m2 day 4 Flashcards
UTI
manifestations, diagnostic studies, care / drug therapy
Clinical manifestations
Abd discomfort
Dysuria
Urgency
Frequency
hematuria
Diagnostic studies
Dipstick analysis → nitrates (bacterimia), WBC, leukocytes
Midstream test
care and drug therapy
Medications: Trimethoprim–sulfamethoxazole (TMP–SMX) or nitrofurantoin (older adults);
Cipro or levaquin
Urinary analgesic
acute pyelonephritis
what, S/S, labs, care and therapies
Inflammation of renal prigma and colecting system
common cause is bacterial infection, but fungi, protozoa, or viruses can also cause
Acute starts in the renal medulla and spreads to the adjacent cortex
Recurring episodes (esp in the presence of abnormalities) scarring of kidneys → chronic pyeloneprhitis
s/s
fatigue to the sudden onset of chills, fever, vomiting, malaise, flank pain,
care and drug therapy
Medications: ampicillin, vancomycin, cipro, septra, NSAIDS, antipyretic
Nursing implementation
Push fluids,
Follow up urine culture
Urinary tract calculi
caused by ? manifestations, labs, interventions, complication
Dietary consumption of large amounds of Ca
Clinical manifestations
Pain+++, infection
Labs & Diagnostics
ultrasound kidney ureter and blader, cysto, renal ultrasound
Nursing & Collaborative Interventions
pain management (now, using toredol aka kedororilac→ nonsteroidal IM injection), strain urine,
Complications
Renal impairment
urinary tract tumors
causes?, s/s, sugircal treatment
one : Kidney cancer
Malignant is more frequent
Renal carcinoma, often occurring equally in men and women 50-70
can be caused by:
Cigarette smoking
Obesity
Exposure to asbestos
s/s
generalized symptoms of cancer
Gross hematuria
Mestastasis → liver lungs and long bones
Surgical treatment → transurethral resection or a radical cysctosocmy
Radiation
Two : Bladder cancer
instrumentation
what is it, used for
Splinting of ureters or urethra to facilitate healing after surgery or other trauma in area
uses
- Bladder decompression
- Facilitation of surgical repair
- Relief of urinary retention caused by lower urinary tract obstruction, paralysis, or inability to void
BPH
S/S, risk factors, labs, complications
Benign prostatic hyperplasia, a noncancerous enlargement of the prostate gland,
Frequency, urgency, retention, nocturia
Risk factors
Aging, family Hx, obesity, sedentary lifestyle
ED
Labs & Diagnostics
Digital rectal exam
Complications
Urinary retention, sepsis
TURP
Transurethral resection of the prostate (TURP) is a surgery used to treat urinary problems that are caused by an enlarged prostate.
- Removal of the prostate tissue using the retreoscope inserted through the utretheta
- Gold standard for obstructive BPH
AKI manifestations
Urinary changes
Fluid volume excess
Metabolic acidosis
Sodium and Ca imbalance
hyperkalemia
Hematological disorders
Waste product accumulation
Neurological disorders
AKI phases
initiation and maintenance phase
AKI: Phases
Initiation Phase
Increase in serum crt and BUN, decrease in UO
Maintenance Phase
Days to weeks
Presence of kidney failure = low serum calcium results → decreased release of phosphate by kidneys
oliguria → 10-14 days, toxins not removed by kidneys
- Urinary output is less than 400 mL in less than 24 hrs
AKI recovery phase
Recovery Phase
GFR becomes normal, kidneys secrete waste but do not concentrate urine
Diuretic phase begins w gradual increase of UO 1-3L per day or more
High urine volume is by osmosis not nephrons as they are still recovering
CKD
clinicalmanifestations, nutritional and drug therapies
Chronic irreversible loss of kidney function, a GFR of less than 60/min for 3 months or longer
Clinical Manifestations
- Anemia
- Bleeding tendencies
- Infection
Nutritional therapy
restrict
- Sodium
- fluid
- Potassium
- Phosphate
Drug therapy
- Hyperkalemia
- Hypertension
- Anemia
- Dyslipidemia
peritoneal dialysis
what and complications
Peritoneal dialysis is a treatment for kidney failure that uses the peritoneum to filter your blood
complications
Exit-site infection
Peritonitis
Abdominal pain
Outflow problems
Hernias
Lower back problems
Bleeding
Pulmonary complications
Protein loss
Carbohydrate and lipid abnormalities
hemodialysis
what/how, complications
a machine to clean blood
- Vascular access site
- Arteriovenous fistulas and grafts
- Central venous catheters
- Temporary vascular access
Complications of hemodialysis
Hypotension
Muscle cramps
Loss of blood
Hepatitis
Sepsis
Disequilibrium syndrome results in high osmotic pressure → cerebral edema
fractures and classifications
Fractures
- Disruption or break in the continuity of the structure of bone
- Majority of fractures from traumatic injuries
- Some fractures secondary to disease process –> Cancer or osteoporosis
Fractures can be classified
- Open or closed
- Complete or incomplete
- Based on direction of fracture line
- Displaced or nondisplaced
types of fractures
8
Transverse
Spiral
Greenstick
Comminuted
Oblique
Pathological
Stress
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