Med-Surg Exam 5

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emmylou
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Med-Surg Exam 5
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2014-11-01 15:34:59
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Urinary Renal Disorders
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Nursing
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  1. Name three types of lower urinary tract infections.
    Cystitis, Urethritis, and Prostatitis
  2. What parts of the lower urinary tract can a UTI occur in?
    ureters, bladder, urethra, and prostate
  3. Which two lower urinary tract infections occur in males?
    Urethritis and Prostatitis
  4. What can happen if someone with a UTI quits taking their antibiotic?
    sepsis and death
  5. What can UTI's lead to if not treated?
    pyelonephritis and urosepsis
  6. What is the most common microorganism to cause a UTI?
    E. coli
  7. What do enterbacteriaceae micro-organisms (klebsiella, proteus), pseudomonas, Staphylococcus saprophyticus and E. coli cause?
    UTI's
  8. If a female has a history of getting UTI's and wants to prevent getting future UTI's, should she wear wet bathing suites for an extended period of time, take bubble baths, or get in a hot tub?
    No, women should limit feminine hygiene sprays, use UNscented tampons and sanitary napkins and be aware that spermicidal jellies can cause a UTI
  9. What should women do after sexual intercourse and why?
    Void, because sexual intercourse is a risk factor for getting a UTI
  10. What can decreased estrogen in women cause?
    UTI
  11. Why are women's urethras a risk factor for UTI's?
    short and close to the rectum
  12. When someone has a UTI, what objective data might you be able to gather?
    Fever, vomiting, voiding in small amounts, nocturia, urethral discharge, and cloudy or foul-smelling urine
  13. Are pyuria and hematuria a sign of a UTI?
    Yes
  14. If you see a patient scratching their perineal area more often than normal, what could this be a sign of?
    UTI
  15. When someone has a UTI, the patient might complain of these symptoms:
    Lower back and abdominal discomfort and tenderness over the bladder area, nausea, urinary frequency and urgency, dysuria, bladder cramping and spasms, and feeling of incomplete bladder emptying or retention of urine
  16. Name 5 risk factors for a UTI:
    Stool incontinence, bladder distention, bladder prolapse in females, poor perineal hygiene, and hypoestrogen in females
  17. Renal complications increase due to what?
    decreased number of functioning nephrons and fluid intake
  18. Why might someone have "inability to empty bladder" and what is it a risk factor for?
    stroke, UTI
  19. Why can a male have "incomplete bladder emptying" and what is it a risk factor for?
    enlarged prostate, UTI
  20. Within how many hours should you discontinue (DC) an indwelling urinary catheter?
    48 hours
  21. When someone has an indwelling urinary catheter, what are they at risk for?
    UTI
  22. Is diabetes a risk factor for getting UTI's?
    Yes
  23. What are older adults more at risk for when considering UTI's?
    bacteremia, sepsis, and shock
  24. Can genetics be linked to getting UTI's
    Yes
  25. Name 3 diagnostic procedures performed for a suspected UTI:
    CT scan, ultrasonography, and transrectal ultrasonography
  26. in UTI's, what does a cystourethroscopy detect?
    strictures and caliculi
  27. When a UTI is complicated, what diagnostic procedure is done?
    cystoscopy
  28. If someone has S&S's of a UTI, what should you rule out first?
    sexually transmitted infections because they can have same symptoms of a UTI
  29. If someone has a UTI, what will the WBC count and differential results be?
    above 10,000/uL and shift to the left
  30. If a patient has a UTI, what are the expected findings for a urinalysis and culture and sensitivity test?
    bacteria, sediment, WBC's, RBC's, and positive leukocyte esterase and nitrates - 68%-88% indicates a UTI
  31. If a patient is having laboratory tests done for a suspected UTI, what should you have the patient do?
    clean themselves before the test(s)
  32. Name 4 manifestations of a UTI in older adults:
    incontinence, loss of appetite, nocturia, and dysuria
  33. If an older adult has a UTI and has hypotension, tachycardia, and a fever, what should you monitor for?
    shock
  34. What is the first sign of an older adult having a UTI?
    mental confusion
  35. Name 6 things you would teach a patient with a UTI
    drink at least 3 liters of fluid daily, bathe daily, empty bladder every 3-4 hours, urinate before and after intercourse, drink cranberry juice, and empty bladder as soon as there is an urgency to void
  36. flouroquinolones (ciprofloxacin, norfloxacin, levofloxacin) and trimethoprim are medications used to treat what?
