kidney failure
A person who experienced a trauma to their abdomen is at risk for developing which type of kidney failure?
AKI (acute kidney failure/acute kidney injury)
Specifically, you could also have put Pre-renal AKI
Before accessing a dialysis fistula, the RN should auscultate for a
bruit
The medical term for a kidney stone is
Urinary Tract Calculi
Pyridium causes:
Relaxation of smooth muscle of the urinary tract
Bring orange urine
Which diuretic is potassium sparing? Lasix (furosemide) or spironolactone (Aldactone)
spironolactone
Labs to monitor to determine AKI - List 2
BUN
Creatinine
GFR
Before accessing a dialysis fistula, the RN should palpate for a
Thrill
List 3 factors that may contribute to kidney stone formation
Living in a warm climate
Drinking large amounts of caffeine
Not drinking enough water
Age 20 to 55
Heredity or person history of stones
Obesity
Sedentary Lifestyle
Dietary influences
What orders would you anticipate for a patient admitted for an acute injury to their abdomen to protect them from developing AKI. List at least 2.
IV fluids
Strict I&Os
Labs to check BUN & Creatnine
Labs to check for hypovolemia from blood loss
Name a urinary analgesic
Pyridium (phenazopyridine)
List the two most common Erythropoietin therapy medications for patients in CKD
Epogen and Procrit
If a person has an Arteriovenous in their right arm for hemodialysis, where should you assess their blood pressure?
left arm
You teach your client with kidney stones to strain their urine once they get home and to put any stones they recover in a specimen cup to take to their follow up appt. Why?
To catch the stone(s) so we know that it came out of the urinary tract and to be able to send it off for testing so we can possibly prevent future stones from testing (once we know what it's made of)
List 3 clinical manifestations of BPH related to urine
◦Nocturia
◦Urinary frequency
◦Urgency
◦Dysuria
◦Incontinence
◦Decrease volume of urine stream
◦Decreased force of urine stream
◦Difficulty initiating a urine stream
◦Intermittency
◦Dribbling at end of stream
An IV or subcutaneous injection that Increases hgb & hct in 2 to 3 weeks given to CKD patients experiencing anemia ia
Epoetin alfa (Epogen, Procrit)
List 1 pre-renal cause of AKI.
List 1 intra-renal cause of AKI.
List 1 post-renal cause of AKI.
See slide 82 urinary PP
List 3 precautions a patient on peritoneal dialysis should take to ensure they don't get peritonitis from their treatment.
wash their hands before handling equipment
discard single use tubing between each exchange
clean access site (soap/water or antibacterial)
monitor for signs of infection at access site (report)
Moving past Rock & Roll to BPH:
What VS is important to monitor for any patient receiving medication therapy for BPH?
Blood Pressure - most of the BPH meds also treat HTN (examples, all three zosins - Doxazosin (Cardura), Prazosin (Minipress), and Terazosin (Hytrin)
The bacteria that causes uti the most is
Ecoli
This medication is used to treat ED, but also can treat Pulmonary HTN and BPH
Tadalafil (Cialis)
Why might a person in AKI be exhibiting Kussmal's respirations (rapid, shallow breaths)?
They are in metabolic acidosis. Kussmal's respirations are a compensation mechanism when in metabolic acidosis.
Your patient on Peritoneal dialysis is exhibiting signs of peritonitis. List 3 signs you would expect to see for peritonitis.
Fever
Hypotension
Tachycardia
Rigid board like abdomen/abdominal pain/rebound tenderness
redness (or other signs of infection) around access site in abdomen
Not Rock & Roll but list 3 clinical manifestations of Acute Pyelonephritis
•UTI symptoms
•Flank pain
•Fever/chills
•Vomiting
•Malaise
•Dysuria, urgency, frequency (s/s of Lower UTI)
•CVA tenderness - costovertebral tenderness to percussion on affected side
Your patient reports urination that starts and stops with dribbling but feels like they have to urinate much more than normal. List 3 tests you anticipate being ordered.
CBC
UA
Bladder Scan
Possible STD screen
Name two alpha-Adrenergic Receptor Blockers meds used to treat BPH
◦Tamsulosin (Flomax)
◦Doxazosin (Cardura)
◦Prazosin (Minipress)
◦Terazosin (Hytrin)