Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

NUR205 > Week 11 > Flashcards

Week 11 Flashcards

(53 cards)

Start Studying
1
Q

Renal function helps…

A

Renal function helps maintain the body’s state of homeostasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

The function of renal and urinary systems is

A 
Regulating fluid and electrolytes (excretion/re-absorption):
Fluid balance 
Acid-base balance 
Electrolyte balance 
Removing wastes

Providing hormones: 
Red blood cell production
Erythropoietin
Bone metabolism
Assists in conversion of Vitamin D to maintain calcium balance
Blood pressure regulation
Renin/Prostaglandins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Subjective data - patient assessment

A

Past medical history and pre-existing conditions: (Diabetes/hypertension/calculi/childbirth/STDs)

Medications (allergies):
potentially nephrotoxic (gentamycin/captopril/NSAIDs/aspirin)
others change urine colour (nitrofurantoin/dantrolene)
increase urine output (diuretics)
alter sphincter function/bladder contraction (Ca. channel blockers/antidepressants/antihistamines)
haematuria (anticoagulants)

Past surgical history/treatments – related to this system
Functional health pattern questions:
Changes in voiding habits/haematuria/pain (dysuria)
Family history

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Objective data - patient assessment

A

Physical examination:
Especially abdominal and kidney palpation
Presence of oedema
Bladder percussion
Digital (rectal) prostatic palpation (DRE)
Inspection of genitalia/urinary meatus
Abnormal anatomy (female circumcision/”whistle-cock”)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Diagnostic tests for renal and urinary system

A

Urinalysis - baseline information – 1st am spec.
24 hr urine collection - creatinine/protein/specific components
Empty bladder at designated time
MSU/catheter spec.
Residual urine – left in bladder after urination (< 50-150mls)
Blood tests – specifically creatinine & urea
Radiological – x-rays/IVP/ultrasound/CT Scan/MRI/’scopes
Radionuclide Imaging/biopsy/cystoscopy
Renal function tests

Patient preparation
? Full bladder/? Encourage fluids/? fasting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

The prostate gland

A

encircles the urethra just below the neck of the bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Benign prostatic hyperplasia (BPH)

A

Proliferation of cells leading to increase in gland size
Occurs in 50% of men over 50 yrs/90% of men over 80 yrs/etc
Depending on lobe affected can gradually compress (and obstruct) urethra

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Prostate cancer

A

Malignant tumour affecting 1 in 11 Australian men/kills 20-25% of those diagnosed
Earlier detection leads to better/more successful treatment
Can lead to urinary retention/obstruction
Frequently diagnosed by pain/fracture after it metastasises

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Clinical manifestations of benign prostatic hyperplasia

A 
Mild to severe
Mild weakening of urinary stream
Frequency
Hesitancy
Dribbling
Incomplete bladder emptying
Retention
Nocturia
Urgency
Dysuria
Incontinence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Treatment of benign prostatic hyperplasia

A

Depends on severity of symptoms/age & condition of pt.
Conservative
“watchful waiting”/dietary changes/bladder training
Medication
anti-androgenics (finasteride)/alpha adrenergic agonists (prazosin)

Surgical :
Microwave thermotherapy/needle ablation
Laser prostatectomy/electrovaporisation
Transurethral resection prostate (TURP) – most common 
(open) radical prostatectomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Urinary retention is

A

Inability of the bladder to empty completely

types: chronic or acute

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Residual urine is the

A

Amount of urine left in the bladder after voiding

Generally 100/150 mLs on 1/2/3 occasions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Assessment of urinary retention

A

Subjective – feel “empty” or “full”/dysuria/previous problem

Objective – pt. dribbling/monitor output (“fluid balance”)distension /palpation/percussion/pt. restless or agitated/bladder scan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Nursing measures to promote voiding

A 
Set environment (privacy)/running water /baths/warm compresses
Catheterisation may be necessary to prevent bladder overdistension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Benign prostatic hyperplasia common surgery is

A

Trans Urethral Resection of Prostate (TURP)
Under general or spinal anaesthetic
From 15 mins to 2-3 hours depending on size of prostate
Complications minimal (haemorrhage/hyponatraemia/infection)
Post-op - large bore 3 way catheter/bladder washout (BWO)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Nursing management for Trans urethral resection of prostate

A

Preop - ? retention - IDC/UTI – antibiotics/education
Postop
Bladder Washout
Accurate monitoring and measurement of input/output essential

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Urinary tract infections are classified according to

