question

most common bacterial infection in women, at least 20 % of women will develop a UTI during their lifetime

answer

Urinary Tract Infection

question

Most common pathogen responsible for UTI is

answer

E. Coli

question

counts of 10 to 5th power 10 5 CFU /ML or more indicate

answer

significant UTI

question

counts as low as 10 to 2nd power 10 2- 10 3 CFU/ML in a person with signs/symptoms are

answer

indicative of UTI

question

common causes for UTI

answer

bad hygiene, immunosupressed, multiple antibiotics, diabetic, Elderly ( UTI and Lungs is the most common site for elderly to develop infections)

question

fungal and parasitic infection are uncommon, however can cause UTI's- patients at risk are

answer

immunosupressed, Diabetic, having undergone multiple antibiotic courses , have traveled to developing countries

question

Renal parenchyma, pelvis, and ureters ( typically causes fever, chills, flank pain) ex. Pyelonephritis: inflammation of renal parenchyma and collecting system

answer

Upper UTI

question

usually no systemic manifestations ( ex. cystitis: inflammation of bladder, and Urethritis: inflammation of Urethra)

answer

Lower UTI

question

more simple bladder infect, burning on urination , full bladder, feeling that you can't pee are signs/symptoms of :

answer

Lower UTI

question

a UTI that as spread systemically and is life-threatening condition necessitating emergency treatment

answer

Urosepsis

question

Occurs in otherwise normal urinary tract and usually involves only the bladder ( usually coexist with other things)

answer

Uncomplicated UTI

question

Coexists with presence of - obstruction - stones - catheters - diabetes/ neurologic disease - pregnancy- induced changes - recurrent infection

answer

Complicated UTI

question

individual with complicated infect: is at risk for:

answer

Pyelonephritis, urosepsis, and renal damage

question

factors increasing urinary stasis Ex: BPH, tumor, neruogenic bladder

answer

predisposing factors of UTI

question

Foreign bodies EX. catheters, calculi, and instrumentation

answer

predisposing factors of UTI

question

urinary stasis can be caused by:

answer

BPH, Tumor, long and short term catheters

question

a common factor contributing to ascending infection is urologic instrumentation ( e.g. catheterization, cystoscopic examinations)

answer

( e.g. catheterization, cystoscopic examinations)

question

Etiology and Pathophysiology Predisposing factors:

answer

Functional disorders such as constipation

question

Other Factors : predisposing to UTI

answer

pregnancy , multiple sex partners (woman)

question

Etiology & Pathophysiology continued:

answer

Hospital- acquired UTI accounts for 30 % of all nosocomial infections - causes often E. Coli - Seldom : Pseudomonas species catheter -acquired UTIs - bacteria biofilms develop on inner surface of catheter Be cautious of this because the Hospital will not be paid!

question

clinical manifestations: Bladder Storage

answer

urinary frequency - abnormally frequent if more often than every 2 hours)

question

clinical manifestations: Urgency

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sudden strong desire to void immediately

question

clinical manifestations: Incontinence

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loss or leakage of urine

question

Urinary frequency, urgency, and incontinence are all related to a ______ type of infection

answer

Bladder

question

Lower Urinary tract symptoms ( LUTS) are experienced in patients who have

answer

UTIs of the upper urinary tracts, as well as those confined to the lower tract. The urine may contain grossly visible blood ( hematuria) or sediment, which gives it a cloudy appearance. Symptoms are related to either bladder storage or bladder emptying

question

Clinical Manifestations: Bladder storage: Nocturia: sign of bladder infect.

answer

waking up two or more times at night to void

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clinical manifestations: Nocturnal enuresis: sign of bladder infect.

answer

Loss of urine during sleep

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clinical manifestations: Bladder emptying : sign of bladder infect.

