renal and urinary tract function Flashcards

Chronic Renal Failure
Terms Definitions
an abnormal constituent of urine is:
the normal quantity of water ingested and excreted in the urine is approximately
The normal amount of sodium ingested and excreated in the urine is approxiomately:
6to 8g/day
Increased blood osmolality will result in:
antidiuredic hormone (ADH) stimulation
A major sensitive indicatior of kidndy disease is the:
creatineine clearance level
a major manifestation of uremia is:
hypocalcemia with bone changes
significant nursing assessment data relevant to renal function should include information about:
*any voiding disorders*the presence of hypertension or DM*the patient's occupation
oliguria is said to be present when urinary ouput is
*less than 30 mL/hour
a 24-hour urine collection is scheduled to begin at 80:00 AM. the nurse should begin the procedure:
after discarding the 8:00 AM specimen
the nurse should inform a patient that preparation for intravenous urography includes:
liquids before the test
nursing responsibilities after renal angiography include
*assessing for the clinical manifestaions *encouraging a fluid intake of 3 L every 24 hours *obtaining a sample of each voided urine to compare it with a prebiopsy specimen
the kidneys are locataed in the posterior wall of the abdomen, from the ______ vertebra to the _____ vertebra.
12th thoracic3red lumbar
the functional unite of each kidney is the:
normal adult bladder capacity is:
300 - 600
the regulation of the amount of sodium excreted depends on the hormone:
the normal urine osmolality ranges between :
300 and 100mOsm/kg
when a person is dehydrated, the urine osmolality is:
water is reabsorbed, rather than excreted, under the control of the:
the antidiuretic hormone(ADH)
the test that most accurately reflects glomerular filtration and renal excretory function is the:
creatine clearance test
the most accurate indicatior of fluid loss or gain in an acutely ill patient si:
the nurse notes that a patient who is retaining fluid has a 1kg weight gain. the nurse knows this is equivalent to about:
the type of incontinence that results from a sudden increase in intra-abdominal pressure is:
stress incontinence
fluid management as a menthod of behavioral therapy for incontinence requires a daily liquid intake of:
1.5 mL
A spastic neurogenic bladder is associated with all of:
*a loss of conscious sensation and cerebra motor control *hypertrophy of the bladder walls *reduced bladder capacity
The major complication of neurogenic bladder is
the major cause of death for patients with neurologic impairment of the bladder is
renal failure
nursing measures for the patient with neurogenic bladder include:
*encouraging a liberal fluid intake *offering a diet low in calcium *keeping the patient as mobile as possible
When managing a closed urinary drainage system, the nurse needs to remember not to:
*allow the drainage bag to touch the floor. *raise the drainage bag above the level of the pateient's bladder. *disconnect the beg
a sign of a possible urinary tract infection is:
*cloudy urine
a woman is tought to cathererize herself by inserting the catheter into the urethra
3 inches
the process that underlies and supports the procedure of hemodiallysis is:
* diffusion *ultrafiltration *osmosis
an incomplete protein not recommended for the diet of a patient managed by long-term hemodialysis is that found in:
with peritoneal dialysis, ura and creatinine pass through the peritoneum by:
diffusion and osmosis
the complete peritoneal dialysis process of removing toxic substances and body wastes takes
36 - 48 hours.
at the end of five peritoneal exchanges, the patient's fluid loss was 500 mL. this loss is kequal to:
1.0 lb (1 L = 1 kg = 2.2 lbs)
the chief danger after renal surgery is:
a nephrosomy tube is inserted to:
*conserve and restore tissue traumatized by obstruction. *provide drainage from the kidney postoperatively. *provide ureter drainage when there ils an interruption of the normal drainage course.