    UTI's
  37. Name the medication used for bladder analgesia to treat UTI's
    phenazopyridine (Pyridium, Urogesic)
  38. For UTI's, what antibacterial medication achieves therapeutic levels in the urine only?
    Nitrofurantoin
  39. When a patient has UTI, what medication is administered less frequently and why?
    Penicillins and cephalosporins because they are less tolerated
  40. When a patient has a UTI, what is typically the first medication they are started on?
    sulfonamides (Bactrim or Septra)
  41. name 4 nursing care things you'd do for a patient with a UTI?
    promote fluid intake up to 3 liters daily, administer antibiotic medications as prescribed, encourage clients to urinate every 3-4 hours instead of waiting till bladder is full, and encourage clients to bathe daily
  42. Why would you avoid the use of indwelling catheters in a patient with a UTI?
    it reduces the risk for infection
  43. What kind of bath are you going to recommend to a patient with a UTI?
    warm sitz bath
  44. What are some risk factor differences associated with older adults in pyelonephritis?
    they might exhibit GI or pulmonary symptoms instead of febrile symptoms. they also experience incomplete bladder emptying
  45. when urine pH increases becoming alkaline in older adults promoting bacterial growth, what is this a risk factor for?
    pyelonephritis
  46. what chronic illnesses are risk factors for pyelonephritis?
    diabetes mellitus, hypertension, and chronic cystitis
  47. what is interstitial inflammation, tubular cell necrosis, and temporarily altered kidney function?
    acute pyelonephritis
  48. In chronic pyelonephritis, what happens at the junction where the ureter connect to the bladder?
    reflux
  49. What is the result in the thickening of the calycles and post inflammatory fibrosis with permanent renal tissue scarring?
    chronic pyelonephritis
  50. Obstructions, urinary anomaly, and vesicoureteral are more common in acute or chronic pyelonephritis?
    Chronic
  51. What is the result of repeated infections that cause progressive inflammation and scarring?
    Chronic Pyelonephritis
  52. During pyelonephritis, what forms in the capsule, cortex, or medulla?
    Abscess
  53. Why does renal function decrease during pyelonephritis?
    impaired filtration, reabsorption, and secretion
  54. After repeated infections of pyelonephritis, why does blood flow decrease to the kidney, glomerulus, and tubular structure?
    scarring
  55. What organism is the most common cause for acute cases of pyelonephritis?
    E. coli
  56. What is one cause for cystitis turning into pyelonephritis?
    Person didn't take antibiotic like they should when they had cystitis and then they get pyelonephritis
  57. What is an infection and inflammation of the kidney pelvis, calyces, and medulla. The infection usually begins is the lower urinary tract with organisms ascending into the kidney pelvis.
    Pyelonephritis
  58. What part of the urinary tract does Pyelonephritis affect?
    Upper
  59. what objective data can you gather form a patient with pyelonephritis?
    fever, tachycardia, tachypnea, hypertension, flank and back pain, vomiting, nocturia, inability to concentrate urine or conserve sodium, and asymptomatic bacteremia
  60. what are 9 symptoms of pyelonephritis:
    chills, colicky-type abdominal pain, nausea, malaise, fatigue, burning, urgency, frequency with urination, and costovertebral tenderness
  61. name 4 risk factors for pyelonephritis:
    chronic urinary stone disorders, spinal chord injury, pregnancy, congenital malformations, and bladder tumors
  62. What are men over the age of 65 who have had prostatitis and hypertrophy of the prostate at risk for?
    pyelonephritis
  63. read over surgery if you want but Henley said we wont be tested on it
    ....
