NUR 114 - Concept of Elimination EXAM IV

Question 1

_____ ______ are small, hard deposits of minerals and acid salts

Answer 1

kidney stones

Question 2

stones in urinary tract

Answer 2

urolithiasis

Question 3

stones in kidney

Answer 3

nephrolithiasis

Question 4

stones in the ureter

Answer 4

ureterolithiasis

Question 5

stones in the urethra

Answer 5

urethrolithiais

Question 6

diets high in what leads to kidney stones?

Answer 6

calcium, vitamin D, and high does of vitamin C

Question 7

type of stone that is associated with high concentrations of calcium in the blood or urine; absorbed in the intestinal tract. Most stones have a calcium component (80 % of kidney stones are from this type.)
RISK FACTORS: increase in intestinal calcium absorption, prolonged immobility, bone disease, vitamin D intoxication, renal tubular acidosis, prolonged steroid use, alkaline urine, dehydration, IBD
MANAGEMENT: diet low in oxalate while maintaining adequate calcium intake, limit foods high in sodium and protein, increase foods that acidify urine.
-increase hydration and exercise. thiazide diuretics and phosphates.

Answer 7

Hyercalcemia (oxalate, phosphate)

Question 8

type of stone that develops when the urine concentration of uric acid is high. Common in men.
RISK FACTORS: gout, pourine intake, acidic urine
MANAGEMENT: avoid foods high in purine. increase hydration. potassium citrate and allopurinol (gout management)

Answer 8

hyperuricemia

Question 9

type of stone associated with an UTI caused by urease-producing bacteria. Stones can grow very large filling the renal pelvis and calyces. May be called staghorn stones because of their shape. (more common in women than men)
RISK FACTORS: UTIs, especially proteus infections
MANAGEMENT: surgery for the removal of stones. antibiotic for infection

Answer 9

struvite

Question 10

type of stone that is rare, associated with genetic defect of amino acid metabolism that precipitates insoluable cystine crystals.
RISK FACTORS: genetic defect, acid urine
MANAGEMENT: diet restricting sodium intake. increase hydration, and penicillamine, and sodium bicarb

Answer 10

Cystine

Question 11

• Severe pain that was sudden onset (often described as a corkscrew feeling)
• Nausea, vomiting, high blood pressure, diaphoresis.
• Elevated temperature, BP, and respirations
• Hematuria
• Persistent urge to void
• Oliguria, Anuria,Dysuria (persistent urge to void and painful urination)
• Foul smelling urine
• Hydronephrosis

Answer 11

clinical manifestations of kidney stones

Question 12

complication of a kidney stone occurs when a blockage persists. the stone is in a place where it is completely blocking urinal flow. so organ goes on to swell. main symptom will be pain (on either side of back, abdominal, or groin pain) increased urge and frequency to void. upon using the restroom they incompletely void. symptoms depends on the severity of the blockage

Answer 12

hydronephrosis

Question 13

what type of test would be recommended for children and pregnant women to reduce the risk of radiation exposure.

Answer 13

ultrasound

Question 14

___% of kidney stones can be spontaneously passed but there are some who have infections or complications and need other measures to treat the stone. often time NSAIDS are prescribed to help alleviate pain.

Answer 14

50

Question 15

ketorolac (Toradol)

ketoprofen (Nexcede)

Answer 15

NSAIDs

Question 16

Oxybutynin chloride (ditropan) 
Tamsulosin (Flomax) 
used to help relax the muscles in the bladder to help pass the stone.

Answer 16

Spasmolytics

Question 17

what is the key preventative measure in regards to kidney stones?

Answer 17

ensuring that the client is hydrated with water and citrus juices. (citrate is a stone inhibitor)

Question 18

____ as often as possible prevents calcium buildup in the bloodstream.

Answer 18

walking

Question 19

_____ the urine in order to catch and study the stone.

Answer 19

strain

Question 20

asparagus
beer and colas
beets
cabbage
celery 
spinach
chocolate and cocoa 
fruits 
green beans
nuts
tea
tomatoes 
rhubarb
coffee
wheat/bran

Answer 20

food highs in oxalate `

Question 21

goose 
organ meats
sardines, herring, salmon
venison
moderate in beef
chicken
crab
pork 
veal

Answer 21

purine rich foods (should be avoided if they have a kidney stone)

Question 22

surgical removal of a stone through an incision in the back

Answer 22

lithotomy

Question 23

if larger than 10 mm, the pain is not managed, and the nausea and vomiting is severe then…

• extra corporeal shock wave lithotripsy
• retrograde ureteroscopy
• laser lithotripsy

Answer 23

treatment for kidney stones

Question 24

as the stone moves the pain will ______.

Answer 24

increase

Question 25

what are you evaluating in the duration of the treatment of kidney stones?

Answer 25

patient's pain is managed infection is controlled diet is appropriate fluid intake is appropriate

Question 26

``` infection urinary stasis and retention immobility dehydration increase in uric acid increase in urinary oxalate ```

Answer 26

risk factors for kidney stones

Question 27

prostate problems are no _______ ?

Answer 27

``` F frequency U urgency N nocturia - hematuria - increase infections - decrease urinary streams - increase in residual urine ```

Question 28

gives strength to micturition and squeezes fluid to the urthera.

Answer 28

function of the prostate gland

Question 29

``` age family history obesity DM Testosterone decreased activity ```

Answer 29

risk factors for benign prostatic hypertrophy

Question 30

half of the men after age __ have BPH.

Answer 30

60

Question 31

``` - Hesitancy ~ Frequency ~ Diminished force of urinary stream ~ Increased urge to urinate ~ Sensation of incomplete emptying ~ Nocturia ~ Straining to begin urination ~ Post void dribbling ```

Answer 31

manifestations of benign prostatic hypertrophy

Question 32

light red to red: normal day of surgery and first post op day very dark red: may indicate increased venous bleeding or inadequate dilution. catheter at risk for occlusion. increase the flow rate and notify physician. bright red: may indicate arterial bleeding. increase flow rate, monitor VS, and notify physician. contains blood clots: occasional blood clots are normal. frequent indicated the catheter may be obstructed. increase the flow rate. clear to light pink: normal through hospitalization.

Answer 32

nursing implications in regard to urine characteristics after surgery.

Question 33

what is the goal of continuous bower irrigation

Answer 33

promotion of the outflow of urine.

Question 34

gold standard for the treatment of BPH.

Answer 34

Transurethral Resection of the Prostate (TURP)