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-weak stream -Hesitancy ( difficulty starting the urine stream)

question

clinical manifestations : Bladder emptying : sign of bladder infect.: Intermittency: is

answer

Interruption of urinary stream during voiding

question

Clinical manifestations: Bladder emptying:sign of bladder infect: Postvoid dribbling is

answer

Urine loss after completion of voiding

question

Clinical manifestations: Bladder emptying : is sign of infection: Urinary retention:

answer

inability to empty urine from bladder

question

clinical manifestations: Bladder emptying: is sign of infection: Dysuria:

answer

difficulty voiding

question

clinical manifestations of : flank pain, chills, and fever indicate infection of :

answer

upper tract ( pyelonephritis) (systemic symptoms associated with upper UTI note : people with significant bacteriuria may have no symptoms of may have nonspecific symptoms such as fatigue or anorexia

question

Clinical manifestations: in older adults know that

answer

- symptoms are often absent - nonlocalized abdominal discomfort rather than dysuria - cognitive impairment possible - fever less likely Presentation is usually totally different than other types of infections: with elderly most common symptom is change of mental status as with other types of infections, b/c as we age immune systems are less responsive. May not see elevated Temp, but a lot of times will see change in mental

question

because older adults are less likely to experience a fever with a UTI, the value of body temp. as an indicator of a UTI is unreliable

answer

clinical manifestations

question

Diagnostic Studies:

answer

History and physical examination Dipstick Urinalysis ( identify presence of nitrites, WBCs, and leukocyte esterase)

question

In a patient suspected of having a UTI, initially conduct a dipstick urinalysis to identify

answer

the presence of nitrites ( indicating bacteriuria), white blood cells (WBCs), and leukocyte esterase ( an enzyme present in WBCs that indicates pyruia) These findings can be confirmed by microscopic urinalysis.

question

How to read a Urininalysis

answer

Dark color, positive nitrate, large amy of WBC, Trace of occult blood, urine culture and sensitivity know how to properly collect for the different procedures. Know how to collect a 24 hour cultures 3 different collections it takes 48 hours for any urine culture to get results on fecal, sputum or any of those will not wait to start antibiotics anyways

question

Diagnostic Studies: Urine for culture and sensitivity ( if indicated) - clean -catch sample preferred - specimen by catheterization or suprapubic needle aspiration more accurate - determine bacteria susceptibilityys to antibiotics

answer

takes 48 hours to get a final report

question

Diagnostic Studies : Imaging studies

answer

CT urography or ultrasonography when obstruction is suspected

question

Collaborative Care: Drug Therapy - Antibiotics selected on empiric therapy or results of sensitivity testing

answer

Treated Easily PO or more complicated cases IV -selected on empiric therapy or results of sensitivity testing -uncomplicated cystitis ( short-term course ( 1 to 3 days) - complicated UTIs ( long-term treatment ( 7 to 14 days) The collaborative care and drug therapy for cystitis are summarized in table 46-4.. many residents of long-term care facilities, especially women, have chronic asymptomatic bacteriuria. However, usually only symptomatic UTIs are treated. 1st- choice drugs to empirically treat uncomplicated or initial UTIs are trimethoprim/sulfamethoxazole (TMP/ SMX) (Bactrim, Septra) nitrofurantoin ( Macrodantin), and fosfomycin (Monurol)

question

Collaborative Care Drug Therapy: Antibiotics

answer

Trimethoprim/sulfamethoxazole (TMP/SMX) - used to treat uncomplicated or initial UTI - inexpensive - Taken twice a day - E. Coli resistance to TMP-SMX increase

question

Collaborative Care Drug Therapy: Antibiotics

answer

Nitrofurantoin ( macrodantin) - given 3 to 4 times a day - long-acting preparation (macro bid) is taken twice daily - Ampicillin, amoxicillin, cephalosporins / to treated uncomplicated UTI

question

Collaborative Care: Drug Therapy: antibiotics

answer

Fluroquinolones - treat complicated UTIs - Example: ciprofloxacin (cipro) Antifungals - Amphotericin or fluconazole - for UTIs secondary to fungi

question

Drug Alert: NItrofurantoin ( Furadantin, Macrodantin)

