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ABSN NUR 326 > Week 3: Urology > Flashcards

Week 3: Urology Flashcards

(92 cards)

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1
Q

What is Nephrolithiasis?

A

Kidney Stones

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2
Q

Cause of obstruction in renal pelvis?

A

renal calculi

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3
Q

Causes of obstruction in ureter?

A

renal calculi, pregnancy, tumors

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4
Q

Causes of obstruction in bladder and urethra?

A

bladder cancer, neurogenic bladder, prostatic hyperplasia (BPH), prostate cancer, urethral strictures (narrowing)

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5
Q

Complications with urological obstructions?

A

stasis of flow, increase chance of infection, back up pressure causing hydronephrosis and hydroureter, AKI

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6
Q

Who is at risk for kidney stones

A

men, white, age 20-30, family hx, renal defect, weather (increase temp=increase risk of dehydratio), obesity

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7
Q

What are kidney stones?

A

crystallized solutes in urine

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8
Q

What are the 3 types of kidney stones?

A

calcium oxalate, struvite (staghorn), uric acid

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9
Q

Risks for calcium oxalate related kidney stones

A

family hx, hypercalcemia, oxaluria

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10
Q

Risk for struvite related kidney stones

A

UTIs

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11
Q

Risk for uric acid related kidney stones

A

gout

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12
Q

S/S of kidney stones

A

renal colic (waves of pain when ureter moves urine), nausea, flank pain, diaphoresis, tachycardia, tachypnea, and s/s of UTI

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13
Q

Treatment for kidney stones

A

help with pain, hydration (IV or PO)

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14
Q

Preventative meds for kidney stones

A

calcium oxalate= thiazide dieuretics
struvite= antibiotics
urate (uric acid)= allpurinol (med for gout)

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15
Q

Protective factors in urine to prevent UTI

A

pH, uni-directional, urea, immune system, women=urethral gland secretions, men=prostatic secretions

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16
Q

UTI risk factors

A

women, CAUTI, age, pregnancy, sexual activity, urinary obstruction, immobility, incontinent

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17
Q

What is pyelonephritis?

A

inflammation of the kidneys

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18
Q

Etiology of pyelonephritis

A

an ascending infection from lower UTI or blood infection

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19
Q

S/S of pyelonephritis

A

fever, chills, CVA tenderness, UTI

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20
Q

Complication of pyelonephritis

A

urosepsis

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21
Q

Treatment of pyelonephritis

A

bactrim, cipro, and vanco

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22
Q

Most common kidney cancer

A

renal cell carcinoma (85%)

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23
Q

S/S of kidney cancer

A

early=NONE, late= CVA tenderness, hematuria, palpable mass, and possible metastasis symptoms (lung= resp distress, etc)

