Trace the path of urine from start (beginning) to end (exit from body)
What is ... urine formation in nephrons (kidneys) --> ureters --> bladder --> urethra --> urinary meatus.
100
How will labs change with kidney disorders?
What is - elevated BUN, creatinine. Maybe elevated electrolytes (ex: K+, PO4++). Perhaps decreased H&H.
100
List one urinary analgesic. What are 2 important nursing considerations?
What is phenazopyridine hydrochloride (pyridium). Only treats pain, not the infection. May discolor urine orange or stain contacts.
100
List s/s associated with acute cystitis
What is ... dysuria, pyuria (foul smelling, cloudy urine), urgency and frequency, suprapubic discomfort. confusion in the elderly
100
what is pyelonephritis and what is the most common cause?
What is ... an infection in the kidney. E. coli
200
Describe polyuria, oliguria, and anuria
What is ... polyuria - increased urination, oliguria - decreased urination, anuria - absence of urination.
200
List nursing 4 nursing considerations for the pt undergoing a renal biopsy
What is ...informed consent. pt NPO 4-6 hrs pre. Coagulation studies. Monitor for bleeding (VS, urine output, H&H, flank pain). Monitor for hematuria. Pt in supine position with back roll.
200
What is the class and purpose of the medications aluminum hydroxide (Amphojel) or sevelamar hydrochloride (Renagel)?
What is ... phosphate binder. Binds to phosphate in the body so that the electrolyte can be eliminated via the GI tract. To manage hyperphosphatemia.
200
hydronephrosis is often the result of which renal disorder?
What is... renal calculi
200
What is the priority nursing care for the pt with urolithiasis.
What is pain managment with meds such as meperidine (demerol) or ketorolac (Toradol)
300
List 3 hormones that acts on your renal system or comes from the renal system and what they do.
What is Renin (from the kidney)= activates the RAS to increase the BP.
Erythropoeitin (from the kidney)= stimulates bones to make RBCs.
Aldosterone (from the adrenal gland)= Increases Na+ absorption and H20 to increase BP.
ADH (from the posterior pituitary gland) = Increases salt, and therefore, H20 reabsorption in the kidney tubules
300
List 3 nursing considerations regarding procedures using radiopaque dye
What is ... instruct the pt to increase fluids to flush renal system. Assess for allergies (shellfish, iodine). NPO after midnight. Assess for SOB, rash, pruritus. Etc.
300
What is the medication oxybutynin chloride (Ditropan) class and use?
What is ... anticholinergic to treat over active bladder by inhibiting bladder contractions, neurogenic bladder.
300
what is PKD? what are the s/s?
What is ... an autosomal dominant inherited trait causing kidneys to fill with fluid filled cysts that enlarge the kidneys. --> kidney failure. s/s = HTN, HA, lumbar and flank pain, widening abd girth, swollen/tender abd. enlarged kidneys
300
List diet modications for the pt with nephrotic syndrome
What is ... adjusted with GFR. protein based on proteinuria. low Na+, small/frequent meals.
400
List normal and abnormal components of urine
What is normal = nitrogenous wastes (urea, uric acid, creatinine), Electrolytes (K+, Na+, PO4-, etc), pigment.
Abnormal = glucose, albumin, blood, ketones, WBCs, casts
400
What is a cystoscopy and list important nursing considerations
What is - lighted, magnified scope inserted into bladder for direct visualization. Pink tinged urine normal (not gros hematuria). Push fluids post. Sitz bath for pain. Monitor for retention post procedure (monitor I&O).
400
List anticholinergic side effects
What is ... dry mouth, dry eyes, urinary retention, blurred vision, constipation, drowsiness
400
What are s/s of the pt with renal failure
What is ... HTN, edema, s/s of fluid excess, bleeding disorders (d/t low Ca+), pruritis, uremic frost and halitosis. Labs (GFR down, BUN/serum creatinine up, e- mostly up)
400
Which illness is glomerulonephritis usually tied with. How might they test for it?
What is ... group A beta hemolytic streptococcus (strep throat. They will take a throat culture or an ASO titer
500
Daily Double: Describe the RAS process.
What is ... increased blood osmalality triggers the kidney (Juxtaglomerular apparatus) to release renin. Renin then acts on the enzyme angiotensinogen (from the liver) to make it Angiotensin 1. Then ACE from the lungs turns Angiotensin 1 into Angiotensin 2. Angiotensin causes vasoconstriction and increased thirst. It also tells the adrenal glands to secrete aldosterone and the pituitary gland to secrete ADH which tells your kidneys to retain salt and H20. --> increased BP
500
What is the TURP procedure indicated for. List important nursing considerations.
What is ...Continuous bladder irrigation. Expected pink tinged urine. Gross hematuria is a problem, we must intervene. Monitor for hemorrhage is priority. Give abx therapy prophylaxis. Monitor VS and UO.
500
List a popular drug for each classification of diuretics and important nursing considerations for each.
What is ...
Carbonic anyhydrase inhibitors = acetazolamide (Diamox): used for glaucoma, monitor for eye pain relief.
Loop diuretics = furosemide (Lasix): potassium wasting diuretic, used for edema and HTN, monitor e- and BP, side effect ottotoxicity.
Osmotic diuretics = mannitol (Osmitrol): used to treat ICP and IOP. used only in acute setting. Causes fluid shifts.
Potassium sparing diuretics = spironolactone (Aldactone): K+ sparing diuretic. Monitor for hyperkalemia and gynecomastia
Thiazide diuretics = hydrochlorothiazide (HCTZ). used for HTN, edema with CHF. etc. monitor for acute attack of gout
500
What is the pathophysiology of nephrotic syndrome
What is ... leaky glomerular membrane allows large molecules to pass through into filtrate causing proteinuria and hematuria. proteinuria means there is no albumin in the blood (hypoalbuminemia) --> decreased oncotic pressure. This leads to edema and reduced blood volume. The liver tries to compensate by making lipoprotein which causes hyperlipidemia.
500
List foods high in K+ and PO4-
What is ... K+ = fruits. PO4-= dairy, nuts, whole grain bread, poultry, etc.