answer

- avoid sunlight. use sunscreen; wear protective clothing. - notify health care provider immediately if fever, chills, cough, chest pain, dyspnea , rash , or numbness or tingling of fingers or toes develops

question

Collaborative Care Drug Therapy: Urinary analgesic Phenazopyridine ( Pyridium)

answer

used in combination with antibiotics provides soothing effect on urinary tract mucosa stains urine reddish orange ( can be mistaken for blood and may stain underclothing)

question

can get pyridium over the counter

answer

note that it doesn't treat bacteria , but can treat the discomfort

question

Although this drug is typically effective in relieving the transient acute discomfort associated with a UTI, the nurse should advise patients to avoid long-term use of phenazopyridine because it can produce hemolytic anemia.

answer

Pyridium

question

Collaborative Care Drug Therapy: urinary analgesic

answer

Methenamine/phenyl salicylate (urised) - use in combination with antibiotics - used to treat UTI symptoms - preparations with methylene blue tint will turn urine blue or green

question

Nursing management: Nursing Assessment: Health History

answer

Nausea, vomiting, anorexia, chills, nocturia, frequency, urgency= Suprapubic/lower back pain, bladder spasms, dysuria, burning sensation on urination

question

if pt is experiencing nausea , vomiting, or anorexia this is more indicative of an

answer

upper UTI

question

Nursing Management : Nursing Assessment: objective data

answer

fever, Hematuria, foul-smelling urine, tender, enlarged kidney Leukocytosis, positive findings for bacteria, WBCs, RBCs, pyuria, ultrasound, CT scan , IVP

question

nursing diagnosis

answer

impaired urinary elimination readiness for enhanced self-health management

question

planning

answer

patient will have relief from lower urinary tract symptoms prevention of upper urinary tract involvement prevention of recurrence

question

Nursing implementation: educational intervention

answer

Health promotion - recognize individuals at risk - debilitated persons - older adults - underlying diseases ( HIV, diabetes) - taking immunosuppressive drug or corticosteroids

question

Health promotion

answer

Emptying bladder regularly and completely , evacuating bowel regularly and completely, wiping perineal area front to back, drinking adequate fluids ( person's wt. in pounds / 2 (twenty percent of fluid comes from food) Teach pt. to drink adequate fluids every 24 hours

question

Health promotion

answer

Cranberry juice or cranberry tablets may reduce the number of UTIs ( its thought that enzymes in cranberries inhibit attachment of urinary pathogens ( especially E. Coli) to the bladder epithelium avoid unnecessary catheterization and early removal of indwelling catheters aseptic technique must be followed during instrumentation procedures cranberry is good especially for chronic UTIs

question

Health promotion

answer

wash hands before and after contact wear gloves for care of urinary system routine and thorough perineal care for all hospitalized patients avoid incontinent episodes by answering call light and offering bedpan at frequent intervals

question

acute intervention

answer

adequate fluid intake - pt may think condition will worsen because of discomfort - dilutes urine, making bladder less irritable - flushes out bacteria before they can colonize

question

acute intervention

answer

avoid caffeine, alcohol, citrus juices, chocolate, and highly spiced foods because these are potential bladder irritants

question

acute interventions

answer

Very important to take full course of antibiotics -application of local heat to ---suprapubic or lower back may relieve discomfort instruct pt. about drug therapy and side effects The nurse may advise the patient to apply a heating pad (turned to its lowest setting) against the back or suprapubic area. A warm shower or sitting in a tub of warm water filled above the waist can also be effective in providing temporary relief.

