med surg 2 exam 2

what is the functional unit of a kidney

nephron

what is the “washing machine” in the kidney

glomerulus

what does the kidney filter

hydrogen, urea (waste product of ammonia), creatinine (waste product of protein)

HUC

what is cystitis

infection in bladder

where does UTI affect

below kidneys (ureters, bladder, urethra)

what is pyelonephritis

infection in the upper urinary (kidney)

diagnostic tests for UTI

CNS, urinalysis, RBC, WBC, cystoscopy

what does urine culture and sensitivity determine

kind of bacteria

s/s of UTI

frequent urination with small amount, nocturia, dysuria, cloudy/ foul smell, hematuria, pyuria, fever, mental changes (elders)

how does cranberry juice help UTI

contains proanthocyanidins, which stops bacteria from attaching

what is a urinary analgesic

phenazopyridine

will turn urine orange

Tx for UTI

ciprofloxacin, nitrofurantoin

risk factors for pyelonephritis

elders, prostate problems, chronic urinary stones, pregnancy, bladder tumors, diabetes

diagnostic test for pyelonephritis

elevated BUN and creatinine, CNS, urinalysis

intravenous pyelogram pre op

check renal function and allergies to shellfish, NPO at midnight,

what might happen during dye injection with intravenous pyelogram

warm sensation and salty taste (is normal)

intravenous pyelogram post op

diuretics and increase fluids

s/s of pyelonephritis

flank and back pain, colicky abdominal pain (spasmodic), costovertebral tenderness, fever, tachycardia, tachypnea, HTN

what is the intervention for pyelonephritis

narcotic, NSAID, antibiotic, increase fluid (unless they have kidney failure), antipyretics

what is a risk factor of glomerulonephritis

streptococcal infection (get throat culture)

s/s of glomerulonephritis

smokey/ coffee color urine, periorbital edema, hypertension, pruritus (chronic), fluid excess symptoms

what causes periorbital edema

low albumin allows fluid to leak, normal albumin levels keeps fluids in vascular space

what is low albumin common in

malnutrition, burns, and liver disease

what is nephrotic syndrome

proteinuria, high fat and cholesterol, edema, low albumin

interventions for nephrotic syndrome

high protein and albumin, low fat cholesterol and sodium, diuretics

what makes up mineral calculi

calcium, oxalate, uric acid

risk factor for renal calculi

dehydration, obesity, supplements

s/s of renal calculi

severe sharp pain on side and back below ribs, pain radiates to lower abdomen and groin, pain/ burning while urinating

intervention for renal calculi

pain meds, fluids, strain urine to determine type of stone

what is TURP

transurethral prostatic resection, a procedure for BPH with hook that chips away at prostate to make a tunnel for urine

s/s of BPH

frequent urge to urinate but slow, difficulty starting, feeling that bladder isnt empty, bladder distention

what to know about bladder irrigation

only use sterile isotonic solution, clots are expected

if output is less check tubing and positioning

if spasms occur, stop

s/s of peritonitis

NV, absent bowel sounds, oliguria, tachycardia

what is ileal conduit common with

bladder cancer, trauma, spina bifida

risk factor for renal failure

diabetes, chronic glomerulonephritis, pyelonephritis, HTN

what is prerenal, intrarenal and postrenal

pre- decreased blood flow

intra- damage to kidney itself

post- obstruction

examples of nephrotoxic meds

vancomycin, ibuprofen, acetaminophen

diagnostic tests for renal failure

urinalysis, renal ultrasound, KUB, CT scan, low sodium, high potassium

what does renal angiography depend on

depends on how bad the kidneys are

interventions for renal biopsy

consent, NPO at midnight, prone position, apply pressure to injection site with sandbag for 30 min, check PT and INR

value for BUN

10-20

value for serum creatinine

0.6-1.2

value for serum uric acid

3-7

value for urine specific gravity

1.010- 1.030

value for urine creatinine

85-135

value for glomerular filtration

125

value for sodium

135-145

value for potassium

3.5-5

value for calcium

9-10.5