Dx studies, Abnormalities, Renal Failure, Kidney Transplant

Question 0

How long are the female and male urethras?

Answer 0

1) Female - 2 inches

2) Male - 8 to 10 inches

Question 1

What is the normal output per day for the bladder?

Answer 1

1,500mL/day

Question 2

Define Anuria

Answer 2

24 Hr urine output < 100mL

Question 3

Define Dysuria

Answer 3

Painful or difficult urination

Question 4

Define Nocturia

Answer 4

Frequent urination at night

Question 5

Define Stress Incontinence

Answer 5

Urination with pressure

Question 6

Define Oliguria

Answer 6

Diminished urine output (100-400mL/24Hrs

Question 7

Define Polyuria

Answer 7

Large urine output ( > 3 L/day)

Question 8

What are the 4 characteristics of a Urinalysis?

Answer 8

1) First study done to obtain baseline information
2) Routine - collected anytime of day but best in AM
3) Examined within 1hr of collection or refrigerated
4) Wash perineal area if soiled

Question 9

What is the method used to collect a Urine Culture and Sensitivity specimen?

Answer 9

Clean catch midstream using a sterile container

Question 10

Which 7 things does a 24 Hr Composite urine collection test for?

Answer 10

1) Electrolytes
2) Glucose
3) Protein
4) 17-Ketosteroids
5) Creatinine
6) Catecholamines
7) Minerals

Question 11

What is Creatinine?

Answer 11

Creatinine is a waste product of protein from muscle breakdown

Question 12

What are the 6 characteristics of a 24 Hr Creatinine Clearance specimen collection?

Answer 12

1) Most accurate test of renal function
2) Resembles GFR
3) 24hr collection (discard 1st specimen, keep last void at 24 hr mark)
4) Blood serum level drawn at the same time
5) Creatinine clearance = Urine creatinine X Urine volume divided by Serum creatinine
6) Normal value = 85-135mL/min

Question 13

What are the 3 characteristics of a Urine Concentration Test?

Answer 13

1) Evaluates renal concentration ability
2) Patient NPO at midnight
3) Collect 3 urine specimens at hourly intervals in mornig

Question 14

What are the two ways to measure Residual Volume and what amount is a normal finding?

Answer 14

1) Residual volume can be monitored using a bladder scan or catheterize the patient immediately after voiding.
2) Normal Residual Volume = <50mL but increases with age.

Question 15

what is the normal range for Creatinine?

Answer 15

0.5 to 1.5 mg/dL (higher in men)

Question 16

what is the normal range of Uric Acid in men and women?

Answer 16

1) Women - 2.5 to 5.5 mg/dL

2) Men - 4.5 to 6.5 mg/dL

Question 17

What is the normal range for Phosphorous?

Answer 17

2.8 to 4.5 mg/dL

Question 18

What is the normal range for Bicarbonate?

Answer 18

22 to 26 mEq/L

Question 19

What is an Intravenous Pyelogram (IVP)?

Answer 19

An X-ray of the urinary tract after IV injection of contrast material

Question 20

Why should patients with renal problems not receive Intravenous Pyelogram (IVP)?

Answer 20

Because IVP can be nephrotoxic and worsen renal function

Question 21

What 5 things must be done before an IVP can be done?

Answer 21

1) Enema to empty colon of feces and gas
2) NPO 8 hours before procedure
3) Assess iodine sensitivity (shellfish)
4) Consent signed?
5) BUN and creatinine results on chart

Question 22

What should you teach your patients to expect during an IVP and what should they do after an IVP?

Answer 22

1) PT will feel warmth, a flushed face, and a salty taste during injection
2) PT should drink lots of fluids after IVP, to flush out contrast

Question 23

What is Antegrade Pyelogram?

Answer 23

Same as an IVP, but the dye is injected directly into the kidney. It is used when there is an allergy to iodine.

Question 24

What is a Retrograde Pyelogram?

Answer 24

An X-ray of urinary tract after injection of contrast material into ureters. A cystoscope is used for visualization.

Question 25

What are the 4 indications for a Cystoscopy that were discussed?

