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NCLEX > Renal System > Flashcards

Renal System Flashcards

(63 cards)

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1
Q

Anuria

A

Urine output of <100mL per day

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2
Q

Arteriovenous fistula definition

A

Surgical creation of an anastomosis of a fistula between an artery and vein.

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3
Q

Azotemia

A

Retention of nitrogenous wast products in the blood

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4
Q

Disequilibrium syndrome

A

Rapid change in the composition of ECF that occurs during dialysis. Solutes are removed from the blood faster than from the CSF pulling fluid into the brain causing cerebral edema.

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5
Q

Nephrolithiasis

A

Formation of kidney stones.

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6
Q

Oliguria

A

<400mL of urine output per day

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7
Q

Urolithiasis

A

Formation of urinary stones.

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8
Q

Definition of Serum Creatinine

A

An end product of protein and muscle metabolism which reflects GFR and is an indicator of kidney disease when elevated.

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9
Q

Normal serum creatinine level

A

0.6-1.3

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10
Q

Normal Blood Urea Nitrogen Level

A

8-25

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11
Q

Normal serum uric acid

A

2.5-8.0

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12
Q

Definition of Blood Urea Nitrogen

A

Indicates renal clearance of nitrogenous waste products.

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13
Q

Factors which affect BUN

A
  1. Dehydration
  2. Poor renal perfusion
  3. High protein diet
  4. Stress
  5. Infection
  6. GI bleeding
  7. Muscle breakdown
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14
Q

Specific gravity of urine - lab value

A

1.016-1.022

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15
Q

Specific gravity of urine - what it tells you

A

Measures the ability of the kidneys to concentrate urine. Increase indicates dehydration, decreased renal perfusion or increased ADH.

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16
Q

Creatinine clearance test

A

Evaluates how well the kidneys remove creatinine from the blood. Involves taking a blood sample and timed urine sample. Provides the best estimate of GFR.

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17
Q

Normal GFR Rate

A

125 ml/min

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18
Q

Acute Kidney Injury

A

Rapid loss of kidney function from renal cell damage. Can be pre-renal, intra-renal or post renal.

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19
Q

Phases of AKI

A
  1. Onset
  2. Oliguric phase (Increase in BUN and SC levels, decrease in SG, GFR and creatinine clearance)
  3. Diuretic phase (gradual decrease in BUN and SC, low CC and slight increase in GFR)
  4. Recovery phase (increase GFR and stabilization of BUN and SC).
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20
Q

