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Skills Written Test 2 Study Guide

Esrd end stage renal disease uremic syndrome

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ESRD- End Stage Renal Disease -> uremic syndrome (fluid/electrolyte imbalances, nausea, vomiting, headache, coma, convulsions) Bacteriuria- bacteria in the urine Bacteremia/urosepsis- bacteria in the blood stream Women are more susceptible to UTIs b/c short uretra and proximity of urethral meatus to the anus CAUTI- Catheter associated urinary tract infection (urine bacteria growth increases 5% each day a catheter is in place High ash juices (cranberry, apple, prune) help prevent UTIs/ Citrus juices increase risk of getting a UTI Lower UTI: o Dysuria- pain/burning during urination o o Hematuria- blood-tinged urine Upper UTI: kidney infection (pyelonephritis) o Flank pain, tenderness, fever, and chills Intravenous Pyelogram (IVP)- diagnostic exam of urinary system- pt must limit fluids prior to test KUB flat plate- X-ray of kidneys, ureters and bladder OAB- overactive bladder (aka. hyperactive bladder)- most common among elderly- type of incontinence- sudden desire to urinate that is difficult to deter. PVR- Post Void Residual- urine remaining after voiding b/c pt cannot completely empty the bladder (report if >100ml)- may need to use an intermittent/straight catheter to check for this (check twice- after 2 urinations) Milk the tubing- squeeze then release tubing starting proximal to the patient then moving out distally to help loosen/remove clots/sediment without irrigation Urine filter- filter for kidney stones
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Inspect color, clarity, and odor of urine o Color- pale, straw, amber, brown/tea-colored (depends on concentration) o Clarity- Transparent= normal Cloudy= in container too long, protein in urine due to renal disease, or bacteria and WBCs in urine (infection) o Odor More concentrated= stronger odor Stagnant urine= ammonia (chronic incontinence) Diabetes or starvation= sweet/fruity Infection= foul odor
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Specimen collection o Random- from normal voiding, indwelling catheter or urinary diversion collection bag (may use specimen hat to collect from children) o Clean void/ clean catch- clean perineal area and collect midstream o Sterile- via port on indwelling catheter using aseptic technique. Transfer to sterile container. Via in and out/ intermittent catheter o Timed- 2, 12, or 24 hour collections; must have every urine sample for the whole time period (specimen is usually kept on ice to reduce bacterial growth) Timed (24 hr) urine specimen container: Specific gravity- weight or degree of concentration of a substance compared with an equal volume of water Daily weight- indicator of changes in total body fluid ( 1L=1kg=2.2lb) Urge incontinence- (more common in younger women & may be caused by irritating factors like UTIs) sense the urge to urinate (frequently), but cannot hold it long enough to get to a toilet Stress incontinence- (more common in older women) intraabdominal pressure exceeds urethral resistence (i.e. sneezing, laughing, lifting, etc.). Muscles around
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ESRD End Stage Renal Disease uremic syndrome...

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