Med_surg2_exam_4[1] - Review NURS 319 MSII Exam 4 Chapter...

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Review NURS 319 MSII Exam 4 Chapter 45 What does dysuria mean? (p.1145) Painful or difficult urination. Possible Etiology and Significance: Sing of urinary tract infection and interstitial cystitis and wide variety of pathologic conditions. How is a creatinine clearance test done? (p. 1146, table 45-8) Creatine is a waste product of protein breakdown (primarily body muscle mass). Clearance of Creatine by the kidney approximates the GFR. (Normal finding 85-153) Collect 24-hr urine specimen. Discard first urination when test is started. Save urine from all subsequent urinations for 24 hour. Instruct pt. to urinate at the end of 24 hour and add specimen to collection. Ensure that serum creatine is determined during the 24 hr. period. Smoking puts a person at risk for what conditions in the urinary tract? (p.1142) Smoking history should be obtained. Cigarette smoking is a major factor for bladder cancer. Tumors are 4 times frequently in cigarette smokers than in nonsmokers. Which medications are nephrotoxic? (p. 1142- table 45-3) Antibiotics Pharm. Agents Other agents Amikacin (amikin) captopril (capoten) gold Amphotericin B cimetidine (Tagamet) heavy metals Bacitracin cisplatin (platinol) contrast medium Cephalosporins cocaine gentamycin cyclosporine Kanamycin ethylene glycol Neomycin heroin Polymyxin B lithium Streptomycin methotrexate Sulfonamides nitroureas (carmustine) Tobramycin NSAIDS(ibuprofen, indomethacin) (Nebcin) Vancomycin Phenacetin, quinine, rifampin, salicylates (large Quantities)
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What are the age-related changes for the urinary system? (p. 1141) anatomic changes in the aging kidney include a 20% to 30% decrease in size and Weight between the ages 30-90 years. By their 70 th decade of life, 30-505 of glomeruli have lost their function. Physiologic changes in the aging kidney include decreased renal blood flow, due to in part to atherosclerosis, resulting in a decreased GFR. Alteration in Hormone levels: ADH, aldosterone, and atrial peptide (ANP) result in decreased urinary concentrating ability, and limitations in excretion of water, Sodium, K, and acid. Physiologic changes in the aging bladder and the urethra. Table on page 1141 for the aging. In a normal person can you palpate the kidney’s? (p.1145) Left kidney is rarely palpated due to the spleen. For the right side of the kidney- the examiners hand left (anterior) hand is placed behind and supports the patient’s right side between the rib cage and iliac crest. The right side flank is elevated with the left hand and with the right hand is used to palpate deeply for the right kidney. The lower pole of the right kidney may be felt as a smooth, rounded mass that descends in inspiration. If it palpable, its size, contour, and tenderness should be noted. Any enlargement is suggestive of neoplasm or owther serious reanl pathologic conditions. How is flank area tenderness assessed?
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Med_surg2_exam_4[1] - Review NURS 319 MSII Exam 4 Chapter...

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