CKI - at risk

A

GFR >90 ml/min

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21
Q

CKI - Mild

A

GFR 60-89 ml/min

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22
Q

CKI - Moderate

A

GFR 30-59 ml/min

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23
Q

CKI - Severe

A

GFR 15-29 ml/min

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24
Q

CKI - End Stage

A

GFR <15 ml/min

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25
CKI - diet
1. Low protein 2. High carb 3. Low K 4. High Phosphate
26
Common problems that accompany kidney disease
1. Activity intolerance and insomnia 2. Anemia 3. GI bleeding 4. Hyperkalemia 5. Hypermagnesemia
27
Uremic syndrome
Accumulation of nitrogenous waste products in the blood cause by the kidneys inability to filter out wast products.
28
Symptoms of uremic syndrome
1. Oliguria 2. RBC and protein in urine 3. Increase urea, uric acid, K and Mg in urine 4. n and v 5. diarrhea and constipation 6 hyper and hypotension
29
Subclavian and femoral catheter
Used for short term or temporary use in AKI hemodialysis. Used until the fistula or graft matures (6 weeks).
30
External arteriovenous shunt
Two cannulas are surgically inserted one into the artery and one into the vein in the forearm or leg to form an external blood path. Patentcy is tested by palpating for a thrill or listening for a bruit.
31
Internal arteriovenous fistula
Connection of an artery to a vein using an internal, artificial graft. This can be gore-tex, or bovine and is used for clients who do not have adequate blood vessels for creation of a fistula. Graft can be used 2 weeks after insertion. Needle inserted through the skin into the graft.
32
Arterial steal syndrome
Too much blood is diverted into the vein and arterial perfusion to the hand is compromised. To check for patentcy palpate for a thrill or auscultate for a bruit.
33
Signs and symptoms of Peritonitis
1. Fever 2. Cloudy outflow 3. Abdominal pain (common for first 2 weeks) 4. Malaise 5. Nausea and vomiting
34
Hyperacute kidney rejection
Rejection occurs when the organ is attached
35
Acute kidney rejection
Happens in the first 6 weeks
36
Chronic kidney rejection
Occurs slowly over months and years
37
Clinical signs of kidney rejection
1. Temperatue >100 2. Pain at graft site 3. 2-3 lb weight gain in 24 hours 4. Edema 5. Hypertension 6. Malaise 7. Increase BUN and SC 8. Decreased CC 9. Increased WCC 10 Rejection indicated on ultrasound or biopsy
38
Urosepsis
Bacteremia originating in the urinary tract usually caused by Ecoli. Can lead to septic shock if not treated. Usually infection comes from a catheter. Fever is the earliest manifestation.
39
Urethritis
Inflammation of the urethra usually associated with an STI.
40
Symptoms of Urethritis
1. Pain/Burning during urination 2. Frequency/ Urgency 3. Nocturne 4. Difficulty voiding 5. Males have clear to micropurulent discharge
41
Polycystic kidney disease
Cysts form which cause hypertrophy of the kidneys leading to cystic rupture, infection, formation of scar tissue and damaged nephrons.
42
Symptoms of polycystic kidney disease
1. Flank, lumbar or abdo pain relieved by lying down 2. fever and chills 3. recurrent UTIs 4. Hematuria, proteinuria and pyuria
43
Hydronephrosis
Distention of the renal pelvis due to a stone blockage and urine backing up behind it. Surgery required to remove the stone.
44
Symptoms of hydronephrosis
1. Dull flank pain radiating to the groin 2. Hypertension 3. Headhead
45
Cytoscopy
Insertion of a catheter to move or bypass renal stone.
46
Extracorporeal shock wave therapy
Ultrasonic waves used to break up renal stones (non-invasive)
47
Percutaneous lithotripsy
Guide inserted and ultrasonic wave emitted near renal stone to break it up (invasive)
48
Epididymitis
Acute or chronic inflammation of the epididymis that occurs as a result of an STI, UTI, prostatitis and long term catheter use.
49
Benign Prostatic Hypertrophy
Slow enlargement of the prostate gland with hypertrophy and hyperplasia of normal tissue.
50
Where is pain referred with bladder trauma?
The shoulder
51
How do you determine the patentcy of an arteriovenous fistula?
Palpate for a thrill or listen for a bruit.
52
What are the symptoms of urethritis?
- Dysuria | - purulent discharge
53
Symptoms of epididymitis
- fever - nausea - vomiting - scrotal pain - chills
54
Kock's pouch
Continent internal reservoir, patient will self-catherize in order to void.
55
Typical time and length of hemodialysis
3 days a week, 3-4 hours per day
56
Dialysis precautions for infection risk
Mask for nurse and patient
57
Common symptom of Polycystic Kidney Disease
Flank pain and hematuria
58
How is fluid given amount established after a transplant
Number of mls given at a rate equal to the number of mls of the previous hours output.
59
Transurethral resection of prostate syndrome
Increased absorption of non-electrolyte fluid used during surgery.
60
Symptoms of transurethral resection of prostate syndrome
- bradycardia - confusion - disorientation - muscle twitching - visual disturbance
61
Fluids that acidify urine
- prune, apricot, cranberry and plum juice
62
Peritoneal dialysis good for patients with these conditions:
1. Heart disease 2. Diabetes Good because of slow shift in fluid, fast in hemodialysis.
63
Hypovolemia, what blood product prescribed?
Albumin as a plasma expander.

NCLEX (48 decks)

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