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PCM III > "renal procedures" (GU) King 12,4 > Flashcards

"renal procedures" (GU) King 12,4 Flashcards

1
Q

methods of UA

A

physical appearance
dipstick evaluation
microscopic evaluation

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2
Q

how do obtain voided male UA sample

A

expose glans and urethral meatus, cleanse withs sterilizing agent the dry with cloth. collect mid stream

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3
Q

how do obtain voided female UA sample

A

separate labia to expose urethral meatus
cleanse meatus front to back with sterilizing agent.
collect mid stream

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4
Q

situations where voided sample not adequate

A

vaginitis, menses, extremes in age, morbid obesity

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5
Q

if patient cannot void, how can you collect UA

A

urethral, suprapubic or nephrostomy cath

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6
Q

what is name for ped UA it

A

PUCK

Pediatrick Urine Collection Kit

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7
Q

pink urine?
orange?
blue/green?
brown/black?

A

pink- blood
orange- medications
blue/green- ingested dyes or pseudomonas
brown/black- myoglobin, bilirubin, rhubarb, medication

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8
Q

what information is on a dipstick

A 
specific gravity
ketones
pH
protein
glucose
blood
bilirubin
leukocyte esterase
nitrites
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9
Q

what is best indication for + infection on dipstick

A

+ nitrites

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10
Q

threshold glucose in DM

A

<180 mg/dL

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11
Q

specific gravity tells you what

A

state of hydration

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12
Q

epithelial cells in UA could mean what

A

contamination usually

sometimes cancer

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13
Q

RBC in UA means what

A

kidney disease, decreased coagulation, cancer, exercise, stones

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14
Q

crystals in UA means what

A

kidney stones

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15
Q 
if there are <2 cells on microscopic eval what is that called?
3-5?
5-9?
large amount?
packed field?
A 
<2 rare/trace
3-5 occasional 1+
5-9 frequent 2+
large amt Many 3+
Packed field TNTC/4+
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16
Q

RBC casts

A

glomerulonephritis with leakage of RBC from glomeruli or severe tubular damage

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17
Q

WBC casts

A

acute pyelonephritis

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18
Q

what can lead to crystal foramtion in urine

A

augmentation of [ ] beyond super saturation capacity
decreased supersaturation capacity
crystals causing more crystallization

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19
Q

most common crystals in urine

A

Ca oxalate

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20
Q

uric acid crytsals are from what

A

poor dilution volume at an acidic pH

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21
Q

most common bacteria to cause UTI

A

E coli

22
Q

24 urine collection tells you what

A

total protein
Ca Na K
Cr and clearance

23
Q

urine protein electrophoresis is used for what

A

bence joines- Multiple myeloma

24
Q

indications to catheterize bladder

A 
acute urinary retnetion
uncontaminated sample
Dx studies
monitor urine output
measure residual volume
surgery on adjacent structure
urinary tract surgery
25
Q

contraindications to catheterizing bladder

A

known obstruction or stricture
reconstructive surgery of urethra or bladder neck
combative or uncoopoerative patient
pelvic trauma
acute infection of prostate and or urethra

26
Q

what are the complications of catheterization of the bladder

A

infection, hematuria, urethral stricture

27
Q

what are the 2 main types of catheters for bladder

A

foley and straight

28
Q

sizies of catheters for bladder

A

16-18 French

29
Q

how far do you put catheter into bladder

A

3 inches so that the balloon can be inflated

30
Q

long term use for catheterization of bladder

A

chronic retention
neurogenic bladder with retention (cannot self cath)
incontinent with complicated skin breakdown or infection
comfort measure for terminally ill

31
Q

indications for suprapubic catheterization

A 
bladder neck stricture, contracture or obstruction
inability to pass urethral catheter
urethral trauma
recent urethra of bladder neck surgery
inability to tolerate self cath
presence urethral or prostate infection
severe phimosis
collect urine sample, analyze, culture
relief urinary retention
32
Q

contraindicaitons for suprapubic catheterization

A

uncooperative patient
blood dyscrasia or anti-coagulation Tx
infection or cellulitis or suprapubic area

33
Q

complications suprapubic cath

A

peri vesicular bleeding
gross hematuria
infection: skin, subcut, intraabdominal, bladder
intestinal perforation

34
Q

procedure for suprapubic cath

A

local anesthetic
1 cm lateral incision 5 cm above pubic symphysis- midline
inserte catheter and obturator inferiorly 60 degrees
advance into bladder dome through rectus sheath
obturator removed, balloon inflated
secure in place and attach drainage bag

35
Q

what can a bladder scan do

A

3-D US that measures bladder volume and post void residual volume

36
Q

What is flow cystometry

A

2 catheters inserted to bladder, one fills while other measures Pressure
to evaluate urinary incontinence and overactive bladder and urinary retnetion

37
Q

indicaitons cytoscopy

A 
urinary incontinence
known suspected malignancy
recurrent UTIs
pelvi pain Sx
pelvic trauma
intraoperative assessment of bladder or urethral trauma
38
Q

contraindications for cytoscopy

A

relative UTI or pyelonephritis, can cause sepsis so Tx with antibiotics before

39
Q

What is IV pyelogram

A

XR of kidneys, ureters, bladder that use contrast into vein

detects problems with kidneystones, cancer or enlarged prostates

40
Q

what is extracorporeal lithotripsy

A

shock waves used to shatter simple stones in kidneys or upper urinary tracts
US waves strike stones

41
Q

what is intracorporeal lithotripsy

A

cytoscopy and laser introduced to break stones into small pieces

42
Q

indications infant circumcision

A

parental desire based on religious, ethnic anc cultural
may decrease UTI and STI
decrease penile cancer rate

43
Q

contraindications infant circumcision

A 
hypospadius or epi
atypical genitalia
undetermined phenotype
less than 12 hrs postpartum
illness
prematurity
familial bleeding disorder
maternal thrombocytopenia
44
Q

risks complications infant circumcision

A

bleeding, infection, trauma to glans or urethra, poor cosmetic result, paraphimosis
degloving penile shaft
meatal stenosis

45
Q

procedure infant circumcision

A

no anesthesia, before newborn goes home

46
Q

indications adult circumcision

A

phimosis, paraphimosis, penile hygiene, recurrent balantitis, neoplastic foreskin, excessive foreskin redundancy
frenular tears
patient or spouse preference

47
Q

contraindications adult circumcision

A

acute inflammation
infection
psychiatric disorder
bleeding disorder

48
Q

complications adult circumcision

A

bleeding, hematoma, infeciton, pain with erection, stricture or scarring
wound disruption usually due to erection

49
Q

indications for vasectomy

A

undesired fertility

50
Q

contraindicaitons vasectomy

A

infection
coagulation disorder
inability to palpate or elevate vas deferens
stress- divorce or financial
innappropriate reasons
concern about ability to perform sexually after the procedure

PCM III (17 decks)

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