COTAC exam 4 review.docx - COTAC exam 4 review(ati chapters on test 56-61 67-72 87-88(Lewis Ch 61 62 63 64 44 45 46 Chapter 56 Renal Diagnostic

COTAC exam 4 review.docx - COTAC exam 4 review(ati chapters...

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COTAC exam 4 review (ati chapters on test 56-61, 67-72, 87-88); (Lewis Ch. 61, 62, 63, 64, 44, 45, 46) Chapter 56: Renal Diagnostic Procedures: Lab tests: Serum Creatinine: (0.6-1.2); Kidney disease is the only thing that increases creatinine levels. BUN: (10-20); results from the breakdown of protein/muscles in the liver, creating the byproduct BUN excreted by the kidneys. Elevated BUN indicates kidney disease, factors that also increase BUN include dehydration, infection, chemo, steroids, and reabsorption of blood in the liver from damaged tissue. Urinalysis: evaluates waste products from kidneys and detects urologic disorders. NOTE: try to collect the first morning void. Assess the color, odor, blood/particles, if its cloudy or clear, etc. 24 hour urine shows creatinine, urea nitrogen, Na, Cl, Ca, catecholamines, and proteins. Renal diagnostic procedures: Xray: (KUB); allows for visualization of structures and to detect renal calculi, strictures, calcium deposits, or obstructions. ***ask female patients if they are pregnant, remove all jewelry and metal objects. CT scan: provides 3D imaging of renal/urinary system to assess kidney size, obstruction, cysts, or masses. **note the dye can cause AKI MRI: useful for dx cancer. **note that pt must stay still during MRI Ultrasound: assess size of kidneys, images of ureters, bladder, masses, cysts, calculi, and obstructions of the lower urinary tract. Cystography: detects urethral or bladder injury after istillation of contrast dye through a urinary catheter to provide an image of the bladder and ureters. **monitor for infection for the first 72hr, encourage fluids, make sure urine output is greater than 30mL/hr Kidney Bx: monitor VS, Hgb, Hct levels, and urinary output. **complications include hemorrhage, infection, etc. Cystoscopy: NPO after midnight. Gerontological considerations: Kidney size and function decrease w/ age. As well as blood flow, especially during hypotensive or hypertensive crisis. GFR decreases by half the rate (compared to a young adult) DM, HTN, and HF can affect GFR Weak urinary sphincter can cause urinary incontinence can cause UTIs Enlarged prostate in men can cause urinary retention and infection Chapter 57: Hemodialysis and peritoneal dialysis
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  • Fall '15
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