  64. A patient comes into the clinic complaining of chills, colicky-type abdominal pain, burning and urgency with urination. After taking their vital signs, doing an assessment, urinalysis, and labs, the patient has a fever, tachycardia, hypertension, tachypnea, flank and back pain, inability to concentrate urine or conserve sodium, and asymptomatic bacteremia, what do you suspect the patient has?
    pyelonephritis
  65. what diagnostic procedures can be done to test for pyelonephritis?
    X-ray of kidneys, ureters, and bladder (KUB), ultrasonography which detects cysts and tumors, Gallium scan, and intravenous pyelogram (IVP) which injects dye
  66. What laboratory tests would be done for suspected pyelonephritis?
    urinalysis and urine culture and sensitivity, WBC count and differential, creatinine and BUN, C-reactive protein, and ESR
  67. What laboratory test will be elevated during acute episodes of pyelonephritis?
    serum BUN and creatinine
  68. What opioid analgesics (opioid agonists) would you administer for pyelonephritis and what for?
    morphine sulfate and morphine, moderate to severe pain
  69. How long would someone take antibiotics at home for pyelonephritis?
    14 days
  70. What are some nonsurgical things you would assess/monitor for a patient who has pyelonephritis?
    nutritional status, I&O, F&E balance, pain status, temperature, pain, increase fluid intake to 2-3 liters/day unless contraindicated, administer antipyretic such as Tylenol, provide emotional support, and assist with personal hygiene
  71. What are some complications of pyelonephritis?
    septic shock, chronic kidney disease, and hypertension
  72. What are some risk factors associated with urolithiasis?
    urinary tract that is damaged, urine flow that is decreased, concentrated and contains particles (calcium)
  73. who gets kidney stones more? men or women
    MEN!!! we're even now :)
  74. What is the cause of urolithiasis?
    unknown
  75. what factor influence whether a person will be able to expel a kidney stone?
    composition, size, and location of stone
  76. Will most patients be able to expel a kidney stone?
    Yes
  77. If you have had a kidney stone under the age of 25 or your family has a history of kidney stones, what are you at risk for?
    35-50% risk of developing future kidney stones
  78. Is a diet high in calcium believed to increase the risk of stone formation?
    No
  79. What are the majority of stones comprised of (75%) and what are 3 other substances stones might contain
    majority: calcium, phosphate, and calcium oxalate, uric acid, struvite, and cystine
  80. what is urolithiasis?
    presence of calculi/stones in the urinary tract
  81. name for things you would teach a client with pyelonephritis:
    educate about nutritional status, take medications as prescribed, instruct client to notify provider is acute onset of pain occurs or a fever is present, and encourage pt to take rest periods as needed from activity
  82. How will you help the family of a patient with pyelonephritis?
    encourage them to express their fears and anxiety related to the disease
  83. How many liters of fluid will you instruct a client with pyelonephritis who is now being discharged to drink per day?
    at least 3 liters
  84. What will you tell a patient with pyelonephritis to do after they will be charged?
    follow up with the provider
  85. What will a client with pyelonephritis who needs assistance with medications and nutritional therapy need after discharge?
    Home care services
  86. Name 2 aminoglycoside antibiotics given for pyelonephritis and why you would not give them if creatinine was increased:
    Tobrex and Amkin. could become toxic to aminoglycosides
  87. Name 2 aminopenicillin antibiotics given for pyelonephritis:
    Principen and Unasyn
  88. What are two cephalosporin antibiotics given for pyelonephritis?
    Cefizox and Fortax
  89. What is the most common IV med given for pyelonephritis?
    Cipro
  90. How long is pyelonephritis treated in the hospital with IV fluids?
    24-48 hours
  91. What quinolone antibiotic would you administer for pyelonephritis?
    Cipro and Levaquin
  92. What anti-infective medication would you give for pyelonephritis?
    trimethoprim (Primsol), Bactrim, Septra
  93. what is some objective data you can gather from a patient who has a kidney stone?
    diaphoresis, pallor, n/v, tachycardia, tachypnea, increased or decreased BP with pain, oliguria, hematuria
  94. if a patient has a renal caliculi and they are complaining of flank pain that radiates down the abdomen, scrotum, testes, or vulva, where is the caliculi?