question

serious upper UTI type

answer

acute Pyleonephritis

question

Etiology of pyleonephritis

answer

actual cells in the kidneys are infected and this is very serious

question

Inflammation of renal parenchyma and collecting system most commonly caused by bacteria,fungi, protozoa, or viruses can also infect kindness

answer

Etiology of pyleonephritis

question

systemic infection from urologic source prompt diagnosis/treatment critical - can lead to septic shock and death - septic shock: outcome of unresolved bacteremia involving gram- negative organism

answer

Urosepsis

question

Infect has gone from kidneys to sepsis- risk for septic shock- life threatening situation

answer

Urosepsis

question

usually begins with colonization and infection of lower tract via ascending urethral route frequent causes E. coli proteus klebsiella enterobacter

answer

Urosepsis

question

preexisting factor usually present , such as backward movement of urine from lower to upper urinary tract

answer

vesicourecteral reflux

question

obstruction from BPH Stricture Urinary Stone

answer

Dysfunction of lower urinary tract

question

nursing intervention

answer

keep bag low bc we don't want back flow of urine, keep bag off of floor also

question

for residents of long-term care facilities, urinary tract catheterization is

answer

a common cause of pyelonephritis and urosepsis

question

commonly starts in renal medulla and spreads to adjacent cortex recurring episodes lead to scarred, poorly functioning kidney and chronic pyelonephritis

answer

pyleonephritis One of the most important risk factors for acute pyelonephritis is pregnancy-induced physiologic changes in the urinary system.

question

mild fatigue chills fever vomiting malaise flank pain are all clinical manifestations of:p

answer

pyleonephritis; symptoms of polyphrinitis is a more serious systemic type upper UTI

question

lower Urinary tract characteristics of cystitis

answer

costovertebral tenderness is usually presented on the affected side

question

manifestations usually subside in a few days, even without therapy

answer

Bacteriuria and pyuria still persist

question

costovetebral tenderness is a sign of a

answer

UTI

question

Diagnostic studies for UTIs

answer

History , physical examination ( palpation for CVA pain), Lab tests: Urinalysis Urine for culture and sensitivity CBC with differential Blood culture ( if bacteremia is suspected)

question

urinalysis results indicate:

answer

Pyuria, bacteriuria, and varying degrees of hematuria

question

WBC casts

answer

may be found in the urine, indicating involvement of the renal parenchyma

question

a CBC

answer

will show leukocytosis ; a shift to the left with an increase in immature neutrophils (bands)

question

Ultrasonography and CT urography

answer

Diagnostic studies that are noninvasive pre or post care

question

Ultrasonography of the urinary system

answer

may be performed to identify anatomic abnormalities, hydronephrosis, renal abscesses, or the presence of an obstructing stone.

question

CT urography is also used to assess for signs of

answer

infection in the kidney and complications of pyelonephritis, such as impaired renal function, scarring, chronic pyelonephritis, or abscesses.

question

If bacteremia is a possibility , close observation and vital sign monitoring are essential prompt recognition and treatment of septic shock may prevent irreversible damage or death

answer

BLOOD CULTURE- USE CHLORICEP SWABS TO KILL BACTERIA ON SKIN. COLLECT FROM TWO DIFFERENT SITES 15 MIN APART TO SEE THAT BOTH SETS COME BACK POSitive IF ONE NEG AND ONE POSTIVE NOT SYSTEMIC KNOW RULES AND REGS FOR COLLECTING BLOOD CULTURES

question

Hospitalization for patients with severe infections and complications such as: nausea and vomiting with dehydration signs/symptoms typically improve within 48-72 hours after therapy starts

answer

The diagnostic tests and collaborative therapy of acute pyelonephritis are summarized in Table 46-7. The patient with mild symptoms may be treated as an outpatient with antibiotics for 14 to 21 days. When initial treatment alleviates acute symptoms and the patient is able to tolerate oral fluids and drugs, the patient may be discharged on a regimen of oral antibiotics for an additional 14 to 21 days.

