question

Urethritis

answer

Inflammation of urethra

question

Cystitis

answer

Inflammation of bladder.

question

Pyelenephritis

answer

Inflammation of the kidney.

question

Urethroplasty

answer

Surgerical repair of the urethra.

question

Calculi

answer

Kidney stones.

question

Nephrolithotomy

answer

Surgical incision into the kidney to remove a stone.

question

Hydronephrosis

answer

Unreileved obstruction of the urinary tract.

question

Nephrostomy

answer

Drainage tube inserted directly into kidney pelvis to drain urine.

question

Nephrectomy

answer

Surgical removal of a kidney.

question

Nephrosclerosis

answer

Thickening and hardening of the renal blood vessels.

question

Which of the following is the most common symptom of cancer of bladder?

answer

Hematuria.

question

When examining the patient, the nurse notes the following diagnostic tests on the patients chart. Which of the following diagnostic tests resuults is most indicative of acute kidney injury?

answer

24 hour creatinine clearance:5mL/min (100 mL/min)

question

Which of the following foods should the patient be taught to avoid for kidney stone composed of calcium oxalate?

answer

Beer.

question

Post operatively, the nurse notes the prescence of mucus in the urinary drainage. Which of the following actions should the nurse take?

answer

Recognize that this is a normal occurrance.

question

Which of the following is the most significant sign of acute kidney injury that the nurse should recognize during data collection?

answer

A decrease in urine output.

question

A patient with acute kidney injury has been instructed to limit potassium intake. The nurse recognizes that teaching has been effective if the patient chooses which of the following snacks?

answer

Gelatin dessert and cranberry juice

question

A patient with severe right flank pain, general weakness, and fever is hospitalized. The patient has a history of recurrent urinary tract infection, and renal calculi are suspected. On the second hospital day, the patient has distention and pain in the suprapubic area. The nurse would evaluate which of the following to be the most likely cause for sudden change?

answer

Urinary tract obstruction.

question

Which of the following is appropriate patient teaching to obtain a midstream urine specimen for culture and sensitivity?

answer

The patient should begin voiding,collect the specimen, and then finish voiding in the toilet

question

A patient is admitted with chronic kidney disease. The patient has potassium level of 6.4mEq/L, is placed on a cardiac monitor and given kayexalate (sodium polystrene sulfonate) by retention enema. Which of the following is the most significant symptom that the nurse should recognize during data collection?

answer

Irregular heart rhythum.

question

The nursing diagnosis of Excess Fluid Volume is made for a patient with chronic kidney disease. Which of the following data is most important for the nurse to collect for this patient based on the nursing diagnosis?

answer

Daily weight.

question

A patient with newly diagnosed chronic kidney disease has elevated sodium, potassium, and serum creatinine levels. When the breakfast tray is served there is a glass of orange juice on it. Which of the following actions should the nurse take first?

answer

Take the orange juice off the tray because it is high in potassium.

question

A patient goes to surgery for fistula creation for dailysis. The patient asks why it needs to be done. Which of the following is the best explanation by the nurse on the advantages of a fistula over a two-tailed subclavian catheter?

answer

There is a larger blood flow, and dialysis is more efficient.

question

After hemodialysis, which of the following nursing interventions is imperative for the nurse to carry out?

answer

Weigh the patient. Obtain vital signs.

question

The patient has a permanent peritoneal catheter inserted and is begun on continuous ambulatory peritoneal dialysis (CAPD). The patient asks how it works. Which of the following would be the best explanation of how this type of dialysis works?

answer

The peritonium acts as a semipermeable membrane through which solutes move by diffusion and osmosis.

question

A patient on dialysis has a severe cerebrovascular accident and is now semicomatose. His family decides that dialysis should be stopped. He is sent home with his daughter and hospice to die. As part of discharge planning, his daughter should be taught to expect which of the following symptoms of untreated end-stage renal failure?

answer

Edema, possible convulsions, then coma, death.

question

A patient is admitted who has involved in a MVA resulting in trauma to the abdomen and back. He has a ruptured spleen and probable trauma to his kidneys. For which of the following changes in the patients urine should the nurse observe?

answer

Hematuria

question

A patient is admitted with symptoms of a recent weight gain, pitting edema of his feet, distended neck veins, and crackles in his lungs. Which of the following nursing diagnoses is most appropriate for the patients plan of care?

answer

Excess Fluid Volume.

question

When teaching a patient about preventing urinary tract infections, which of the following information should the nurse include?

answer

Void frequently. Void after sexual intercmmourse.

question

A patient is admitted to the hospital with a diagnosis of a kidney stone. Which of the following interventions should be included in a plan of care?

answer

Strain all urine.

question

The nurse is taking a history on a patient with a diagnosis of bladder cancer. Which of the following would the nurse expect to find in the patients history?

answer

Tobacco use.

question

While changing the pouch at the stoma site of an ileal conduit, the nurse notes the stoma is constantly spilling urine. Which of the following actions should the nurse take?

answer

Continue to change pouch.

question

The nurse is caring for a patient with glomerulonephritis. Which of the following interventions should the nurse recommend be included in the patients plan of care?

answer

Increase fluid intake.

question

The nurse is caring for a postoperative patient who is recieving 0.9% NS IV at 125 mL/Hr, morphine for pain control, and gentamicin (Garamycin) IVPB every 8 Hrs for 24 Hrs. The patient is allergic to iodine. Morning labs are WBC 8500, Hgb 12.4 g/dL, creatinine 2.2 mg/dL. Which of these findings is a priority for the nurse to report to the RN?

answer

Creatinine level (normal is 0.7 to 1.2).

question

A patient with chronic kidney disease who is on hemodialysis asks for a snack in the afternoon. The patients potassium level remains high. Which of the following foods could be given?

answer

Gelatin dessert. Clear carbonated beverages. Cranberry juice.

question

How should the nurse assess the patency of a new right arm fistula?

answer

Palpate for thrill and ascultate bruit over the fistula.

question

A patient is returning to the medical unit after a dailysis session. The nurse notes bleeding from the patients vascular acess in the in left arm. Which of the following is the nurses first action?

answer

Apply pressure to site.

question

Anuria

answer

Complete suppession of urine formation by the kidneys.

question

Azotemia

answer

An increase in nitrogenous bodies in the blood , especially urea, as measened by the serum blood urea nitrogen (BUN) level.

question

Glomerulonephritis

answer

A form of nephritis in which the lesions involve primarly the glomeruli.

question

Hydronephrosis

answer

Abnormal dilation of kidneys caused by obstruction of urine flow.

question

Nephropathy

answer

Any disease of a kidney

question

Nephrotoxin

answer

A toxin having a specific destructive effect on a kidney tissue.

question

Oliguria

answer

Diminished urination.

question

Peritoneal dialysis

answer

The employment of the peritoneal surrounding the abdomin cavity as a dialyzing membrane for the purpose of removing waste products or toxins accumulated as a result of renal failure.

question

Polyuria

answer

Excessivd urination.

question

Stent

answer

Any mold or device used to hold tissue in place or to provide a support, graft or anastomosis while healing is taking place.

question

Uremia

answer

Excess in the blood of urea, creatinine, and other nitrogenous end products of protein and amino acid metabolism.

question

Urethtoplasty

answer

Plastic repair of the urethra.

question

Urosepsis

answer

Septicemia resulting from urinary tract infection.

question

What are the predisposing, causes, symptoms, laboratory abnormalties, and treatment of urinary tract infections?

answer

Urinary tract infection is an ascending infection, starts at extenal urinary meatus and progresses to bladder and kidneys.

question

Predisposing factors of UTI

answer

Stasis of urine in tbe bladder, result from obstruction, like clamped catheter or not voiding enough. Contamination in the perineal/urethral areas, from fecal soiling, intercourse, or infection from that area. Instrumentation or having instruments or tubes inserted in urethra. Faulty valves, previous UTIs, women more then men because of short length urethra and close to anus. Older adults are increased due to diminished immune response, DM, neurogenic bladder.

question

S/Sx of UTI

answer

Dysuria, urgency, frequency, incontinence, nocturia, hematuria, back pain, cloudy, foul smell urine. Elderly may also have fatigue, change in cognitive function, fever .

question

Types of UTIs

answer

Urethritis-an inflammation of the urethra that may result from a chemical irratant, bacterial infection, trauma, or exposure to a sexually transmitted disease. Tx-is removal of cause, gram negative rods, gram positive cocci/clamydia. Phenazopyridine (Pyridium) a urinary analgesic, may turn urine orange.

question

Types of UTIs

answer

Cystitis-inflammation/infection of bladder wall. Urinalysis include cloudy urine, presence WBC (less than 100,000) bacteria, RBC, Nitraits usually+, leukocyte estraese + , elevated sedimentation rate, increased neutrophils. Tx-sulfa medication like sulfamethoxazole and trimethopin (Bactrim/Septra) or ciproflaxacin (Cipro).Estrogen intravaginal cream prevent UTIs.

question

Prevention for UTI

answer

Drink cranberry juice, urinate after sexual intetcourse, take showers not baths, wipe front to back, finish a medications, increase fluids, return for follow up urinalysis or culture to insure infection is gone.

question

What are the predisposing causes, symptoms, treatment, and teaching for kidney stones?

answer

Obstructions are caused by strictures, stones, tumors. Urethra stricture is a narrowing of the lumen of the urethra caused by sear tissue. Renal calculi (kidney stone) are hard , usually smaIll stones that form somewhere in the renal structures. Stones that are less than 5 mm are usually passed in urine

question

Causes of kidney stones

answer

Family HX, chronic dehydration and infection, dietary factors, medications, imobility. Stoned more common in men than women usually ages 30/50.

question

S/Sx of kidney stones

answer

Flank back pain, renal colic, pain radiate down genitalia, hematuria, dysuria, frequency, urgency, enuresis, costovertebral tenderness, nausea, vomiting, diarrhea.

question

Prevention of kidney stones

answer

Avoid foods that increase calculus development (High purine foods-organ meat , anchovies, herring, sardines in oil, meat extracts, cosomme, gravies). Low purine foods (fruit, milk, cheeses, eggs, refined grains, vegtables)(exept asparagus, beans, califlower, mushrooms, peas, spinach). Encourage fluids.

question

Complications of kidney stones

answer

Shock, sepsis, hydronephrosis, hydroureter, chronic kidney disease.

question

Diagnostic for kidney stones

answer

Urinalysis, crystals and urine pH,24 hr renal creatinine clearence, BUN, creatinine, KUB-revels most calculi, retrograde pyelography, trasound.

question

Tx for kidney stones

answer

Flushed out by body, IV fluids to help flush stones, strain urine, pain medication, thiazide diuretics and allopurinol (Aloprin, Zyloprin). Surgical removal.

question

What are risk factors/symptoms of cancer of the bladder and cancer of the kidneys?

answer

Cancer of the bladder is most common kind of cancer of urinary tract. More common in men(50/70yrs)(caucasian), rare in people younger than 40. Bladder cancer begins in the linning of the bladder called urothelium (benign growth). Cancer of inner lining called superficial cancer. Cancer spread to muscle wall is called invasive cancer. Bladder cancer matastasis to liver, bones, and lungs.

question

Causes of bladder cancer

answer

Smoking, exposure to industrial pollution, also arises from prostate, colon, rectum in men, lower reproductive tract in women (later stage).

question

S/Sx of bladder cancer

answer

Painless hematuria, blood in urine, fistula formation, pelvic pain, pain in lower back, painful urination, changes in bladder habits, inability to void.

question

Tests for bladder cancer

answer

Routine urinalysis, urine test for enzyme telomerase, urine for cytology, cytoscopy/transurethral biopsy, also intravenous pyelogram.

question

Tx for bladder cancer

answer

Cjemotheropeutic agents instilled, systemic chemotherapy, bacille calmette-guirin vaccine (prevent tumors), photodynamic therapy (light sensitive to tumors), surgery, cystoscopy and pyelogram to burn off cancer tissue.

question

Cancer of the kidney

answer

Is most common cancer, men/women ages 50/70.

question

Risk factors for cancer of kidney

answer

Smoking, obesity, HTN, kidney dialysis, expodure to radiation, asbestos, industrial pollution, cancer usually metastasizes before diagnosis.

question

S/Sx of cancer of kidney

answer

Hematuria, dull pain flank area,fever, wt. loss, night sweats,HTN, anemia, polyrythemia, swelling of legs, fatigue, anorexia, constipation, metastasis symptoms are wt loss,cough, bone fracture, liver abnormalties, increased weakness.

question

Tests for cancer of kidney

answer

IVP,cystoscopy, pyelogram, ultrasound, examination of kidneys, CT-scan, MRI, and renal biopsy.

question

Tx for kidney cancer

answer

Surgery, radical nephrectomy(remove entire kidney), radiation, nephron-sparing surgery (remove tumor).

question

Nursing care for cancer of kidney

answer

Watch for bleeding, signs of hypovolemic shock, urine output (color, bleeding, signs of infection), assess for SOB, diminished breath sounds, pneumothorax.

question

How do you provide care for a patient with an ileal conduit or continent resevoir?

answer

Ileal conduit an involved surgery in which a 6-8 inch section of the ileum/colon is removed and used as a conduit for urine. 1-gather supplies, clean area, flange, wicks(gauze) to absorb urine, clean gloves, empty old pouch, remove/discard, place towel to catch urine, cut flange(1/16 or 1/18 lg than stoma), clean skin, center flange and place, use heat from hand to get good seal, ensure pouch is closed with flange.

question

The care for a continent resivor is.

answer

Contient resivor-(kock pouch)-which is created from a segment of ileaum that has been made into a resivor for urine. Resivor is created using a portion of the ascending colon and terminal ileum, making a lg pouch than kock pouch.

question

Hydronephrosis

answer

Is destention of the renal pelvis/calices caused from untreated obstruction of urine flow in the urinary tract. Kidney enlarges as urine collects can hold 5 to 8 mL.

question

S/Sx of hydronephrosis

answer

Maybe asymptomatic, obstruction of urine causes frequency, urgency, dysuria, flack back pain.

question

Tx- for hydronephrosis

answer

Relieving obstruction, removal of obstruction, stents (tubes) put into drain urine, nephrostomy or collection bag.

question

Complications for hydronephrosis

answer

Increased incidents of UTIs, kidney failure from unrelieved pressure, I&O measured for possible urine retention and should report promptly. Nephrostomy is patent and not kinked. If nephrostomy is present along with other urine output must be measured seperatly.

question

Renal system trauma

answer

Most common injury of urinary system. Caused by MVA, sports, falls, gunshot wounds, stabing more younger men.Assessment:Hx of injury, inspect abdomen.

question

Diagnosis of renal system trauma

answer

Urinalysis, IVP, ultrasound, CT, MRI.

question

Tx of renal system trauma

answer

Bedrest, surgical intervention.

question

Nursing care for renal trauma

answer

Measure I&O, VS, provide IV fluids, pain relief.

question

Bladder trauma

answer

Pelvic fracture, multiple trauma, rupture of bladder is possible. S/Sx-hematuria, abdominal pain, inability to void, shock, pelvic hematoma. Diagnosis-IVP, x-ray. Tx-urinary/suprapubic catheter till bladder heals.

question

Polycystic kidney disease

answer

Is hereditary disorder that can result in chronic kidney disease. Effects men/women equally. Also characterized by formation of multiple cycts in kidney/replace normal kidney structures.

question

Polycystic kidney disease continue

answer

S/Sx-dull heavyness, flank/lumbar region, hematuria, HTN, UTIs. Tx-none. Complications-UTIs, headaches, HTN, counseling because of child inheriting it.

question

Diabetic nephropathy

answer

Most common cause of kidney disease. Long term complications of DM that damages small BV in the kidneys. Effects diabetes type 1 (15-20 yrs) and type 2. Increases osmotic pressure from hyperglycemia, increases diuresis, increases glomerular filtration rate.

question

Risk factors for diabetic Nephropathy

answer

HTN, genetic predisposition, smoking, CVA, hyperglycemia. Control of BG reduces risks.

question

Complication of diabetic nephropathy

answer

Neurogenic bladder from incomplete emptying, result urine retention, then infection or obstruction of urine, nephrotoic syndrome causes massive edema from low levels of albumin in blood.

question

S/Sx of diabetic nephropathy

answer

Decreased urine ouyput, toxic waste accumulate, chronic kidney disease, see symptoms of CKD.

question

Tests for diabetic nephropathy

answer

Watching onset of protein spillage or microalbuminuria in urine, serum creatinine levels,24 hr. Creatinine clearance test.

question

Tx of diabetic nephropathy

answer

Strict BG control/BP, ACE inhibitors or ARBs to slow the decline of the glomerular filtration rate, dialysis to maintain life, or kidney/kidney and pancraes transplant.

question

Nephrotic syndrome

answer

Is excretion of 3.5 or more of protein in urine per day, from increased glomerular membrane permeability, serum albumin/serum protein decrease, with low protein massive widespread edema (anasacara) occurs, liver produces lipoproteins as result serum cholesterol, low density lipoproteins, triglyceride levels increase, urine may appear foamy from lipoproteinemia, loss of immunoglobins lead to increase infection/BP.

question

Tx- for nephrotic syndrome

answer

Focus on cause, low to moderate protein intake to prevent build up of nitrogen wastes from impaired kidney function. Diuretics, lipid lowering drugs, anticoagulant for thrombosis, corticosteroids.

question

Complications for nephrotic syndrome

answer

Impaired immune function, nutrition imbalance, increased blood coagulation.

question

Nursing care for nephrotic syndrome

answer

Edema, prevent infection, daily wts, I&O, abdominal girth, protect edematous tissues, prevent malnutrition.

question

Nephrosclerosis

answer

Kidney damage causing sclerostic changes in the small arteries/arterioles, such as arteriosclerosis with thickening/hardening of renal BV. Changes in BV results in decreased blood supply to the kidney (ischemia) and destroy kidney.

question

Nephrosclerosis continue

answer

S/Sx-proteinuria, hyaline casts in urine, symptoms of CKD. Tx-decreased BP, treat HTN(antihypertensive medication), low sodium diet, diaylsis. Prognosis is poor, widespread, prone to MI, CVA.

question

Nephrosclerosis continue

answer

ND-Inefcective Hetb Maintance. Teach- control of HTN, symptoms of CKD.

question

Glomerulonephritis

answer

Is an inflammatory disease of tbe glomerulus. Caused by immunological abnormalties, toxins, vascular disorders, systemic diseases, resulting immune reaction in glomerulus causes inflammation that causes it to be more porus, allowing protein, WBC, RBC to leak in urine.

question

S/Sx of glomerulonephritis

answer

Oliguria, HTN, Electrolyte imbalance, edema, flank pain.

question

Diagnosis of glomerulonephritis

answer

Urinalysis, ultra sound, x-ray, biopsy.

question

Nursing care glomerulonephritis

answer

VS, symptom support, rest, fluid, sodium, protein restrictions, education.

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