    ureter or bladder
  95. if a patient has a renal caliculi and they are complaining of flank pain, where in the renal system is the stone?
    kidney or ureter
  96. what symptoms will a patient with a kidney stone complain  of?
    severe pain, pain intensifying throughout ureter, urinary frequency or dysuria, fever
  97. name some risk factors for kidney stones:
    urinary stasis, retention, immobilization, dehydration, and decreased fluid intake
  98. what can high alkalinity or acidity be a risk factor for?
    stones
  99. what is increased production or decreased clearance of purines (contributing to increased uric-acid levels) a risk factor for?
    kidney stones
  100. name some foods that have oxalate in them which can cause stones:
    black tea, spinach, beets, Swiss chard, chocolate, and peanuts
  101. what is increased oxalate production (genetic) or inability to metabolize oxalate a risk factor for?
    kidney stone
  102. increased intestinal absorption or decreased renal excretion of calcium is a risk factor for what?
    kidney stone
  103. What kind of anesthesia is used for lithotripsy
    Moderate/conscious sedation and make sure monitor ECG
  104. What is ESWL used for (extracorporeal shock wave lithotripsy) used for and how does it work
    Kidney stones, sound laser to break stones into fragments
  105. What does Dilropan relieve for overactive bladder
    Pain
  106. What NSAID med do you give for kidney stones
    Ketorolac
  107. What med is used in the first 24 hours of acute onset of stones
    Morphine sulfate
  108. What do you do with a patient's urine who has a kidney stone
    Strain all urine and check for stone
  109. Why would you encourage ambulation for a patient with a kidney stone?
    To promote passage of the stone
  110. When caring for patient with kidney stones, what 5 things would you assess/monitor
    Pain status, I&O, urinary pH, administer meds and IV fluids
  111. Name 5 radiology examinations used to detect kidney stones
    KUB (kidney ureter bladder), CT MRI, renal ultrasound and intravenous pyelogram (IVP)
  112. Why is a CT or MRI used for testing for kidney stones
    Can detect cystine or uric acid stones which cannot be seen in an x ray
  113. In a urinalysis for kidney stones what would you look for regarding metabolic disorders
    Abnormal serum calcium phosphate and uric-acid levels
  114. In a urinalysis for kidney stones what is seen microscopically?
    Crystals
  115. When RBC's and WBC's are elevated in a urinalysis what does that indicate?
    Infection
  116. for prevention of cystine stones you...
    limit animal protein intake
  117. What does Zyloprim do regarding kidney stones
    decrease uric acid
  118. what do you avoid to prevent uric acid stones
    decreased intake of purines (organ meats and sardines)
  119. for struvite stones what do you avoid
    high-phosphate foods (dairy, red meat, and whole grains)
  120. for calcium oxalate stones what do you avoid
    sodium and oxalate sources
  121. why are orthophosphates used to treat kidney stones?
    decrease saturation of calcium
  122. Why are thiazide diuretics used to treat kidney stones?
    increases absorption of calcium
  123. for calcium phosphate stones what would you teach patient who has had them
    limit intake of animal protein, sodium intake and calcium (dairy)
  124. What would teach a patient who's had kidney stones about how to prevent more kidney stones
    role of diet and medications
  125. Name 2 complications for kidney stones and what happens with the complications
    1. obstruction - decreased urine output, and 2. hydronephrosis  - urine backs up and causes distention of the kidney. Call provider to remove stones
  126. what is captopril used for regarding kidney stones
    lowers urine cystine
  127. What are 7 symptoms for glomerulonephritis that deals with fluid volume excess?
    pitting edema in lower extremities, weight gain, SOB, orthopnea, bibasilar rales, periorbital edema, and hypertension
  128. what are 3 renal symptoms for glomerulonephritis?
    decreased urine output, smoky or coffee-ground emesis, and proteinuria
  129. what are 3 risk factors for glomerulonephritis?
    vascular injury, high protein and sodium diets, and diabetes mellitus
  130. when older adults have glomerulonephritis, why are they at risk for chronic kidney failure?
    they have decreased working nephrons
  131. what 3 symptoms do older adults report of for glomerulonephritis and are vague symptoms?
    fatigue, nausea, and joint aches
  132. what are immunological risk factors for glomerulonephritis?
    primary infection with group A beta-hemolytic streptococcal infection (most common), and systemic lupus erythematous
  133. is acute glomerulonephritis more a child or adult disorder?
    child
  134. what is the 3rd leading cause for end-stage kidney disease?
    chronic glomerulonephritis
  135. what is progressive destruction of the glomeruli and eventual hardening (sclerosis)?
    chronic glomerulonephritis
  136. can chronic glomerulonephritis occur without a previous history or known onset?
