Renal Basics
Functions of Kidneys
The kidneys regulate fluid, electrolytes, acid-base balance, blood pressure, and produce erythropoietin.
Care of Nephrostomy Tubes
Nurses ensure nephrostomy tubes remain patent, prevent infection, and monitor urine output carefully.
Medication that causes urine to turn orange and can stain clothing
Phenazopyridine (Pyridium)
Does not treat the infection, relieves the symptoms of a UTI
Types of Incontinence
Urge (strong need to void when bladder is not full)
Stress (Weak pelvic floor)
Mixed (combo urge and and stress)
Overflow (Underactive bladder muscle)
Functional (Can't get to bathroom in time)
Reflex (Contraction without warning or urge)
Cystitis
This type of UTI causes bladder discomfort and requires hydration and antibiotics for effective treatment.
What are some prevention techniques for UTI's?
Proteinuria
Indicates damage to the kidneys
Urine culture and sensitivity specimen
Proper clean-catch technique involves perineal cleaning and midstreamurine collection to avoid contamination and ensure accurate results.
Medication that requires careful monitoring of renal function and drug levels to avoid nephrotoxicity and hearing loss.
gentamicin (Garamycin)
Grey-Turners Sign and Cullen's Sign
Grey Turner sign: Bruising over flank/lower back → retroperitoneal bleeding.
Cullen’s sign: periumbilical → intraperitoneal hemorrhage
Nephrotic Syndrome
Massive Proteinuria, Hypoalbuminemia, and Edema
Monitor daily weights!
Purpose of the Glomerulus
Fluids, electrolytes, and other substances are filtered out of the blood as it passes through the glomerulus
Urinary Diversion Surgery Post-Op
Stoma should be pink and moist; protect skin with barriers, monitor mucus in urine, assess bowel sounds, and educate patients on appliance management.
This medication binds with phosphorus to increase serum calcium
Aluminum Hydroxide (Amphojel)
Age-Related Urinary Changes
Decreased renal blood flow, decreased ability to concentrate/dilute urine, nocturia, decreased erythropoietin, sclerosis of renal blood vessels
Acute Kidney Injury
Initiation, oliguric, diuretic, and recovery. Sudden onset, reversible
BUN and Creatinine levels
Help assess kidney function (creatinine) and indicate dehydration or reduced filtration (elevated BUN)
*BUN/creatinine ratio: What is going on if it is elevated/decreased?
Catheterization and Infection Control
Aseptic catheter insertion, secure device placement, closed drainage, empty when half full, ensure tubing is patent, perform peri care twice a day, and bag positioning prevent infections and trauma.
Medication that smooths bladder muscles to treat incontinence
oxybutynin (Ditropan)
Risk Factors for Bladder Incontinence
Age, chronic illness, medications, and environment.
Chronic Kidney Disease
Irreversible, need dialysis to treat
DAILY DOUBLE
Renal Calculi
Urinary calculi cause severe flank pain and hematuria, requiring pain monitoring and possible lithotripsy.
Hemodialysis vs Peritoneal Dialysis
Hemodialysis: The machine is the filter, AV fistula (feel the thrill, hear the bruit, monitor for patency), 3-4 times a week, depression/suicide risk, no constriction (BP, needle sticks, tight clothing) on fistula arm
Peritoneal Dialysis: Peritoneal cavity is the filter, More freedom and independence, 2000-2500 ml of fluid for 10 minutes, dietary needs (increase fiber and protein), risk for peritonitis
Renal Transplantation Post-Op Care
Monitor urine output (30ml/hr), Monitor fluid/electrolyte, monitor color of urine (pink-tinged/hematuria is common immediate post-op), monitor vital signs, monitor for signs of rejection (fever, increased BP, decreased urine output, Increased BUN/creatinine)
DAILY DOUBLE
Glomerulonephritis
Main cause: Strep Group A
Benign Prostatic Hyperplasia