Renal Flashcards
(136 cards)
1
Q
Where are the kidneys located?
A
Retroperineally
T12 and T3
2
Q
What is the loop of Henle?
A
Reabsorps sodium B water from glomerulus
Produces concentrated urine (dark yellow)
3
Q
When is renin released?
A
Blood loss
Hypotension
↓ sodium
↑ potassium
↓eCF
4
Q
What controls voiding?
A
Impulses from brain
T11 and L2
S2 to S4
5
Q
Aging affects kidneys by
A
Decreases ability to concentrate urine
6
Q
What do anticoagulants cause?
A
Hematuria
7
Q
What can Rn check on PA of renal?
A
Distention of bladder
8
Q
What is a urine analysis?
A
1st morning void
Examine w/in 1st hr
9
Q
What is a creathine clearance test?
A
24hour urine that determines GFR
10
Q
What is a urine cytology?
A
Screens for bladder cancer
11
Q
What is a urodynamic study?
A
‘urinary tract function
12
Q
What does increased bun indicate?
A
Dehydration
Proteinuria
13
Q
What is osmolarity of urine?
A
50-1200
14
Q
What is the ph of urine?
A
4.8 - 8.0
15
Q
What does UTI does not cause?
A
Increased gravity, BUN and creatinine
16
Q
What does a u/a look for in CAUTI’S?
A
Nitrates
WBC
Leukocyte esterase
17
Q
Leukocyte esterase indicates
A
Pyuria
18
Q
ecoli is resistant to
A
Bactim
Ciprofloxacin
19
Q
What is the cause of acute pyelonephritis?
A
E. coli
Proteus
Klebsiella
Enterobacter
20
Q
What are the preexisting factors of acute pyelonephritis?
A
Vesicourteal reflex
Obstruction
Pregnancy
Cystitis
21
Q
What are obstructions?
A
BPH
Renal calculi
Strictures
22
Q
What does an u/s identify
A
Hydronephoresis
Renal abscess
Obstructing stones
23
Q
What does a CT scan?
A
Pyelonephritis
Scarring
Abscess
24
Q
Why is A CBC taken w/ pyelonephritis?
A
To look for leukocytosis w/ a left shift
25
What causes an inflamed kidney W) fibrosis and atrophy?
Chronic pyelonephritis
26
What do you test for w/ recurring UTI'S?
Chronic pyelonephritis
27
What is associated w/ urethritis?
STD
28
What meds treat trichomonias?
Flagyl and monistat
29
What med will not treat trichomoniasis?
Bacterium
30
What meds treat monillial infections?
Nystatin
Clotrimozale
Fluconazole
31
What meds treat chlamydia?
Doxyclicline
Azithromycin
32
What causes ic?
. Delayed emptying
Sex
Stress
Premenstrual
33
What causes scarring?
Acidic urine
34
What are hunner lesions?
Inflamed bladder wall
35
What foods increase urine ph?
Fruits
Veggies
Non-cheese dairy
36
What foods decrease ph?
Fish
Meat
Cheese
37
What does OTC prelieffor ic do?
Alkalizer urine
38
What reduces burning and frequency?
Tricyclic antidepressants
Amitripityline
Nortriptyline
39
What does elimeron do for ic?
Reduces irritation
Takes weeks-months
40
What is instilled into the bladder for ic?
'DMSO
Heparin
Lidocaine
Sodium bicarb/ hydraulic acid
41
What is the surgical intervention for ic?
Sacral neuro-modulation / fulguration for hunner lesions
Diversion for illegal conduit
42
What are the interventions for ic?
Log record
Vitamin
Lose clothing
43
What does glomerlonephritis cause?
3rd leading cause of esrd
44
What is glomerlonephritis caused by?
Strep
Goodpasture syndrome
45
What does a u/a show W/ glomerlonephritis?
Proteinuria
Leukocytes
↑ gravity, bun, and creatine
46
What happen to gfs W/ glomerlonephritis?
GFR decreases
47
A pt W/ apsgn should rest until
Proteinuria and hematuria subsides
That will indicate no more inflammation
48
When does apsgn develop?
1-2 weeks after strep Group A infection
49
What does au/a show W/ apsgn?
Erythrocyte caste
50
What are the interventions for apsgn?
Rest
fluid and sodium restriction
↓ protein
Diuretics
51
What do arbs do?
Prevent blood vessel restriction
Give for a haeadache
52
What disorder is ace and arbs used for?
Apsgn
53
What are the ace drugs?
Lisinopril
Catapril
54
What are the arb drugs?
' Lasartan
Valsartan
55
What do arbs not cause?
'do not cause a cough
56
What test is used to show scarring?
Biopsy
57
What causes chronic glomerlonephritis?
Glomerlonephritis
Nephrotic syndrome
58
What are the interventions for chronic glomerlonephritis?
Restrict: protein, sodium, phosphorous,
Treat HTN and UTI
59
What is scarring of the glomeruli caused by?
Hypertension
60
What is not found in urine wl nephrotic syndrome?
Blood
WBC
Leukocytes
61
What is need when urine gets backed up in the kidney?
Nephrostomy
62
What does a pt. Have w/ nephrotic syndrome and decreased albumin?
Ascites and massive edema
63
What does nephrotic syndrome lead to?
Hyper coagulation
Thromboembolism
64
Pressure on the bladder leads to?
Ureter dialation
Vesicourteal reflux
Hydronephoresis
65
What happens to ph with calculi?
It increases
66
What will a u/a show with calculi?
Blood in urine
67
What does urine ph test for?