s/s of calcium deficit
carpopedal spasm and tetancy
s/s of calcium excess
muscle hypotonicity and flank pain
s/s of fluid volume deficit
oliguria and weight loss
s/s of fluid volume excess
magnesium deficit
positive Chvostek's sign
s/s of potassium deficit
soft, flabby muscles and weakness
s/s of potassium excess
irritability and intestinal colic
s/s of protein deficit
chronic weight loss and fatigability
s/s of sodium deficit
fingerprinting on the stermum
s/s of sodium excess
rough, dry tougue and thirst
list three classification of medications that cause urinary retension by inhibiting contractility
anticholinergics, antispasmodics, and tricyclic antidepressants
list four reasons for catherterization
a. to allow drainage in patioents with neurogenic bladder dysfuknciton. b. to bypass an obstruction that blocks urine flow. c. to provide postoperative drainage following urologic and other surgeries d. to monitor hourly urinary ouput in critically ill patints
list several pathogens responsible for catheter-associated urinary tract infections
escherichia coli, klebsiella, proteus, pseudomonas, enterobacteriaceae, serratia, and candida
list several sighs and symptoms associated with catheter-induced urinary tract infections
signs and symptoms seen in catherter-induced urinary tract infections may include cloudy urine, hematruia, fever, chills, anorexia, and malasise
one leading cause of death for lpatients undergoing chronic hemodialysis is
aterioseclerotic cardiovascular disease is one leading cause of death
list six potential complications of dialysis treatment
hypotension, air embolism, chest pain, dysrhythmias, pruritys, dialysis, disequilibrium, painful muscle cramping, nausea, vomiting, and exasnguination
the most common and serious complication of continuous ambulatory peritoneal dialysis (CAPD) is:
pertonitis is the most common and most serious complication of CAPD
two complications of renal surgery that are believed to ve caused by reflex paralysis of intestinal peristalsis and manipulation of the colon or duodenum during surgery are:
abdominal distenstion and paralytic ileus are common complications oif renal surgery
edward, a 29-year-old diabetic, chose CAPD as a way of managing his end-stage renal disease. Edward chose CAPD because it helped him:
avoid several dietary restricitons; have cnotrol over his daily activities; control his BP
using CAPD. edword needs to dialyze himself:
approximately 4 to 5 times a day with no night changes
Edward needs to be aware that toxic wastes are exchange during the equilibration or dwell time, which usually lasts for
10 to 15 minutes
edward needs to be taught how to detect sighs of the most serious and most common complication of CAPD, which is:
edward's diet should be modified to be:
high in protein
the most common site of a lower urinary tract infection (UTI) is the:
there is an increased risk of UTI's in the presence of
altered metobolic states; urethral mucosa aabration; immunosuppression
the most common organism reponsible for UTI's in the elderly is:
Escherichia coli
resent clinical trials for antibacterial agents against UTIs found the following drug to be significantly effective;
a majority of randomized studies have indicatied that daily consumption of _______ juice decreases the incidence of UTIs:
health information for a female patient diagnosed a shaving cystitis includes:
cleanse around the perineum and urethral meatus (from front to back) after each bowel movement; drink liberal amounts of fluid; shower rather than bathe in a tub
complications of chronic pyelonephritis include:
end-stage renal disease; hypertension; kidndey stone formation
acute glomerulonephritis refers to a group of kidney diseases in which there is:
an inflammatory reaction; cellular complexes that lodge in the glomeruli and injure the kidney; an antigen-antibody reaction to streptococci that rewuls in circulating molecular complexes
in most cases, the major stimulus to acute glomerulonephritis is:
group A streptococcal infection of the throat
laboratory findings consistent wiht acute glomerulonephritis include :
hematuria; proteinuria; white cell casts
chronic glomerulonephritis is manifested by:
anemia secondary to erythropoiesis
the major manifestion of nephrotic syndrome is
oliguria is a clinical sigh of acute renal failure that refers to a daily urine output of:
a fall in CO2-combining power and blood pH indicates a _____ accompanying renal funciton
metobolic acidosis
hyperkalemia is a serious electrolyte imbalance that occurs in acut e renal failure (ARF) and resuls from:
protein catabolism; electrolyte shifts in response to metobolic acidosis; tissue breakdown
potassium intake can be restricted by eliminating high-potassium food such as:
citrus fruits
a patient with ARF and dnegative nitrogen balance is expected to lose about:
0.5 kg/day
the leading cause of end-stage renal disease is
diabetes mellitus
in chronic renal failure (end-stage renal disease), decreased glomerular filtration leads to:
increased pH; decreased creatinine clearance; increased blood urea nitrogen(BUN
decrased levels of erythropoietic, a substance normally secreted by the kidneys, leads to ________ serious complication of chronic renal failure.