A

Lower tract – urethritis/cystitis/prostatitis (dysuria/generally unwell)
Upper – pyelonephritis/interstitial nephritis/renal abscess
Complicated (IDC/obstruction/stone/pregnancy/recurrent)
Uncomplicated – in otherwise normal tract
Initial or recurrent
Unresolved or persistent
Bacteria type

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Urinary tract sterility is maintained by

A 
Complete emptying of bladder
Antibacterial capabilities of mucosa
Peristaltic actions of urethra
Vesico-ureteric competence (valve/trigone angle/musculature)
Urine acidity (<6.0) and flow
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Predisposing factors for UTI

A

Obstruction (stone/stricture/BPH)
Urinary retention/incomplete bladder emptying (high ‘residuals’)
Foreign objects (catheterisation/stents)
Sex/age/immunological/pregnancy/hormonal/hygiene/anatomical
Immunosuppression
Co-morbidities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

UTI diagnosis

A

Via urine dipstick test(indication not diagnostic)
MSU
Clinical manifestations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

UTI - lower urinary tract clinical manifestations

A 
Dysuria
Frequency
Urgency
Nocturia
Weak stream
Dribbling
Hesitancy
Intermittency
Incomplete emptying of bladder
Haematuria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

UTI - upper urinary tract clinical manifestations

Study These Flashcards
A 
Dysuria
Frequency
Urgency
Nocturia
Weak stream
Dribbling
Hesitancy
Intermittency
Incomplete emptying of bladder
Haematuria
Abdominal/flank/supra-pubic pain
Vomiting/diarrhoea
Fever/chills
Confusion
General malaise
23
Q

UTI - upper and lower urinary tract in older patients clinical manifestations

Study These Flashcards
A

Confusion/lethargy
Frequency/urgency/dysuria
Anorexia
Low grade febrile episodes

24
Q

Prevention of UTI

Study These Flashcards
A

Avoid indwelling catheters, aseptic insertion & hygienic care of catheters
Personal hygiene
Void after sex/wipe front to back
Medications as prescribed:
Antibiotics, analgesics, and antispasmodics
Increased fluid intake
Avoid urinary tract irritants such as coffee/tea/citrus/spices/ cola/alcohol
Frequent voiding/reduce urine retention
? Prophylactic cranberry juice
Patient education

