exam 3 detailed

Question 1

what does a 24 hour urine collection measure

Answer 1

creatinine clearance, urea nitrogen, sodium, chloride, calcium, and proteins

Question 2

Lithotripsy

Answer 2

breaks stone into smaller pieces

Question 3

Percutaneous nephrolithotomy

Answer 3

a surgical procedure to remove kidney stones that are too large to pass on their own or don’t respond to other treatments
go in through the skin

Question 4

Open ureterolithotomy

Answer 4

Removes a stone from the ureter

Question 5

Open nephrolithotomy

Answer 5

Removes a stone from within the kidney

Question 6

nephrostomy tube

Answer 6

a thin, flexible tube that drains urine directly from the kidney into a bag outside the body.

Question 7

SIgns and Symptoms of UTI

Answer 7

pain, fatigue, fever, confusion, frequency, urgency, dysuria, nocturia,
hematuria, retention, feeling of incomplete bladder emptying

Question 8

Dx of UTI

Answer 8

history, physical exam, urinalysis, CBC, cystoscopy if
recurrent

Question 9

UTI treatment

Answer 9

antibiotic therapy, phenazopyridine (urinary analgesic), antipyretic,
increased fluid intake, warm sitz bath 2-3 times a week can relieve pain

Question 10

UTI PT education

Answer 10

full abx course, drink 2-3 L/day, wipe front to back, do not
hold urine, phenazopyridine (urinary analgesic) will turn urine orange

Question 11

UTI Labs

Answer 11

urinalysis–>expect positive WBCs, Nitrite, bacteria, leukocyte esterase, casts; Urine culture and sensitivity; CBC-> elevated WBCs

Question 12

Renal calculi s/s

Answer 12

lank pain, fluctuating pain (depending on location of stone), oliguria,
anuria, dysuria, hematuria, bladder distention.

Question 13

Renal Calculi Dx

Answer 13

x-ray KUB, CT KUB, Ultrasound KUB

Question 14

Renal Calculi Treatment

Answer 14

NSAIDs, Antiemetics, Antibiotics, increase fluid intake (to aid in
passing stone and prevent further stone formation), watchful waiting (for
stones to pass), straining of urine

Question 15

Renal Calculi- Calcium pt education

Answer 15

avoid milk and other dairy products

Question 16

Renal Calculi- Oxalate

Answer 16

avoid spinach, black tea, and rhubarb

Question 17

Renal Calculi- Uric Acid

Answer 17

decrease purine intake–> poultry, fish, gravies, red
wines, sardines

Question 18

Renal Calculi- Struvite

Answer 18

results after a bacterial infection.
Avoid high
phosphate foods (dairy, red or organ meats, whole grains)

Question 19

Renal Calculi Labs

Answer 19

urinalysis–> rule out infections, may be positive for RBCs,
Hyperkalemia, Hyperphosphatemia

Question 20

Polycystic Kidney Disease s/s

Answer 20

weight gain (due to cyst formation and increased kidney size), flank pain, headache (stroke risk r/t hypertension), hematuria, hypertension (r/t decreased kidney perfusion and initiation of the RAAS system), dysuria, nocturia, constipation (enlarged kidney compresses bowels), enlarged abdominal girth (r/t enlargement of kidneys), kidney stones

Question 21

Polycystic Kidney Disease treatment

Answer 21

blood pressure control (typically with ACEs or ARBs because they
work directly on the RAAS system), pain management (typically acetaminophen and nonpharmacologic interventions), interventions to slow progression of kidney damage (surgical cyst drainage, dialysis, smoking cessation), infection prevention, Pt will inevitably need a kidney transplant (if they live that long)

Question 22

Polycystic Kidney Disease Dx

Answer 22

ultrasound, family history/genetic testing

Question 23

Polycystic Kidney Disease pt education

Answer 23

importance of diet (decrease sodium intake), importance of smoking cessation (hypertension risk),

Question 24

Polycystic Kidney Disease labs

Answer 24

urinalysis: + proteinuria, + hematuria; decreased GFR; elevated BUN and creatinine levels, fluctuation in sodium level (can be wasted or retained)

Question 25

Hydronephrosis

Answer 25

The dilation of the renal pelvis and calyces, which can affect one or both kidneys.

Question 26

Hydroureter

Answer 26

The dilation of the ureter

Question 27

Hydronephrosis/Hydroureter s/s

Answer 27

flank pain, anuria, abdominal asymmetry (may indicate kidney mass), abdominal tendernes

Question 28

Hydronephrosis/Hydroureter Dx

Answer 28

renal ultrasonography (1st choice), UA, CBC, CT or X-Ray KUB

Question 29

Pyelonephritis

Answer 29

kidney infection

Question 30

Pyelonephritis Dx

Answer 30

urinalysis, culture and sensitivity, Imaging (X-ray KUB, CT)

Question 31

Pyelonephritis treatment

Answer 31

antibiotics, increase fluid intake, pain interventions, antipyretic

Question 32

Pyelonephritis labs

Answer 32

BUN may be elevated (but creatinine will not), urinalysis- + WBC, + nitrite, + bacteria, cloudy, foul odor

Question 33

Voiding Cystourethrogram

Answer 33

an X-ray exam that uses a contrast material to image the bladder, urethra, and kidneys while the bladder is filling and emptying

Question 34

Glomerulonephritis

Answer 34

a term for a group of kidney diseases that damage the glomeruli, the tiny filters in the kidneys

Question 35

ACute Glomerulonephritis

Answer 35

strep infection after 10 days

Question 36

Chronic Glomerulonephritis

Answer 36

occurs 20-30 year

Question 37

s/s Glomerulonephritis

Answer 37

Proteinuria, hematuria, hypertension, edema (especially in the face and hands), Pulmonary edema (dyspnea, shortness of breath, crackles), neck vein distension, weight gain

Question 38

Stages of bone healing

Answer 38

Hematoma formation within 24-72 hours of fracture  Granulation tissue invades hematoma to form fibrocartilage within 3 days- 2 weeks  Fracture site is surrounded by new vascular tissue known as a callus within 3-6 weeks  Callus is gradually resorbed and transformed into bone within 3-8 weeks Consolidation and remodeling of bone can continue for up to 1 year after

Question 39

External Fixation

Answer 39

assess pin sites every 8- 12 hours for s/s of infection

Question 40

elective amputation

Answer 40

surgical removal r/t chronic disease –> more commonly the lower extremities

Question 41

traumatic amputation

Answer 41

result of an injury/trauma –> more commonly the upper extremities

Question 42

Phalen’s maneuver

Answer 42

wrist flexion for 1 minute (numbness in hands indicates positive test),

Question 43

Tinel’s sign

Answer 43

repetitive tapping of the transverse ligament (results in paresthesia indicates positive test)