    Yes
  137. what is the prognosis of acute glomerulonephritis?
    varies depending on the cause, but usually spontaneous recovery usually occurs
  138. what is it when insoluble complexes develop and become trapped in the glomerular tissue producing swelling and capillary cell death?
    acute glomerulonephritis
  139. what is inflammation of the glomerular capillaries, usually following a strep infection
    glomerulonephritis
  140. what are three diagnostic procedures done for glomerulonephritis?
    KUB (x-ray of kidney, ureter, and bladder), renal ultrasound and kidney biopsy
  141. name 4 lab tests for glomerulonephirits?
    urinalysis, throat culture, creatinine clearance 24 hr urine collection and GFR
  142. what two lab tests would be elevated if someone had glomerulonephritis?
    BUN and creatinine
  143. Why would WBC count be elevated when testing for glomerulonephritis?
    positive for strep
  144. what electrolyte imbalance is associated with glomerulonephirits?
    hypokalemia
  145. what are three rare symptoms in older adults for glomerulonephritis?
    confusion, sleepiness, and possible seizures
  146. is pruritus associated with acute or chronic glomerulonephritis?
    chronic
  147. is fever associated with acute or chromic glomerulonephritis?
    acute
  148. what is the best nursing intervention for someone who intrarenal acute kidney injury?
    monitoring daily weights
  149. how will you prevent nephrotoxicity in patients with prerenal acute kidney injury?
    avoid nephrotoxic medications or combining two or more meds which may increase nephron destruction
  150. What are the 4 stages of acute kidney injury?
    • 1. onset
    • 2. oliguria
    • 3. diuresis
    • 4. recovery
  151. what is the sudden cessation of renal function that occurs when blood flow to the kidneys is significantly compromised?
    acute kidney injury
  152. does a person with polycystic kidney disease experience constipation?
    Yes
  153. what will a urinalysis show in someone with polycystic kidney disease?
    hematuria and proteinuria
  154. what are 4 symptoms of polycystic kidney disease?
    pain (flank or abdominal), distended abdomen, enlarged tender kidney upon palpation, hematuria or cloudy urine
  155. what is polycystic kidney disease?
    inherited disorder in which fluid-filled cysts develop in the nephrons
  156. name 4 complications of glomerulonephritis:
    uremia, pulmonary edema, CHF, anemia of iron
  157. what is plasmapheresis?
    filters antibodies out of circulating blood volume by removing the plasma
  158. what antibiotic would you administer for glomerulonephritis?
    Megacillin, Erythrocin, azithromycin
  159. what three drugs would you administer to a patient who has glomerulonephritis?
    diuretics, vasodilators, and corticosteroids
  160. how many stages of chronic kidney disease are there?
    5
  161. what are the three different kinds of acute kidney injury/chronic kidney disease?
    prerenal, intrarenal, and postrenal
  162. what diet changes will be implemented for someone with kidney injury?
    regulate potassium and sodium, high protein intake, possible TPN
  163. when taking history for someone who might have acute glomerulonephritis, what questions would you ask?
    • have you had any recent infections?
    • have you traveled anywhere?
    • do you have lupus?
    • are you a diabetic? (screening for diabetic nephropathy)
  164. if someone has chronic glomerulonephritis, what question would you ask during the history taking process?
    have you had a recent strep infection?
