What are the 3 locations you can use as vascular access for hemodialysis?
Subclavians, internal jugular, and femoral catheters
When the foreskin cannot be retracted over the glans of the penis. If a patient is not circumcised then the foreskin must be retracted and cleansed daily or a buildup of secretions accumulate and inflammation occurs.
Urological emergency. Penis is large, hard, and painful. It can cause gangrene and lead to impotence if not treated. Most men wait until is has been a rather long time before seeking treatment.
Caused by inflmmation, trauma, or STD's can cause ______. Treated with dilation of the urethra.
What is the treatment of choice for phimosis?
Female client reports to the nurse that she experiences a loss of urine when she jogs. What type of incontinence is this?
What is a KUB?
Kidneys-ureters-bladder. An xray. (non invasive) Useful in determining presence of tumors, cysts, and stones
What nursing intervention is needed when a paitnet is being prepared for a ultrasonography?
Requires a full bladder
Ultrasonography uses sound waves to detect tissue abnormalties
What procedure requires an injection of radioisotope which is monitored as it moves through the blood vessels of the kidney. It is good for evaluation of renal perfusion or function.
______: injection of IV radiopaque contrast. Visualize layers of the kidney.
_______: catheters are advanced into renal pelvis then dye is injected (identifies location of stones)
________: contrast into bladder to determine if backflow occurs
What nursing intervention is important with a patient receiving a nuclear scan?
Drink lots of fluids to promote exceretion of radioisotope by the kidneys
________: femoral artery is pierced and catheter is fed up to renal artery then contrast is introduced. Evaluate renal blood flow, hypertension.
What nursing measure can you anticipate with a femoral catheter insertion?
Lie 30 degrees angle for 6 hours with affected leg straight
________: contrast is instilled into bladder through a urethral catheter. Patient feels urge to void and catheter is removed, and the patient voids and this is visualized on the flouroscope. Examines bladder and urethra.
What allergies do you need to determine for radiology procedures?
What post op intervention is important for urologic procedures?
Prone position and or bed rest for 6-8 hours
What structure allows urine to flow from the kidney to the bladder?
What is an excellent measure of renal function?
Creatine clearance (creatine is a waste product of skeletal muscle).
- You need a 24 hour urine collection to assess renal function
What lab value is decreased with CRF?
What is the best description of an AV graft?
synthetic tubing tunneled beneath the skin connecting an artery and a vein
What foods should be selected for a patient with CRF?
Foods high in iron and calcium.
(Protein, fluid, and sodium Restriction!)
What is the maximum amount of weight that should be gained between dailysis treatments?
Which type of incontinence is the involuntary loss of urine due to the absence of sensations?
What type of incontinence refers to the loss of urine through an intact urethra as a result of a sudden increase in intra-abdominal pressure?
What is the most common symptom of UTI's in older adults?
changes in cognitive functioning
What finding is hallmark for the diagnosis of nephritic syndrome?
Proteinuria (protein exceeding 3.5 g per day)
What is the correct term for the ability of the kidneys to clear solutes from the plasma?
What is the number one symptom of nephrotic syndrome?
What term would be used to describe a urine output of 400 ml in 24 hours?
______: concentration of urea and other nitrogenous wastes in the blood
excess of urea and other nitrogenous wastes in the blood
A history of infection caused by streptococcus is associated with what disorder?
Retention of which electrolyte is the most life threatening effect of renal failure?
Which medication is given to decrease potassium levels in renal failure?
Which period of acute renal failure is accompanied by an increase in the serum concentration of substances usually excreted by the kidneys?
Oliguria (UOP < 400 cc/day)
What kind of diet does a person who has acute glomerulonephritis need to follow?
Increased carbohydrates to provide energy, decreased proteins and sodium
What is the treatment for benign prostate hypertrophy (BPH)?
Transurethral resection of the prostate (TURP)
What complication is very common after TURP?
Obstructed catheter! Examine tubing for blockage
What type of drainage would you expect to find post op TURP?
How often is hemodialysis performed?
3 times per week, 4 hour treatments
The ______ is the kidney, the _______ is the solution used to bathe the kidney.
What type of catheters are inserted for long term use with dialysis?..... What is greatest complication?
Double lumen catheters.
Greatest complication is Infection
______: anastomosis of an artery and vein. Takes 4-6 weeks to mature.
What is used when the patient has small veins that wont develop properly into a fistula?
Arteriovenous graft (AV graft): you are able to used sooner than fistula, you can use within 2-3 weeks.
How do you assess for patency of a vascular access site?
Auscultate for bruit
Palpate for thrill
What do you need to carry as a dialysis nurse?
Hemostats- b/c if kidney clots or tubes comes loose, you clamp the tubing.
If a patinet seems sleepy or restless after a dialysis treatment, and nausea/vomiting may be a symptom as well, what is occuring?