recent research about the long-term toxicity of aluminum products have led physicians such A:
calcium carbonate
dietary intervention for renal deterioration includes limiting the intake of:
fluid; sodium and potassium; protein
preoperative management for a patient who is to undergo kidney transplantation includes:
bringing theemtabllic state to as normal as level as possible; suppressing inmmunologic defense mechanisms; making certain that the patient is free of infection
postoperative management for a recipient of a transplanted kidney includes:
aseptic technie to avoid infection; protective isolation while immunosuppressive drug therapy is as its maximum dosage; hourly urinary ouput measurements to estimate the degree of kidndy function
a major clinical manifestation of renal stones is;
patients with urolithiasis need to be encouraged to:
increase their fluid intake so that they can excreate 3000 to 4000 mL every day, which will help to prevent additional sotne formation.
a patient being prescribed a diet moderately reduced in calcium and phosphours should be taught to avoid:
whole grain breads
the usual early clinical sign of a renal tumor is:
painless hematuria
the most common symptom of cancer of the bladder is
gross painless hematuria
the predominant cause of bladder cancer is
cigarette smoking
the most effective intravesical agent for recurrent bladder cancer is
Bacille Calmette-Guerin (BCG)
the urinary diversion whereby the patient will void from his rectum for the rest of his life is known as a :
tuberculosis of the kidney and lower urinary tract is always:
secondary to renal tuberculosis
all of tlhe following statements about interstitial cystitis are correct:
it is associated with pain in the abdomen and perineum; it is characterized by severe voiding symptoms; it is seen in women between the ages of 40 and 50 ykears
the organism most commoly responsible for UTIs in women is:
Escherichia coli
mame common sighs and symptoms associated with an uncoplicated lower UTI (cystitis):
cystitis, from an uncomplicated lower UKTI, is usually associated with feelings of urgency, burning, and pain on urination; nocturias; incontinence; pelvic pain; and sometimes hematuria and back pain
s/s of acute pyelonephritis:
chills, fever, lower back or flank pain, costrovertebral angle (CVA) tenderness, bacteriuria, pyuria, and leukocyosis
describe the physical apperance of the urine early in the sstage of acute glomerulonephritis:
the urine in the early stages of acute glomerulonephritis is kcharacteristically cola-coloered.
name physiologic disorder that characterize the nephrotic syndrome:
proteinuria, hypoalbuminemia, edema, and hypercholesterolemia
list major conditions that cause acut erenal failure
prerenal conditions are hemorrhage and sepsis; intrarenal conditions are crush injuries and infections; postrenal consitions are obstruction distal to kidney or kidneys
list several clinical manifestations seen in patients with acute renal failure
clical manifestations seeen in chronic renal failure include lethargy, headache, muscle twitching, seizures, nausea, vomiting, and diarrheal there is also dehydration and the odor of urine onl the breath.
name several signs or symptoms seen in patients with threatened kidney transplant rejection
threatended graft rejection is suspected in a patient who evidences oliguria, edema, fever, apprehension, increased blood pressure, weight gain, and swellilng or tenderness over the graft or lkidney.
list crystalline substances known to form stoens in the urinary tract:
urinary tract stones are f ormed by calcium oxalate, calcium phosphate, and uric acid.
identify seven complications that may occur after an ileal conduit:
wound infection, wound dehiscence, urinary leakage, ureteral obstruction, hyperchloremic acidosis, small-bowel obstruction, and ileus and stomal gangrene
the majority of nosocomial infectios in the hospital are caused by
instrumentation of the urinary tract or catheterization
________, secondary to decreased glomerular filtration and loiguria, is the most immediate life-thratening imbalance in acute renal failure
painless hematuria is the earliest clinical manifestation of:
renal trauma
the nurse needs to assess for symptoms consistent wiht pathology secondary to reduced renal blood flow. symptoms would include:
reduced glomerular filtration, renal ischemia, and tubular damage
oliguric phase will be marked by what laboratory studies:
blood urea nitrogen fo 10 mg/dL; serum potassium of 6 mEq/L; urinary volume < 600 mL/24hours
after the diuretic phase, the nurse should recommend a:
high-protein dite
the nurse expects the period of recovery to follow a period of oliguria and to last approximately:
6-12 months
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