  165. what would you do/monitor for if someone had a complication of uremia from glomerulonephritis?
    give high carb diet, monitor for if they have a metallic taste, cramps
  166. what would you teach a client before they have lithotripsy?
    could have bruising after surgery, can take several weeks to resolve, could have hematuria for days after surgery
  167. when someone with a UTI has a catheter, what will you assess/monitor/implement?
    assess daily for need, consider alternatives, sterile procedure, use smallest size that will work, no more than 10 mL into balloon, and avoid routine catheter irrigation
  168. when someone with a UTI has a catheter, where do you place the collection bag?
    below level of bladder at all times
  169. what history would you ask of someone with a UTI?
    renal problems (kidney stones, functional diseases), impaired immune response (DM, autoimmune)
  170. what are some complications of UTI?
    urosepsis, and preterm labor/birth
  171. what med used for UTI's can cause urine to turn orange?
    phenazopyridine (Pyridium, Urogesic)
  172. what is azotemia and what is it a complication of?
    it is the accumulation of nitrogenous wastes in the blood is in uremic poisoning and it occurs in acute renal failure
  173. is polycystic kidney disease reversible or irreversible?
    irreversible
  174. what complications can someone with polycystic kidney disease end up with and what are the symptoms?
    uremic state - n/v, pruritus, and fatigue
  175. when assessing someone for polycystic kidney disease symptoms, what would you look for?
    pain (flank or abdominal), distended abdomen, enlarged tender kidney on palpation, hematuria or cloudy urine, and dysuria and nocturia
  176. when taking a history from someone who might have polycystic kidney disease, what questions would you ask?
    genetic Hx, family history of polycystic kidney disease, family Hx from sudden death of stroke, Hx of constipation, changes in urine and high BP
  177. what are someone intrarenal acute kidney injury causes?
    physical injury, hypoxic injury, chemical injury (NSAIDS, nephrotoxins), and immunologic injury
  178. what lab values would you review for someone with prerenal acute kidney injury?
    H&H, BUN, creatinine, and electrolytes
  179. for someone with prerenal acute kidney injury, what would you monitor/assess?
    monitor for hypovolemia and hypotension, I&O, assess need for diuretics, and monitor F&E
  180. what are some causes of prerenal acute kidney injury?
    obstruction, shock, decreased CO leading to decreased renal perfusion, sepsis, and hypovolemia
  181. if acute kidney disease is not treated what could it lead to?
    chronic kidney disease
  182. in someone with polycystic kidney disease, what would you teach the patient and family members?
    how to measure BP, discuss salt, protein, and fiber, and drug administration
  183. what would you restrict in someone with polycystic kidney disease if kidney injury is getting worse?
    protein
  184. name 4 interventions you would do for someone with constipation as a result of polycystic kidney disease:
    nutritional management, regular exercise, fluid management, and stool softeners
  185. what would teach someone with polycystic kidney disease to do to help with pain?
    relaxation techniques
  186. what would you apply to the abdomen and flank region on someone with polycystic kidney disease?
    dry heat
  187. would you administer antibiotics if cysts infection is causing discomfort in someone with polycystic kidney disease?
    Yes
  188. what analgesic would you want to avoid giving in someone with polycystic kidney disease?
    aspirin. use NSAIDS cautiously!
  189. what lab test would you expect to be done if infection was suspected in someone with polycystic kidney disease?
    urine culture and sensitivity
  190. would you restrict fluid intake in someone with intrarenal acute kidney injury?
    Yes
  191. what would you assess for in someone with intrarenal acute kidney injury?
    edema, heart failure, pulmonary edema, flank pain, n/v, lethargy, tremors, and confusion
  192. in someone with intrarenal acute kidney injury, what two urine manifestations would they have?
    oliguria and anuria
  193. what are two abnormalities you would see in an EKG in someone with intrarenal acute kidney injury?
    dysrhythmias, and tall T waves
  194. in intrarenal acute kidney injury, which is increased and which is decreased: calcium and potassium
    potassium is increased and calcium is decreased
  195. what would you teach someone with chronic kidney disease about their skin?
    to notify the provider if they see signs of skin breakdown
  196. what kind of antacids would you instruct a person with chronic kidney disease to avoid?
    antacids containing magnesium
  197. what would you teach someone with diabetes mellitus regarding chronic kidney disease
    adhere to strict glucose control because uncontrolled diabetes can lead to chronic kidney disease
  198. after someone with chronic kidney disease is discharged, what services may be consulted?
