A&P I
What is the primary function of the kidneys?
maintain f/e and filter waste for elimination pg 1321
What is BUN?
blood urea nitrogen. Measures the effectiveness of the kidney excretion of urea nitrogen which is a byproduct of protein breakdown in the liver. Kidneys filter out urea from blood and excrete into urine. High BUN suggests kidney problems. Pg 1331
What normal flora produced in the bladder helps to prevent cystitis?
Mucin pg 1327
Type of incontinence associated with increased abdominal pressure (coughing, sneezing) that causes leaking of urine.
stress incontinence pg 1345
What is hydronephrosis?
enlargement of the kidney from blocked urine lower in the tract that fills the kidney up with urine -> damage. Pg 1361
From which artery does the kidney receive its blood supply?
Renal artery pg 1322
What time of day should a urinalysis be given for best results?
first void. Pg 1334
What is the most common cause of UTIs in hospitalized patient?
catheter usage. Pg 1368. Prevention chart 66-1 pg 1356
What is the first laboratory test performed on patient who presents with incontinence?
urinalysis pg 1347
What are 3 manifestations of urolithiasis?
severe pain (when stone is moving), nausea, vomiting, pallor, diaphoresis, oliguria/anuria, bladder distention, higher VS (pain or infection). Pg 1362
What hormone is produced in the kidneys that helps regulate BP?
Renin pg 1324
What is urine specific gravity?
concentration of particles (lytes and water) in the urine. High levels (more concentrated urine) happens with decreased kidney function, dehydration, or meds used during surgeries/anesthesia. Low levels (dilute urine) happens with high fluid intake and diuretics. Pg 1332
What are the three manifestations of a UTI?
frequency, urgency, dysuria, cloudy/foul smelling urine. Pg 1357
This type of exercise is used to help strengthen the pelvic floor muscles in stress incontinence?
Kegel exercises. Pg 1347
Your patient has been diagnosed with urolithiasis. What nursing intervention should be performed every time the patient voids?
strain urine, if stone collected – take to lab immediately for analysis. Pg 1364
What does the glomerulus filter out?
small particles – water, electrolytes, and creatinine. Does not filter out large molecules (blood, albumin, or proteins) therefore, should not be present in the urine. pg 1324
What is contrast-induced nephropathy and how do we prevent it
contrast dye that causes AKI within 24-72h of admin. Should always be given fluids prior to and afterward to monitor for AKI (especially those with dehydration, older, or pre-existing renal problems. Pg 1338
What is one of the two antibiotics that specifically work in the bladder for an UTI?
fosfomycin or nitrofurantoin. Pg 1359
What is bladder training?
chart 66-5 pg 1351. Void q45min and ignore sensation to void in between times. Decrease time by 15min until patient able to stay continent. Once patient is able to stay continent, increase time by 15min until patient is able to go 3-4hr without voiding.
Fluid intake is important to prevent stone formation in the GU system. How much water should a person drink a day (unless contraindicated)?
at least 3L/d or until urine is clear/yellow. Pg 1366
chart 66-11
What is the renal threshold and how does it pertain to DM?
able to filter out up to 200mg/dL of glucose. After this, glucose will be put into urine (“spilled out”) instead of being reabsorbed back into the blood stream. pg 1325
How do you collect a 24h urine specimen? (the whole process).
measures urine levels of creatinine, urea, sodium, chloride, Ca, etc. with all urine collected in 24h period. Must be refrigerated or on ice for entire time. First void is discarded. Must be free of stool and blood. Pg 1334-35
List two nursing interventions for cystitis?
drink enough fluid to keep urine a clear/yellow color, cranberry supplements, avoid caffeine/sodas/tomato products. Pg 1357 chart 66-8
A patient present with neurogenic bladder. What is the best way for this patient to a completely empty bladder?
intermittent self-catheterization. Pg 1351
Name two types of urinary diversions for a patient who will be undergoing a cystectomy.
Figure 66-4 pg 1368. Ureterostomy (ureters directly out to a stoma – wears a pouch), conduits (ureters connected to intestines then to stoma – wears a pouch), sigmoidostomy (ureters connected to sigmoid colon and excreted with stool – no stoma), and ileal reservoir (pouch surgically created to make a new bladder – straight catheted).