What is Urolithiasis? Nephrolithiasis? Ureterolithiasis? What causes it? When is emergency tx needed?
A calculi in the urinary tract. Renal colic when in ureters or urethra.
Nephro: kidney stones
Uretero: ureteral stones
high acidity or alkalinity contributes to stone formation
if blocking ureter, causes hydroureter-emergency treatment is needed
Blockage leads to hydroureter leads to infection -> hydronephrosis -> permanent kidney damage
What are the S&S of Renal Colic?
Flank pain "unbearable"
increased BP and pulse
increased WBC in urine
What is the treatment for Urolithiasis?
Lithotripsy (shock waves)-breaks stone into small fragments
Stent: placed by ureteroscopy-enlarges ureter for passage of stones; done under MAC
Strain all urine
Monitor WBC in urine
Monitor for hematuria
What does a urinalysis test? what is normal for each?
Color: should be clear yellow or clear, never cloudy. Can be dark yellow or amber when concentrated
Specific gravity: particles in solution an increase in fluid = decreased sp gravity (1.010-1.030)
pH: measures acidity or alkalinity
Glucose: present in urine when BS > 220
ketones: should be 0; present when fat metabolism instead of glucose
C&S: do from front to back, look for bacteria
Creatinine clearance: over 24 hours; measures GFR
How is bladder cancer treated? What if it is extensive? What is the care for bladder chemo?
Bladder mucosal tumors are removed; tumor in muscle layers are excised and tx with chemo inside the bladder as a wash; Radical cystectomy with urinary diversion is used for more extensive CA followed by chemo and Radiation
Bladder chemo: no fluids 1 hour prior
administer thru catheter
no voiding for 2 hours, change position q 15 minutes
1x/wk for 6 weeks and then q 6 mo x 2 years
What are the different type of surgical management for bladder Cancer?
Cystectomy: removal of bladder with ureteral diversion
Enterostomal therapist is consulted for stome placement
TURBT: done through cystoscope (first line tx?)
Segmental Cystoectomy: part of bladder removed
What is Polycystic kidney disease? S&S?
autosomal Dominant inherited; cysts develop on nephrons
S&S: pain in flank, HTN, Nocturia, increased UN and creat; increased abdominal girth
What is the treatment for Polycystic kidney disease?
decrease sodium intake; alanced I &O; anti-HTN; diuretics (furosemide); dialysis
What is Acute Glomerulonephritis? What are the S&S? how is it dx?
AN infection that settles in the kineys, such as syphilis, Hep B, Chicken pox, M/M