question

Drug therapy ( antibiotics)

answer

parenteral administration in hospital to rapidly establish high drug levels. NSAIDS or antipyretic drugs for fever and discomfort Urinary analgesics

question

Relapses may be treated with

answer

6 week course of antibiotics and follow-up urine culture and imaging studies PT MAY NEED TREATMENT FOR 6 WEEKS WITH CHRONIC ISSUES

question

Reinfections treated as individual episodes or managed with long-term therapy

answer

Prophylaxis may be used for recurrent infection

question

Nursing Assessment: Health History

answer

Previous UTIs, calculi, stasis, retention, pregnancy, STDs, bladder cancer Antibiotics, anticholinergics, antispasmodics Urologic instrumentation Urinary hygiene Subjective and objective data that should be obtained from a patient with pyelonephritis are similar to those for the patient with UTI

question

Nausea, vomiting, anorexia, chills, nocturia, frequency, urgency Suprapubic or lower back pain, bladder spasms, dysuria, burning sensation on urination

answer

Nursing Management Nursing Assessment

question

Fever Hematuria, foul-smelling urine, tender, enlarged kidney Leukocytosis; positive findings for bacteria, WBCs, RBCs; pyuria; ultrasound, CT scan, and IVP abnormalities LOOK AT LABS TO VALIDATE DIAGNOSIS

answer

Objective data

question

Acute pain Impaired urinary elimination

answer

Nursing Management Nursing Diagnoses

question

Patient will have Relief of pain Normal body temperature No complications Normal renal function No recurrence of symptoms OUTCOMES WE WANT TO ACHEIVE

answer

Nursing Management Planning

question

Early treatment for cystitis to prevent ascending infections Patients with structural abnormalities are at high risk Stress the need for regular medical care WARN OF SYMPTOMS OF RELAPSE, FINISH ANTIBIOTICS,

answer

Nursing Management Nursing Implementation

question

Continue drugs as prescribed Follow-up urine culture Recognize manifestations of recurrence or relapse Encourage adequate fluids Nursing interventions vary depending on the severity of symptoms.

answer

Nursing ManagementNursing Implementation Ambulatory and home care

question

Rest to increase comfort Long-term, low-dose antibiotics to prevent relapses or reinfections Explain rationale to increase compliance The patient should drink at least eight glasses of fluid every day, even after the infection has been treated.

answer

Ambulatory and home care

question

Use of nonanalgesic relief measures Appropriate use of analgesics Pass urine without urgency Urine free of blood Adequate intake of fluids

answer

Nursing Management Evaluation

question

Crystals in a supersaturated concentration can unit to form stones - Keeping urine dilute and free flowing can prevent SEVERE PAIN GIVE LARGE DOSE OF FLUID, START IV, 150 CC FLUID AN HOUR TO PASS GIVE MORPHINE FOR COMFORT AMBULATE THEM THEY CAN INTEREFERE WITH NORMAL FLOW OF URINE

answer

URINARY TRACT CALCULI - NEPHROLITHIASIS

question

abnormalities that result in increased urine level of calcium, oxaluric acid, uric acid and citric acid

answer

Metabolic

question

Warm climates cause increased fluid loss, low urine volume and increased concentration of urine

answer

Climate

question

Large intake of proteins that increase uric acid, excessive tea or fruit juices that elevate urinary oxalate, Low fluid intake

answer

Diet

question

family history, sedentary, immobility

answer

Genetic Factors

question

sardines, herring, mussels, liver, goose, venison, meats, sweet breads

answer

Purine:

question

All dairy products made from milk, sardines, herring, salmon, dried fruits, chocolate and cocoa

answer

Calcium:

question

dark roughage, spinach, rhubarb, asparagus, cabbage, tomatoes, beets, nuts celery, beans chocolate, worcestershire sauce

answer

Oxalate:

question

Abdominal or flank pain, hematuria, renal colic, nausea vomiting Pain associated with the passage of calculus is intense and colicky Possible urinary trat infection accompanied by fever and chills

answer

Urinary Stones Symptoms CRAMPING PAIN FROM FLANK TO ABDOMEN NAUSEA, VOMITING ASSOCIATED WITH SEVERE PAIN DUE TO MOVEMENT OF STONE PT. CAN GET INFECT FROM URNIARY STASIS OR BACK UP

question

Urinalysis, urine culture, IVP, retrograde pyelogram (localizes degree and site of obstruction, ultrasounds and cystoscopy