    nephrology, nutritional, and smoking cessation services
  199. name 4 medications someone with chronic kidney disease might take
    erythropoietin alfa, aluminum hydroxide gel, ferrous sulfate and furosemide (Lasix)
  200. what is Kayexalate and what patient would be taking this medication?
    kayexalate increases elimination of life-threatening potassium levels and is given to people with chronic kidney disease
  201. when would you administer Digoxin to someone with chronic kidney disease receiving dialysis?
    after they have dialysis
  202. for someone with chronic kidney disease, what would you monitor?
    urinary elimination, vital signs, and weight
  203. what type of diet would someone with chronic kidney disease have?
    high in carbs and  moderate in fat
  204. when someone with chronic kidney disease has a dialysis, what would you want to monitor?
    vascular access or peritoneal dialysis insertion site
  205. name 5 complications of chronic kidney disease
    dysrhythmias, fluid overload, uremia, metabolic acidosis, and hypertension
  206. name 8 diagnostic tests for chronic kidney disease
    ultrasound, KUB, CT scan, MRI without contrast dye, aortorenal angiography, cystoscopy, retrograde pyelography, and kidney biopsy
  207. is metabolic acidosis a complication of Acute kidney  failure?
    yes
  208. what is chronic kidney disease related to in most cases?
    fluid volume overload
  209. name some objective data for someone who has chronic kidney disease
    involuntary leg movements, depression and intractable hiccups
  210. name some health prevention and promotion methods for chronic kidney disease?
    drink at least 3 liters of fluid daily, smoking cessation, teach importance of adherence to medication regimen, encourage yearly testing for albumin levels if they have diabetes and hypertension
  211. is dialysis or kidney transplantation a cure for chronic kidney disease?
    No
  212. what classifies end-stage kidney disease?
    when 90% of functioning nephrons have been destroyed
  213. is systemic lupus erythematous a risk factor for chronic kidney disease?
    yes
  214. what are some risk factors for chronic kidney disease?
    acute kidney injury, diabetes mellitus, chronic glomerulonephritis, nephrotoxic medications, polycystic kidney disease, recurrent severe infections, and renal artery stenosis
  215. if a African American has high blood pressure, what are the especially at risk for?
    chronic kidney disease
  216. what are older adults at risk for when they have chronic kidney disease and are on bedrest and have a last of thirst
    dehydration
  217. which age group is more at risk for chronic kidney disease and why?
    older, normal aging process - decreased working nephrons and decreased GFR
  218. in the beginning of chronic kidney disease, may the patient be symptomatic or asymptomatic?
    asymptomatic
  219. is chronic kidney disease irreversible?
    no
  220. what would you teach someone about prevention of acute kidney injury?
    drink 2-3 liters of fluid daily, smoking cessation, weight loss, cautious use of NSAIDS, and control of high BP and diabetes
  221. would TPN possibly be required with someone with acute kidney injury?
    yes
  222. for nutrition, what would you restrict in someone with Acute kidney injury in the oliguric phase who does NOT require dailysis?
    intake of potassium, phosphate and magnesium
  223. what diagnostic tests would you do for someone with Acute kidney injury and why?
    X-ray - detect caliculi, ultrasound - detect obstruction, CT scan - detect obstruction or tumors, kidney biopsy - detect immunological disease or kidney dysfunction reversibility and need for dialysis
  224. how much can creatinine increase in acute kidney injury?
    1 to 2 mg/dL every 24-48 hours or 1-6 mg/dL within a week or less
  225. in acute kidney injury, how much can BUN rise to?
    80 to 100 mg/dL within one week
  226. what lab values would you monitor for acute kidney injury?
    creatinine, BUN, and urine specific gravity
  227. what would you assess/implement for in someone with postrenal acute kidney injury?
    changes in urination stream or difficulty starting stream, blood in urine, and main have on high protein diet
  228. what causes postrenal acute kidney injury?
    stone, tumor, prostate hyperplasia, urethral stricture, and spinal chord injury

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