Answer 25

1) To insert ureteral catheters 2) Remove renal calculi 3) Obtain biopsy 4) Tx of bleeding

Question 26

What 2 things must be done in order to prepare for a Cystoscopy?

Answer 26

1) NPO for 8 hours before test | 2) Consent signed?

Question 27

Which three side effects of Cystoscopy should you teach your patients about?

Answer 27

1) Burning on urination 2) Pink tinged urine (bright red bleeding is abnormal) 3) Urinary frequency

Question 28

After a Cystoscopy procedure, which 5 possible complications should the patient be monitored for?

Answer 28

1) Orthostatic hypotension 2) Urinary retention 3) Hemorrhage 4) Bladder infection 5) Perforation of bladder

Question 29

What is a Renal Arteriogram (Angiograph) and what is it used for?

Answer 29

1) Angiography - When a catheter id inserted into the femoral artery and passed up through the aorta to the level of the renal arteries. 2) Used to visualize the renal blood vessels and locate any stenosis. It can also be used to distinguish between renal cysts and tumors.

Question 30

What are the 4 nursing considerations to implement for a patient post-op for a Renal Anteriogram?

Answer 30

1) Pressure dressings of femoral artery injection site 2) Bed-rest with affected leg straight for 6 hrs 3) Observe site for bleeding every 30 mins 4) Take peripheral pulses every 30 mins

Question 31

What is a Cystometrogram used for?

Answer 31

Used to measure bladder tone under pressure.

Question 32

What is the normal rate for GFR and what rate is indicative of End Stage Renal Disease (ESRD)?

Answer 32

1) Normal GFR - 125mL/min | 2) ESRD - < 15mL/min

Question 33

What are the 8 skin changes that occur as a result of ESRD?

Answer 33

1) Dry, pale skin 2) Dry, brittle hair 3) Pruritus 4) Petechiae and Ecchymosis 5) Uremic frost 6) Thin nails 7) Yellow-gray discoloration of the skin

Question 34

What are the 4 reproductive complications that happen as a result of ESRD?

Answer 34

1) Infertility 2) Decreased libido 3) Low sperm counts 4) Sexual dysfunction

Question 35

Why should patients with ESRD not use salt substitutes?

Answer 35

Because they contain potassium chloride and ESRD patients are limited to 2-4g each day.

Question 36

What is the daily restriction for patients with ESRD regarding protein?

Answer 36

0.6 to 0.8 g/kg of body weight per day

Question 37

What is the daily restriction for patients with ESRD regarding phosphate?

Answer 37

1000 mg/day

Question 38

What are the 4 phases of Acute Renal Failure (ARF)?

Answer 38

1) Initiation or Onset 2) Oliguric 3) Diuretic 4) Recovery

Question 39

What are the 5 Risk Factors for ESRD?

Answer 39

1) Diabetes 2) Hypertension 3) Proteinuria 4) Family Hx 5) Increasing age

Question 40

Which electrolyte imbalances are manifested on a patient with renal failure?

Answer 40

1) Hyperkalemia 2) Hypermagnesemia 3) Hypocalcemia 4) Hyperphosphatemia 5) Hypochloremia

Question 41

During hemodialysis, toxins and wastes in the blood are removed by which method?

Answer 41

Diffusion - particles move from an area of higher concentration in the blood to an area of lower concentration in the dialysate.

Question 42

The presence of which substance in the urine is hallmark of the diagnosis of nephrotic syndrome?

Answer 42

Protein (predominantly albumin) exceeding 3.5 g/day is the hallmark of the diagnosis of nephritic syndrome.

Question 43

(T/F) Tea-colored urine is a typical symptom of Glomerulonephritis.

Answer 43

True

Question 44

Why is not treatment administered for metabolic acidosis in in patients with chronic renal failure?

Answer 44

Because metabolic acidosis usually produces not symptoms in patients with chronic renal failure and requires no treatment.

Question 45

Which 4 situations are indications for acute dialysis?

Answer 45

1) Hyperkalemia 2) Fluid overload 3) Impending pulmonary edema 4) Increasing acidosis