answer

Urinary Tract Stones - Diagnostic Studies WILL PROBABLY TO A CT TO SEE THE STONE

question

Treat the symptoms of pain, infection and obstruction Many stones will pass spontaneously while larger stones will may require stent placement to prevent obstruction The second priority is to evaluate cause of stone formation to prevent future problems

answer

Urinary Tract Stones - Collaborative Care BIG THINGS: MANGAGE PAIN, PREVENT INFECT, AND PREVENT OBSTRUCTION IF LARGE MAY HAVE TO GO IN AND REMOVE IT OR LITOTHOPY TO BREAK IT DOWN SO PT. CAN PASS IT

question

Encourage fluid intake to produce urine output of 2 L/day Assess and manage pain Strain all urine Encourage ambulation to increase peristalsis and promote stone movement.

answer

Nursing Interventions KEY FACTORS TO MANAGING PT. WITH KIDNEY STONE

question

Immunologic processes affecting predominately renal glomerulus in both kidneys - third leading cause of ESRD , end stage renal disease

answer

Glomerulonephritis WILL USUALLY EFFECT BOTH KIDNEYS 3RD LEADING CASUE OF END STAGE RENAL DISEASE ON DIALYSIS

question

Post-streptococcal infection complication Infective endocarditis Viral Infections (HIV, Hepatitis) Systemic lupus erythematosus Scleroderma Diabetic neuropathy Hypertension

answer

Common Causes or Risk Factors for Glomerulonephritis VERY COMMON WITH DIABETIC NERUOPATHY CANT FILTER PROPERLY

question

glomerular filtration Hypertension Oliguria Hematuria with rusty appearance of urine due to bleeding in upper urinary tract Proteinuria, elevated BUN and Creatinine

answer

General Signs and Symptoms of Glomerulonephritis NOTICABLE AROUND FACE , EYES , ORBITAL EDEMA, ELEVATED BUN AND CREATININE

question

Focuses on symptom relief Rest until signs of glomerular inflammation (proteinuria, hematuria, hypertension) subside Restrict sodium and fluid intake Dietary restriction of protein When caused by autoimmune diseases, corticosteroids may be used

answer

Nursing Management NO CURE SO FOCUS AND COMFORT/ KEEP IN CONTROL

question

Results from glomerulus become excessively permeable to plasma proteins that leads to low plasma albumin and tissue edema

answer

Nephrotic Syndrome WITH NEPHROTIC SYNDROME PT PUTS OUT TOO MUCH PROTEIN IN URINE. PURPOSE OF PROTEIN ( CREATES OSMOTIC PRESSURE) TO KEEP IN VASCULARATURE WILL CAUSE FLUID TO SEEPS OUT OF THE CELLS WILL SEE EDEMA

question

Primary Glomerular disease Systemic Lupus Diabetes Infections Neoplasms

answer

Common Causes of Nephrotic Syndrome

question

Peripheral Edema Proteinuria Hypertension Decreased serum albumin

answer

Manifestations of Nephrotic Syndrome

question

Corticosteroids Cyclophosphamide (Cytoxic drug used with limited success in steroid resistant cases) Management of edema ( Diuretic Therapy,sodium restriction, daily weights, I/O, measuring abdominal girth and extremity size Keep edematous areas clean and dry Nutritional status compromised because of excessive loss of protein in urine - small frequent meals

answer

Nursing and Collaborative Management TREAT WITH STEROIDS WILL SEE SEVERE EDEMA DAILY WT. MOST ACCURATE MEARUEMENT WET LOSS OR GAIN OF 2.2 LBS = 1,000 L OF FLUID LOSS

question

What is the landmark to locate the kidneys

answer

the Costovertebral angle (CVA) and it's formed by the ribcage & vertebral column

question

( T 11- T12) and sacral (s2-s4)

answer

is responsible for urination control

question

a pt. complaining of : Burning, frequency, and difficulty when urinating is indicative of a