25
Treatment of UTI
Antibiotics ``` Recurrent UTIs: Prophylactic antibiotics Investigate abnormalities/treat cause Cranberry juice(?) Patient education ```
26
Renal failure is
partial or complete kidney dysfunction Leads to accumulation of metabolic wastes Leads to alteration in fluid/electrolyte and acid-base balance
27
Acute renal failure
Rapid loss of renal function (hours or days) Decreased GFR & ? oliguria Reversible (potentially) but high mortality rate More common in elderly
28
Chronic renal failure
Slow insidious and irreversible | Can have acute on chronic episodes
29
End-stage renal disease
Final, irreversible stage of chronic renal failure
30
Azotaemia is the
accumulation of nitrogenous wastes
31
Uraemia is
symptomatic changes in multiple body systems due to progressive azotaemia
32
Glomerular filtration rate
~ 100 - 120 ml/minute
33
Catabolism is the
breakdown of body proteins
34
Acute renal failure - pre renal
Factors that decrease renal blood flow: Hypovolaemia (haemorrhage) Dehydration/nausea & vomiting Decreased cardiac output (heart failure/MI) Decreased peripheral vascular resistance (septic shock) Decreased renal blood flow (renal vein emboli)
35
Acute renal failure - intrarenal
``` Factors that cause direct damage to the renal parenchyma: Nephrotoxic injury (drugs – gentamycin/heavy metals) Infection (pyelonephritis/glomerulonephritis) Thrombosis Toxaemia (pregnancy) Malignant hypertension SLE (systemic lupus erythematosus) ```
36
Acute renal failure - post renal
``` Mechanical obstruction BPH Bladder cancer Renal calculi Neuromuscular disorders Prostate cancer Spinal cord diseases Strictures Trauma ```
37
Phases of acute renal failure
1. Initiation phase From time of injury to clinical manifestations evident 2. Oliguric (Maintenance) phase Notable fall in GFR and tubular damage Uraemic symptoms and oedema increase/hypertension Confusion/fatigue/acid-base imbalance/anaemia/ECG changes (hyperkalaemia) 3. Diuretic (maintenance) phase Glomeruli and tubules still dysfunctional High urine volume/still severely uraemic with all it’s affects Dehydration potential 4. Recovery Phase (3 – 12 months) Glomerular and tubular repair and regeneration Gradual recovery and improvement in all areas
38
Clinical manifestations of acute renal failure
Potentially evident in every body system Persistent nausea & vomiting & diarrhoea Lethargy/general malaise/fatigue Signs of dehydration (dry mucous membranes/skin) Uraemic fetor CNS symptoms Twitching/drowsiness/headache/seizures Urine output variable according to the stage of ARF (~20mLs/hr) ECG changes Haematuria
39
Diagnosis of acute renal failure
Urinary changes/blood tests/renal function tests/scans
40
Treatment of acute renal failure
Detect & resolve the underlying cause Treat the clinical manifestations & prevent complications Nutritional support Continuous renal replacement therapy (haemodialysis) Used more frequently for early intervention to prevent complication and recovery Medications: IV fluids/volume expanders to improve renal perfusion Diuretics to increase urine output (decrease fluid overload/washout wastes) Antihypertensives to decrease blood pressure NSAIDs/nephrotoxic drugs ceased Proton-pump inhibitors/other to prevent GI haemorrhage Calcium resonium to decrease hyperkalaemia (!) All drug doses need to be titrated carefully as most are excreted through the kidneys
41
Nursing care for acute renal failure
Monitoring: Vital signs/skin assessment (for dehydration) Subjective & objective assessment (cardiac/pulmonary function) Fluid balance monitoring (intake and output) - strict Previous 24 hrs output + 600mls (insensible loss) - ??? Daily weight/regular oral hygiene Administer drugs (& monitor for side effects) Monitor lab. results (frequent) General nursing care (skin)/bed rest (reduce metabolic rate) Asepsis Patient & family support/education Nutritional (dietician monitored) Balance bodily requirements with preventing fluid & electrolyte disorders Daily kilojoules – 125-150kj/kg Increased carbohydrates to provide energy (& spare protein) Protein (high in essential amino acids) – 0.6-2.0g/kg (restricted) Potassium in diet dependant on serum levels (restricted) Sodium (restricted to decrease oedema) Phosphate (restricted) ``` Enteral feeding (TPN – Total Parenteral Nutrition) if unable to eat/drink but will likely require haemodialysis to remove extra fluid Fluid balance monitoring (intake & output) – strict/daily weight ``` All fluid and food is measured/weighed/specially prepared
42
Chronic renal failure is the
Result of chronic disease processes with gradual destruction of glomerular filtration and tubular function Can be as a result of ARF where full recovery not achieved
43
Chronic renal failure management
Preserve existing renal function Preventing and managing complications Providing psychological support Pharmacological: Complex as many drugs are excreted via the kidneys Treat underlying cause of CRF and associated conditions Manage clinical manifestations Diuretics/antihypertensives/resonium/phosphate binders etc Nutrition and fluid management: Nutritional and fluid management in line with ARF
44
Nursing care of chronic renal failure
(Basically as per ARF) Fluid management Nutritional management Full nursing care Patient self management: Educate and encourage Community resources and support groups Depends on setting – home/regional/tertiary hospital
45
End-stage renal failure
Requires renal replacement therapy Haemodialysis Peritoneal dialysis Kidney transplantation Either in-hospital or at home
46
Urinary catheterisation diagnosis
Monitoring urine output Instillation of radio-opaque dye/medications Obtaining specimens
47
Urinary catheterisation treatment
``` Obstruction/retention Post procedure (surgery/childbirth) ```
48
Urinary catheterisation types
Intermittent/indwelling Insertion into bladder/ureter/kidney Ileal diversion (bags)
49
Urinary catheterisation complications
``` Only if necessary Bladder scanners instead of residual catheters UTIs (during insertion/while inserted) Track for infection Mucosal irritation Invasive and embarrassing Bladder spasms Urethral false passage/rupture Urethral strictures Pressure necrosis Allergy (most now latex free) ```
50
Supra-pubic catheterisation
Temporary Post surgical/Post trauma Permanent Urethral destruction Patient choice (? easier care if paralysed) Residual urine pre removal (clamp for 4 – 6 hrs/pt attempts to void then unclamp & drain. 2 x successful residual urines under 100/150 - removed)
51
Advantages to supra-pubic catheterisation
Comfort & mobility/less UTI/spont. voiding post removal easier
52
Complications of supra-pubic catheterisation
Encrustaceans/bladder stones/UTIs/presence of wound | Requires more specialised care
53
Nursing management of indwelling (urethral) catheter
Depends on type/indication Monitor drainage:e Amount/colour/odour Fluid balance chart Secure catheter (an issue of importance): With traction (if ordered) for tamponade (post TURP bleeding) Prevent urethral erosion/comfort/accidental removal/leakage For men – abdomen or upper thigh (varying practice) For women – upper thigh Surgical tape or proprietary device (varies) Monitor for infection

NUR205 (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions