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NURS122 > GU > Flashcards

GU Flashcards

1
Q

Questions to assess when a pt has kidney/urinary issues

A

OPQRST pain
frequency
amount
hematuria
dysurea (pain)
change in color or odor

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2
Q

anuria vs. oliguria vs. polyuria

A

anuria - no urine
oliguria - little urine
polyuria - lots of urine

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3
Q

ideally, when should urinalysis sample be collected?

A

1st catch in the morning

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4
Q

what is KUB test

A

kidney, ureter, bladder x-ray

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5
Q

what is IVP test

A

intravenous pyelogram which uses contrast dye to view kidneys, ureters, bladder, and urethra

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6
Q

what is cystoscopy

A

examine the bladder lining and urethra

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7
Q

how does the GU change with age

A
  • kidney size decrease
  • decreased renal blood flow, GFR
  • decreased ability to conserve Na, excrete acid, dilute/con. urine
  • increased prostates
  • decreased bladder elasticity
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8
Q

how does change in bladder elasticity affect urine output

A

increased residual volume

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9
Q

cause of nocturia

A

change in dilution and concentration of urine

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10
Q

what is vesicoureteral reflux

A

blockage or failure of bladder muscle and leading to urine flowing backward into ureters and kidneys

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11
Q

signs of an elderly pt having GU issues

A
  • mental confusion or frequent unexplained falls
  • sudden onset of incontinence
  • fever, tachycardia, tachypnea, hypotension (without urinary symptoms)
  • loss of appetite, nocturia/dysuria
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12
Q

causes of cystitis

A
  • not emptying bladder completely
  • damage or irritation around urethra
  • bacteria transfer to urethra
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13
Q

signs of cystitis

A
  • increased frequency/urgency with burning urination
  • hematuria
  • cloudy/smelly urine
  • pelvic discomfort
  • pressure in lower abdomen
  • low-grade fever
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14
Q

treatment of cystitis

A

antibiotics and pain meds
encourage fluids

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15
Q

what can pyelonephritis lead to

A

sudden severe kidney infection
leading to kidneys swelling
can cause permanent kidney damage

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16
Q

cause of chronic pyelonephritis

A

pts with urinary obstructions

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17
Q

upper vs. lower UTI symptoms

A

upper - fever, chills, flank pain
lower - dysuria, urgency, hesitancy

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18
Q

bacteria that cause most UTIs

A

E. coli

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19
Q

pyelonephritis meaning

A

inflamed renal parenchyma & collecting system

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20
Q

cystitis meaning

A

inflammation of bladder

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21
Q

urethritis meaning

A

urethra inflammation

22
Q

name 1 urinary tract analgesic

A

pyridium (Phenazopyridine)

23
Q

what does cranberry juice do

A

prevents attachment of pathogens to bladder wall

24
Q

what is renal colic

A

sudden acute pain in kidneys from obstruction of urine flow from kidneys to bladder

25
signs of renal colic
sharp, severe pain in lower back and can radiate to groin can have hematuria
26
how does urine pH help diagnose renal calculi
acidic - uric acid/cystine stones alkaline - calcium phosphate stones
27
treatment of renal calculi
3-4 L water a day minimum (ideally want 2L urine output per day) most will pass unless larger than 4mm
28
teaching for post-op lithotripsy (stent)
hematuria for several days, bruising or discomfort to back/abdomen avoid aspirin or anti-coagulant drugs will have discomfort from more stones passing
29
nurse interventions for any post-operation
encourage fluids, movement strain all urine & check urine pH pain management change in diet
30
what foods to avoid for renal calculi
avoid high purine foods such as red meat, organ meats, alcohol, sardines/anchovies/shellfish
31
3 phases of acute renal failure
- oliguric-anuric - diuretic - recovery
32
causes of prerenal failure
hypotension or poor blood flow to kidneys secondary to other source
33
causes of intrarenal failure
inflammation, drugs, infection, decreased blood flow to kidneys
34
causes of postrenal failure
sudden urine obstruction from enlarged prostate kidney stones bladder tumor or injury
35
what labs can be expected from oliguric-anuric stage of ARF (acute renal failure)
- 1-7 days - increased BUN, creatinine - decreased urine output, possible fluid overload (hypervolemia) leading to decreased Hgb, Hct, RBC count - changes in electrolytes: hyperkalemia, hyponatremia - metabolic acidosis - fatigue/malaise
36
what precautions should oliguric stage of acute renal failure should a pt be placed on
seizure precautions - low Na pulmonary edema - hypervolemia risk for growth disturbance - lack of appetite, disturbance to diet
37
what is happening anatomically during oliguric-anuric stage of ARF
- renal tubule damage leading to decreased urine output
38
what happens anatomically during diuretic phase of ARF
- kidneys attempt to heal but results in damage or scarring - increased GFR, daily urine ideally over 400ml, poss electrolyte imbalance still - creatinine/BUN still elevated - poss anemia: kidneys make erythropoietin - dehydration/hypovolemia
39
what happens anatomically during recovery phase of ARF
- can take months to yrs - decreased edema - renal fxn improves
40
signs and symptoms of ARF
fluid build up/edema chest pain muscle weakness
41
interventions for ARF
surgery meds nutrition dialysis
42
what is differential diagnosis?
other diagnosis besides the first thing you can think of/relate it to
43
what 3 factors are the most important to look at for a urine dipstick
nitrates blood leukocyte esterase
44
what is normal GFR
less than 60
45
what abx to use for UTI
fluoroquinolone - ciprofloxacin sulfonamide - TMP-SMX (septra) nitrofurantoin bactrim
46
contraindication for hemodialysis
hemophilia (major bleed risk)
47
what to do when a kidney pt has hyperkalemia
infuse regular insulin with D10W or D20W to get K into cells and sugar to prevent hypoglycemia
48
normal urine pH
4.5 -8.0 okay
49
WBC normal range
4,000 - 12,000
50
normal Hct range
35-50
51
when is shockwave delivered with extracorporeal shock wave lithotripsy (ESWL)
ECG placed and shockwave synced to R wave
52
rapid decrease in fluid post hemodialysis can cause what
seizures from cerebral edema, and increased intracranial pressure

NURS122 (28 decks)

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