answer

UTI

question

if a renal artery bruit is heard , this may indicate:

answer

impaired blood flow to the kidneys : is due to renal artery stenosis ( narrowing of the renal artery)

question

if costovertebral angle (CVA) tenderness are present

answer

may indicate a kidney infection or polycystic kidney disease

question

Normal WBC levels in urine

answer

5/hpf greater levels would indicate inflammation or UTI

question

Ranges for specific gravity are:

answer

1.003-1.030

question

normal creatine clearance values range from

answer

70-135 ml/min

question

what is the most accurate indicator of kidney/renal function

answer

creatinine clearance

question

Bun is also used, but not as reliable as

answer

creatinine clearance

question

When a patent is having a urine cytology study , the 1st urine void of the day

answer

should not be used

question

Large Amt of urine passed at any given time is called

answer

polyuria

question

blood urea nitrogen (BUN) is order in pt with

answer

Dehydration

question

getting up frequently to urinate at night greater than 6 times and with large amounts of urine would have a _____ level checked in urine

answer

Glucose level test - do detect diabetes mellitus

question

insertion of a catheter into the femoral artery up to the aorta and to the level of the renal arteries is called a

answer

renal arteriogram

question

nursing interventions for Renal Arteriogram procedures

answer

Assess for iodine sensitivity Administer Enema the night before Explain the procedure to the patient

question

Normal levels of Phosphorus are

answer

between 2.4 and 4.0 mg/dl

question

normal levels of Potassium are

answer

between 3.5 and 5.0 mEq/L

question

phosphourous of 6.0 and potassium of 6.2 would indicate

answer

renal failure; kidneys are not functioning properly and therefore can not excrete potassium and phosphorous which would make the levels higher

question

When the bladder reaches 400-600 ml of urine

answer

the pt feels uncomfortable and needs to pee

question

When the bladder reaches 200-250 ml of urine in the bladder this can cause

answer

moderate distention and the urge to urinate

question

bladder capacity varies but generally ranges from

answer

600-1000 ml

question

serium albumin levels are assessed with

answer

chronic kidney disease

question

serium creatinine levels are assessed with

answer

renal disorders

question

renal biopsy is contraindicated in those with

answer

high BP

question

bowel prep is appropriate for kidney failure and

answer

castor oil, bisacodyl is ok for use

question

fleet enema, milk of magnesia, and magnesium is

answer

not suitable for kidney/renal failure bed it can't be eliminated

question

Normal Blood Urea Nitrogen Levels

answer

7-18 or 8-20 for client ; 60

question

Normal creatine levels

answer

0.6 to 1.2 mg/dl

question

Glomerular filtration (GFR) Norm is

answer

120 ml/ min

question

Normal creatine clearance is

answer

85-125 ml/min for males and 75-115 ml/min for females

question

group B beta-hemolytic strep infection indicates

answer

acute glomerulonephritis

question

acute viral pneumonia infection

answer

acute glomerulonephritis

question

Fatigue , headache, polyruia as well as loss of weight, anorexia, and excessive thirst are signs of

answer

chronic pyelonephritis

question

fever, chills, flank pain ; dysuria

answer

acute pyelonephritis / UTI

question

nausea, vomiting, pallor, and cool, clammy skin

answer

uretral stone

question

dull, aching flank pain and microscopic hematuria

answer

renal stone in kidney

question

gross hematuria and dull suprapubic pain with voiding

answer

stone in bladder

question

may produce no symptoms, but a ureteral stone "always" causes pain on the affected side because a

answer

ureteral spasm occurs when the stone obstructs the ureter

question

used to evaluate kidney function not stones

answer

creatine/Bun levels

question

5,000-10,000

answer

is a normal WBC count

question

a WBC of 14,000

answer

is elevated an indicates an infection

question

the urine collection bag of a catheter

answer

has to be kept below the level of the bladder to prevent reflux of urine into the renal system and off the floor (microbes)

question

what does serum creatinine of 1.4 mg/dl indicate:

answer

dehydration

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