Struvite stones
68
What is a lithotripsy?
Removes stone from urinary tract
69
What does a lithotripsy use?
Laser,
ESWl
Ultrasonic sound wave
Electro hydraulic
70
How does a pt reduce the risk for calculi?
Keep urine dilute and free flowing
71
What are struvite stone?
Alkalitic
72
What are Uris acid and cystine stones?
Acidic
73
What can cause AKI?
Heart failure
Nephrotoxic drugs
Decreased blood
Inflammation
74
What are the causes of prerenal AKI?
Decreased BP and blood flow
Hypovolemia
75
What disorders cause prerenal AKI?
Dehydration
Heart failure
Decreased CO2
76
What are the causes of intrarenal AKI?
Direct damage
Inflammation
Toxins
Drugs
Infection
77
What disorders cause intrarenal AKI?
Acute tubular necrosis
Ischemia
78
What are the diagnostics for intrarenal AKI?
Renal biopsy
U/a will show abundant cells, cast, and proteins
79
What do you not use for intrarenal cause of AKI?
Contrast media test
80
What cause postrenal AKI?
Enlarged prostate
Stones
Tumor
Hydronephoresis
81
What happens in the oliguric phase of AKI?
Less than 400ml/day
Metabolic acidosis
Hyperkalemia
Hyponatremia
Fatigue and malaise
82
What does a u/a show during the oliguria phase of AKI?
Cast
RBC and WBC
Increased BUN and Creatnine
83
What happens in the diuretic phase of AKI?
Increase output
Hypovolemia
Dehydration
Hypotension
84
What helps identify the specific cause of AKI?
Osmolarity
Gravity
Sodium
85
What are the hyperkalemia meds for AKI?
Calcium gluconate
Regular insulin and dextrose
Sodium bicarbonate
Kayexalate
Veltassa
Hemodialysis
86
What does calcium gluconate do?
Protects heart from dysrhythmias
87
What does sodium bicarbonate do?
Increases ph
88
What does Vettasa do?
Treats CKD symptoms
89
What disorders indicate RRT?
Pericarditis
Pericardial effusion
Cardiac tamponede
90
What levels indicate need for RRT?
BUN>120
Metabolic acidosis
Increased potassium
Overload
91
What is the nutrition intervention for AKI?
Restrict sodium
Increase Carbs and fat
92
What are nephrotoxic meds?
Aminoglycosides
93
What is the GFR of CKD?
less than 60 for more than 3 months
94
Stage 1 GFR
Greater or equal to 90
95
Stage 2 GFR
60-89
96
Stage 3 GFR
30-59
97
Stage 4 GFR
15-29
98
When does uremia begin?
GFR below 10
99
What interventions are done with a pt with diabetes and CKD?
Reduce insulin
100
When do fatal dysrythmias begin?
Potassium above 7
101
What does fluid overload lead to?
Dilutional Hyponatremia
102
What increases with CKD?
Phosphorous
PTH
Glucose
Insulin
Triglycerides
103
What cause Polyuria?
Inability to concentrate urine
104
What does increased ammonia lead to?
Causes encephalopathy and pruritis
105
When GFR decreases…
BUN and creatnine increase
106
What happens to the heart with CKD?
Arythmias
107
What are the elctrolyte levels with CKD?
Increased potassium and phosphorus
Decreased sodium and calcium
108
What potassium foods should we encourage with CKD?
Eggplant
White rice
Celery
Carrot
Peach
109
What happens when magnesium levels are high?
Decreased reflexes and mental status
Dysrythmias
Hypotension
Respiratory failure
110
What does urea cause?
Gastro problems
111
When does restless leg syndrome begin?
Stage 5
112
What is a late neuro change with CKD?
Peripheral neuropathy
Dialysis encephalopathy
113
What causes pruitis with CKD?
Calcium and phosphorus in skin
114
When does uremic frost become an issue?
BUN>200
115
When is a albumin to creatnine ratio completed?
In first morning void
116
What do you give to decrease proteinuria?
ACE and ARBS
117
What is the levels for a creatnine clearance test?
Women: 87-107
Men: 107-139
118
What are the interventions for hypertension with CKD?
DASH diet’
Restrict sodium and fluid
119
When is phosphate restricted with CKD?
Not until RRT
120
What are the phosphate binders and when do you give them?
Phoslo
Caltrate
Renewal
Give with each meal
121
What is calciferol?
Vitamin D replacement that reduces PTH
122
What are the anemia meds?
Alfa
123
What do you give for dyslipedemia?
Statins (Lipitor)
124
What is the nutritional treatment for CKD?
Restrict:
Protein
Water
Sodium
Potassium
Phosphorus
125
What do you give for RBC formation?
Folic acid
126
When is immediate dialysis needed?
Encephalopathy
Neuropathies
Hyperkalemia
Pericarditis
HTN
127
Diffusion
High to low
128
Osmosis
Low to high
Pulls fluid from blood
129
What does ultrafiltration do?
Removes fluid
130
What does a PD cath have?
2 polyester cuffs (Dacron)
131
What are some complications of PD?
Peritonitis
Hernia
Lower back problems
Bleeding
Pulmonary complications
Decreased proteins
132
What do you do pre op PD?
Empty bladder and bowel
Get a weight
133
What is an AVF?
Anastomosing cephalon vein
Listen for thrill and bruit
134
What is an AVG?
Brachial artery to antecubital vein
135
What are the HD complications?
Hypotension
Muscle cramps
Low blood
Hepatitis
136
What color fluid should CRRT be?
Clear yellow
