone bodies in urine
-Microscopic examination of urine sediment after centrifugation to detect RBCs, WBCs, Casts, Crystals, and Bacteria
-Obtain via Mid-strem clean catch

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3
Q

Determines whether bacteria are present, as well as their stains and concentration

A

Urine culture

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4
Q

Includes the identification of the antimicrobial therapy that is best suited for a particular stain

A

Sensitivity

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5
Q

Assess the status of kidney function and Evaluate the severity of kidney disease

A

Renal function tests

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6
Q

What are the test for renal functions tests?

A

-Renal concentration tests
-Creatinine clearance
-Serum creatinine
-Blood urea nitrogen (BUN)

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7
Q

An expression of the degree of concentration of the urine that measures the density of a solution tot he density of water

A

Specific Gravity

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8
Q

Measures the number of solute particles in a kilogram of water

A

Urine osmolality

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9
Q

The end product of muscle energy metabolism

A

Creatinine

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10
Q

This test measures effectiveness of renal function

A

Creatinine

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11
Q

The nitrogenous end product of protein metabolism

A

Urea

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12
Q

Serves as an index of renal function

A

Blood Urea Nitrogen (BUN)

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13
Q

Normal creatinine level

A

0.6-1.2 mg/dl

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14
Q

Normal BUN Level

A

7-18 mg/dl

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15
Q

Detects and evaluates progression of kidney disease

A

Creatinine clearance

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16
Q

Creatinine clearance method of collection

A

24-hour urine specimen

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17
Q

The test measures volume of blood cleared of endogenous creatinine in 1 minute- approximate GFR

A

Creatinine clearance

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18
Q

X-ray visualization of KUB

A

Kidney, Ureter, Bladder (KUB) Studies

19
Q

Performed to delineate the size, shape, and position of kidneys and reveal urinary system abnormalities

A

KUB Studies

20
Q

Nursing responsibilities when patient is having KUB studies

A

-Assure the patient that procedure is painless
- Bowel preparation, as ordered- to prevent gas and fecal interference with visualization
(laxative in the evening)
(Enema in AM)

21
Q

Direct visualization of the urethra, bladder wall, trigone, urethral opening through a cystoscope

A

Cystoscopy

22
Q

Cystoscopy Nursing Responsibilities (Before)

A

-Secure written consent
- Reinforce teaching that procedure is done under local/general anesthesia
-Force fluid if local anesthesia- To prevent ascending UTI
-NPO if general anesthesia
-Inform that desire to void is felt as cystoscope is inserted
-Place patient in lithotomy during procedure

23
Q

Cystoscopy Nursing Responsibilities (After)

A

-Bed rest until VS are stable- to prevent orthostatic hypotension
-Pink-tinged urine is NORMAL 24-48 hours after procedure
- Dysuria, frequency and hematuria are common (due to tissue irritation)
- Observe for urinary retention, signs of infection and excessive hematuria. Notify physician
- Monitor VS and I&O
- Hot sitz bath to relieve pelvic discomfort, as ordered
-Force fluids to prevent ascending UTI

24
Q

An IVP shows the kidneys, ureter, and bladder via x-ray imaging as the dye moves through the upper and then the lower urinary system

A

Intravenous Pyelography

25
Q

Uses a radiopaque contrast agent given via IV

A

Intravenous Pyelography

26
Q

Intravenous Pyelography Nursing Responsibilities (Before)

A

-Secure written consent
-NPO 6 to 8 hours
-Bowel Preparation
-Assess allergy to seafoods and/or iodine
-Epinephrine at bedside (Anaphylactic shock is a potential complication)

27
Q

Intravenous Pyelography Nursing Responsibilities (After)

A

-Monitor VS
-Increased fluid intake- to help excrete dye
- Inform patient that a burning sensation on voiding may be experienced
- Monitor for signs of delayed allergic reaction

28
Q

A contrast agent is then injected via cystoscope

A

Retrogade Pyelography

29
Q

Indications for retrograde pyelography are:

A

-IVP does not provide adequate visualization of the collecting systems
- ESWL
-Allergy to IV constant agent

30
Q

Nursing responsibilities of retrograde pyelography (before)

A

-Secure written consent
- Assess for allergy to dye
- Inform patient that discomfort may be felt during procedure
- Prepare epinephrine at bedside

31
Q

Nursing responsibilities of retrograde pyelography (after)

A

-Monitor VS
-Monitor for urinary retention, infection, and prolonged hematuria. Notify physician
-Increase fluid intake to prevent UTI and to excrete dye

32
Q

Also known as Renal Arteriography

A

Renal Angiography

33
Q

It provides X-ray image of the renal arteries

A

Renal Angioraphy

34
Q

A contrast agent is injected to opacify renal arterial supply

A

Renal Angiography

35
Q

Indications for Renal Angiography

A

-Evaluate renal blood flow in suspected renal trauma
- Differentiate renal cysts from tumors
-Evaluate hypertension

36
Q

Renal Angiography Nursing Responsibilities (Before)

A
  • Bowel Preparation
  • Shave injection site (groin for femoral, axilla for axillary)
    -Mark peripheral pulse sites- for easy access during postprocedural assessment
37
Q

Renal Angiography Nursing Responsibilities (After)

A
  • Monitor VS until stable
    -If axillary approach was done, take BP on opposite arm
  • Assess injection site for swelling and hematoma
  • Assess neurovascular status of operative extremity and compare with uninvolved extremity
  • Cold compress to injection site to decrease edema and pain
  • Sandbag over catheter insertion site- to further prevent bleeding
    -Bed rest x 24 hours, no sitting
    -Monitor urine output- to assess renal function
38
Q

A small section of the renal cortex is obtained either percutaneously (needle biopsy) or by open biopsy through a small flank incision

A

Kidney Biopsy

39
Q

Kidney Biopsy Indications

A
  • Unexplained acute kidney injury
  • Persistent proteinuria or hematuria
  • Transplant rejection
  • Glomerulopathies
40
Q

Kidney Biopsy Contraindications

A
  • Bleeding tendencies
  • Uncontrolled HTN
  • Sepsis
  • Solitary kidney
  • Large polycystic kidney
  • Kidney neoplasm
  • UTI
  • Morbid obesity
41
Q

Kidney Biopsy Nursing Responsibilities (Before)

A
  • Check coagulation studies (to identify any risk of posy biopsy bleeding)
  • Secure written consent
  • NPO for 6 to 8 hours
    -Obtain urine specimen for baseline
  • Establish an IV line
42
Q

Kidney Biopsy Nursing Responsibilities (Before) If needle biopsy:

A

-Position: Prone with sandbag under the abdomen
- Instruct patient to breathe in and hold that breath while needle is being inserted (to prevent kidney from moving)
- Sedation will be given and skin biopsy site will be infiltrated with local anesthetic

43
Q

Kidney Biopsy Nursing Responsibilities (Before) If open biopsy:

A
  • Position: Prone
  • Similar preparation with major abdominal surgeries
44
Q

Kidney Biopsy Nursing Responsibilities (After)

A

-Monitor VS and for signs and symptoms of internal bleeding
- IV fluids as prescribed (to help clear the kidneys and prevent clot formation)
- Bed rest and pressure dressings should be maintained for the prescribed period of time
-Urine may contain blood for the first 24 to 48 hours
-Analgesics, as prescribe

MS FINALS TOPICS (5 decks)

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