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24
Q

Treatment of kidney cancer

A

surgery and chemo

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25
Risk factors for kidney cancer
SMOKING, obesity, age, male and genetics
26
Most common bladder cancer
urothelial carcinoma (>90%)
27
Risk factors for bladder cancer
SMOKING, male, exposure to toxins, and decreased fluid intake
28
S/S of bladder cancer
early=hematuria, late=urinary frequency, urgency, and dysuria
29
Treatment for bladder cancer
stage 1 (early)= intravesical chemo late= systemic chemo
30
Define intravesical chemo
chemo that is administered locally to the effected area
31
BCG vaccine
intravesical treatment for bladder cancer
32
MOA for BCG vaccine
stimulates an inflammatory response where it is injected
33
S/E of BCG vaccine
bladder irritation and risk of infection
34
Instructions for administering BCG vaccine `
empty bladder before administration, wait 2 hours and change positions q15
35
Azotemia definition
the s/s due to decreased kidney filtration
36
Oliguria definition
decreased urine output (<400mL/day)
37
Glomerular Fraction Rate (GFR) lab
amount of blood that is being filtered through the kidneys (mL/min)
38
Normal BUN value
10-20mg/dL
39
Normal Cr value
0.5-1.2mg/dL
40
Normal BUN/Cr ratio
10:1
41
Normal GFR value
<90mL/min
42
Chronic Kidney Disease (CKD) definition
kidney damage for more than 3 months with or without a GFR <60
43
Risk factors for CKD
family hx, age >60, male, african american, HTN, DM, smoking, and obesity
44
Someone with CKD cannot...
maintain acid-base balance, remove waste production from metabolism, or maintain F/E balance
45
Three key characteristics of CKD
glomerulosclerosis, interstitial fibrosis, and interstitial inflammation
46
GFR for Stage 1
>90 (normal)
47
GFR for Stage 2 CKD
60-89
48
GFR for Stage 3 CKD
30-59
49
GFR for Stage 4 CKD
15-29
50
GFR for Stage 5 CKD (end-stage)
<15
51
S/S for Stage 1 CKD
asymptomatic
52
S/S for Stage 2 CKD
asymptomatic w/ possible HTN
53
S/S for Stage 3 CKD
HTN
54
S/S for Stage 4 CKD
Manifestations start showing, s/s of F/E imbalance, acid-base imbalance, and inability to rid of metabolic waster. This is often when someone would get diagnosed
55
S/S for Stage 5 CKD
s/s of all stages and uremia (retention of metabolic waste, shown in BUN)
56
What s/s come from F/E imbalance in CKD?
edema, hyperkalemia, hyperphosphatemia, hypermagnesemia , acidosis
57
What s/s come from not urinating in CKD?
anorexia, malnutrition, itching and CNS changes
58
What s/s come from decreased erythropoietin in CKD?
anemia
59
What s/s come from decreased vitamin D in CKD?
renal osteodystrophy
60
Treatment for CKD
treat the HTN with an ACE or ARB, treat the HLD with a statin, and treat the symptoms/complications of CKD
61
Pharmacotherapy for CKD
ACE or ARB, statin, loop diuretic, sodium bicarbonate, calcium carbonate, calcitriol, and erythropoietin
62
Indication for Sodium Bicarbonate
metabolic acidosis
63
Indication for Calcium Carbonate
hyperphosphatemia
64
Indication for Calcitriol
renal osteodystrophy
65
Indication for erythropoietin
anemia
66
Calcium carbonate MOA
binds to phosphate, so you MUST take with meals bc majority of PO4 intake is through diet
67
S/E of calcium carbonate
hypercalcemia
68
MOA for calcitriol
activated form of Vitamin D which stimulate absorption of Ca and PO4
69
S/E of calcitriol
hyperCa, HyperPO4, GI upset, bone pain, cardiac arrhythmias, neuro changes
70
What medication are contraindicated with CKD?
Digoxin, DM meds= glyburide, metformin, antibiotics= vanco (must be renally dosed), opioids
71
What is the functional unit of the kidney
nephrons
72
Define glomerulonephritis
inflammation of glomeruli, can be local (1 kidney) or diffuse (both kidneys)
73
What is glomerulus?
network of arterioles within the bowmans capsule in the kidneys
74
What are the three layers of the glomerulus?
1. endothelium 2. basement membrane 3. podocytes (special epithelial cells)
75
Etiology of glomerulonephritis
2 types 1. Type II sensitivity where anti-GBM antibodies attack basement membrane (5% of accounts) 2. Type III sensitivity where antibodies deposit complexes in the basement membrane (90% of accounts)
76
Triggers for glomerulonephritis
post infection, Berger (primary disease), systemic autoimmune (Lupus, Goodpasture)
77
S/S of glomerulonephritis
H.A.R.P= hematuria, azotemia, retention, and proteinuria HTN, increased BUN, increased Cr, fluid retention, and oliguria
78
Pharmacotherapy for glomerulonephritis
steroids, diuretics, immunosuppressants, ACE and ARBS for HTN possible dialysis if serious enough
79
Causes of glomerulopathy
DM nephropathy, and hypertensive glomerular disease
80
Pathology of glomerulopathy caused by DM nephropathy
thickening of basement membrane
81
Pathology of glomerulopathy caused by HTN
decreased renal prefusion causes sclerotic glomerular changes
82
What is nephrotic syndrome ?
the glomerulus is too permeable to plasma proteins (albumin) so there is an increase in urine (>3g/day)
83
S/S of nephrotic syndrome
edema, HTN, HLD, hypercoagulation (due to loss of antithrombin II and plasminogen)
84
What is an Acute Kidney Injury (AKI)
decreased volume and perfusion to the kidneys due to exposure to toxins or sepsis
85
What are the three classes on AKI
1. prerenal 2. intrarenal 3. postrenal (RARE)
86
What is the prerenal class of AKI?
inadequate prefusion
87
What is the s/s of prerenal AKI
decreased BP, hypovolemia, sepsis, vasoconstriction, and renal artery stenosis (narrowing) decreased GFR
88
What is intrarenal AKI?
acute tubular necrosis
89
What are the s/s of intrarenal AKI?
hypotension and volemia inflammatory response
90
What is postrenal AKI?
urinary tract obstructions, super rare
91
Lab changes for AKI
decreased GFR, decreased UOP, increased BUN, increased Cr,
92
Treatment for AKI
stabilize the patient until kidney function returns and treat the cause

ABSN NUR 326 (10 decks)

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